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Arch Hellen Med, 29(2), March-April 2012, 233-239


Hospital mergers in Europe: The experience of Greece and future prospects

K. Tsavalias, O. Siskou, L. Liaropoulos
Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece

Hospital mergers in Europe are being implemented in the context of an overall reform of health services. The mergers aim to improve efficiency and effectiveness, upgrade the quality of health services and rationalize the distribution of health services in hospitals. The incentives for the consolidation of clinical wards and hospitals are reduction of costs, economies of scale and increase in productivity. According to the OECD, the modern hospital sector in Europe shows a decrease in the numbers of hospitals and beds. In Greece, however, the numbers of both general hospitals and acute hospital beds have increased during recent years. Based on review of studies conducted in countries such as the UK, Norway, Denmark, and Sweden from 1992 until the present, mergers have gained both positive and negative points. On the one hand, the positive effects include cost saving, as in the case of Denmark where the resources saved were estimated at from 19.5% to 22.5%. In Britain, also, savings from the creation of 11 new merged trusts reached up to £ 178,700 in the first year, and £ 346,800 in the second year. In Greece, which is faced with chronic disorders in the management of the healthcare system, an attempt to merge hospital clinics and administrations is at present in progress. Eight hospitals are about to become primary health care units or one day clinics. The goal of the project is to save € 75 million in 2012 and € 150 million by 2015. Conversely, after hospital mergers the efficiency in many hospitals (e.g., UK, Norway) appears to decrease and conflicts among the personnel have increased due to the changes. Although the consequences of hospital mergers in Europe have not yet been fully evaluated, it is apparent that, even in the short term, cost savings and management improvements are achieved, but the objectives of improved quality of healthcare services and economies of scale remain in question. In conclusion, the new trend in health policy is to decrease the numbers of hospital beds and create units which provide specialized treatment, in order to reduce costs and increase the efficiency of both hospitals and the health sector as a whole.

Key words: Consolidations, Cost reduction, Economies of scale, Efficiency, Mergers.

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