Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

Employer Consolidation and Wages: Evidence from Hospitals

We test whether wage growth slows following employer consolidation by examining hospital mergers. We find evidence of reduced wage growth in cases where both (i) the increase in concentration induced by the merger is large and (ii) workers’ skills are industry-specific. In all other cases, we fail to reject zero wage effects. We consider alternative explanations and find that the observed patterns are unlikely to be explained by merger-related changes besides labor market power. Wage growth slowdowns are attenuated in markets with strong labor unions, and wage growth does not decline after out-of-market mergers that leave local employer concentration unchanged. (JEL G34, I11, J22, J24, J31, J42, R32)

Exploring Patients’ Experience on Hospital Merger: Have they benefited from Cluster Hospital Initiative in Malaysia?

Cluster Hospital Initiative (CHI) in Malaysia is a hospital merger exercise to establish an integrated network of specialist and non-specialist hospitals. The resource sharing, services realignment, and better care coordination from this integration have been shown to improve operational efficiency and quality of care from the providers’ perspective. However, there are very limited studies which focus on the effects of hospital merger on patients. Therefore, this study aims to explore patients’ and caregivers’ experiences of CHI. A qualitative study using purposive sampling was conducted from July to August 2017 at the three pilot sites. Semi-structured in-depth interviews were conducted with 85 patients and caregivers who received healthcare services before and after CHI. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic text analysis. Three main themes transpired from the analysis were changes in healthcare service delivery, time spent on healthcare-related activities, and financial implications. Firstly, participants were generally satisfied with the increased access to specialist services, better quality of care, and upgraded equipment and facilities. Secondly, many participants experienced a shorter waiting time and reduced travelling time after CHI. Thirdly, CHI led to financial savings for the participants in terms of reduced out-of-pocket expenditure and productivity loss. This study demonstrated that the implementation of CHI appeared to be well-received by the patients. The expected benefits brought on by hospital mergers were also acknowledged by the study participants. A follow-up study is recommended due to the short duration of CHI implementation and low awareness about the initiative among patients.