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Accountability, autonomy, and governance challenges of public university hospitals in Egypt

In Egypt, public university hospitals play a crucial role not only in education and research but also in the provision of healthcare services. What adds to the complexity of public university hospitals is their existence within two sectors; higher education and healthcare. This work highlights the i...

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Main Author: Badr, Yasmine
Format: Thesis
Published: AUC Knowledge Fountain 2017
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access_status_str Open Access
author Badr, Yasmine
author_browse Badr, Yasmine
author_facet Badr, Yasmine
author_sort Badr, Yasmine
collection Thesis
dc_rights_str_mv The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy.
description In Egypt, public university hospitals play a crucial role not only in education and research but also in the provision of healthcare services. What adds to the complexity of public university hospitals is their existence within two sectors; higher education and healthcare. This work highlights the inability of Egyptian public university hospitals to achieve their tripartite mission as a result of improper institutional governance arrangement that does not empower hospitals to cope with the requirements of both sectors. Despite the importance of institutional governance to university hospitals in Egypt, this topic remains under researched in the literature. This qualitative study aims to explore the existing institutional governance arrangement of public university hospitals in Egypt, identify key issue domains that they face and means to overcome these challenges, and the current reforms undertaken in public university hospitals. In-depth interviews are carried out with ten participants covering six different public university hospitals across Egypt selected purposively. Interviews range between 30-60 minutes each with subject-matter experts, top leaders/ managers in public university hospitals and medical schools, and representatives from regulatory bodies. The analysis of the study follows the framework for public hospital governance and the owner model of university hospital governance. Findings of this research reveal that public university hospitals follow the unified governance arrangement. It has a number of advantages such as easier agreement between clinical and academic enterprises, and alignment of academic plans with clinical training. Yet, there are associated problems with the existing governance arrangement manifested in the limited autonomy of university hospital managers, centralization of decision making at different organizational levels, financial mismanagement, and imbalance between academic and clinical endeavors in certain cases. The study recommends the continuation of the unified governance arrangement to university hospitals, yet with more autonomy to the dean, general manager of hospitals and hospital managers. The need to develop boards of directors professionally in terms of composition and size is crucial to the accountability of university hospitals. Hospital managers need to be adequately empowered in alignment with their clinical, administrative and financial responsibilities. Financially, all revenue streams need to be consolidated electronically and linked to the missions.
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spelling oai:fount.aucegypt.edu:etds-1549 Accountability, autonomy, and governance challenges of public university hospitals in Egypt Badr, Yasmine In Egypt, public university hospitals play a crucial role not only in education and research but also in the provision of healthcare services. What adds to the complexity of public university hospitals is their existence within two sectors; higher education and healthcare. This work highlights the inability of Egyptian public university hospitals to achieve their tripartite mission as a result of improper institutional governance arrangement that does not empower hospitals to cope with the requirements of both sectors. Despite the importance of institutional governance to university hospitals in Egypt, this topic remains under researched in the literature. This qualitative study aims to explore the existing institutional governance arrangement of public university hospitals in Egypt, identify key issue domains that they face and means to overcome these challenges, and the current reforms undertaken in public university hospitals. In-depth interviews are carried out with ten participants covering six different public university hospitals across Egypt selected purposively. Interviews range between 30-60 minutes each with subject-matter experts, top leaders/ managers in public university hospitals and medical schools, and representatives from regulatory bodies. The analysis of the study follows the framework for public hospital governance and the owner model of university hospital governance. Findings of this research reveal that public university hospitals follow the unified governance arrangement. It has a number of advantages such as easier agreement between clinical and academic enterprises, and alignment of academic plans with clinical training. Yet, there are associated problems with the existing governance arrangement manifested in the limited autonomy of university hospital managers, centralization of decision making at different organizational levels, financial mismanagement, and imbalance between academic and clinical endeavors in certain cases. The study recommends the continuation of the unified governance arrangement to university hospitals, yet with more autonomy to the dean, general manager of hospitals and hospital managers. The need to develop boards of directors professionally in terms of composition and size is crucial to the accountability of university hospitals. Hospital managers need to be adequately empowered in alignment with their clinical, administrative and financial responsibilities. Financially, all revenue streams need to be consolidated electronically and linked to the missions. 2017-02-01T08:00:00Z thesis application/pdf https://fount.aucegypt.edu/etds/550 https://fount.aucegypt.edu/context/etds/article/1549/viewcontent/Thesis_Governance_20of_20univeristy_20hospitals_YasmineBadr_20180114.pdf The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy. Theses and Dissertations AUC Knowledge Fountain governance accountability
spellingShingle governance
accountability
Badr, Yasmine
Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title_full Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title_fullStr Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title_full_unstemmed Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title_short Accountability, autonomy, and governance challenges of public university hospitals in Egypt
title_sort accountability autonomy and governance challenges of public university hospitals in egypt
topic governance
accountability
url https://fount.aucegypt.edu/etds/550
https://fount.aucegypt.edu/context/etds/article/1549/viewcontent/Thesis_Governance_20of_20univeristy_20hospitals_YasmineBadr_20180114.pdf
work_keys_str_mv AT badryasmine accountabilityautonomyandgovernancechallengesofpublicuniversityhospitalsinegypt