Negative factors affecting the efficiency of restructuration of public hospitals

Purpose: To diagnose causes of unsatisfactory (failure factors) of restructuring operations undertaken in public hospitals located in the Silesian Province (Śląskie Voivodeship). A level of achievement of an individual objective set for restructuring operation was a measure of their effectiveness. Design/methodology/approach: The present research study was conducted in three stages and preceded by pilotage. In the first stage, the process of restructuration as perceived from public hospitals was analysed, in the second stage - from the point of view of their establishing entities. Two survey questionnaires were used to accomplish these stages. The research studies were conducted among the management staff of 17 public hospitals and among 14 establishing entity representatives. The third step was aimed at assessing and sorting all the identified failure factors. The group expert assessment method was applied for its implementation by 20 people. Findings: The most common objective of public hospital restructuration was to improve the quality of provided services and then to reduce debts. The average degree of achievement of the first objective amounted to 75.2%, while the second - 67.7%. The research studies led to the identification of 30 factors which have a significant negative influence on restructuration; among them 'adoption of improper assumptions on the restructuring plan in relation to financial forecasting' was considered the most important. Research limitations/implications: The research studies were conducted in public hospitals located in the Silesian Province (Śląskie Voivodeship) and which operated as independent public health-care units. Practical implications: In order to conduct restructuring operations, public hospitals and their establishing entities should apply project management methodologies, under which they will plan and implement their restructuring operations. Originality/value: Studies have shown the effectiveness of restructuring hospitals located in Silesia and identified the factors that have a negative impact on hospital restructuring.