Poor management of public hospitals has been a key concern in developing countries. This paper compares management differences between three different groups of South African hospitals, in order to understand how these differences might affect hospital functioning. The groups were public hospitals; contractor hospitals publicly funded but privately managed; and private hospitals owned and run by private companies. Public sector structures made effective management difficult and were highly centralised, with hospital managers enjoying little autonomy. In contrast, contractor and private groups emphasised efficient management and cost control. These differences appeared to be reflected in cost and quality differences between the groups. The findings suggest that in the context of a country such as South Africa, with a relatively well developed private sector, there is potential for the government to profit from the management expertise in the private sector by identifying lessons for its own management structures; and by contracting out service management.
Advances in Health Care Management (2005) 5 73-100 [DOI: 10.1016/S1474-8231(05)05003-2]