Uncomfortable realities: the challenge of creating real change in Europe's consolidating hospital sector.
BACKGROUND
This article examines uncomfortable realities that the European hospital sector currently faces and the potential impact of wide-spread rationalization policies such as (hospital) payment reform and privatization.


METHODS
Review of relevant international literature.


RESULTS
Based on the evidence we present, rationalization policies such as (hospital) payment reform and privatization will probably fall short in delivering better quality of care and lower growth in health expenses. Reasons can be sought in a mix of evidence on the effectiveness of these rationalization policies. Nevertheless, pressures for different business models will gradually continue to increase and it seems safe to assume that more value-added process business and facilitated network models will eventually emerge.


CONCLUSIONS
The overall argument of this article holds important implications for future research: how can policymakers generate adequate leverage to introduce such changes without destroying necessary hospital capacity and the ability to produce quality healthcare.
['Jeurissen|Patrick|P|', 'Duran|Antonio|A|', 'Saltman|Richard B|RB|']
D002204:Capitation Fee D054976:Clinical Governance D017046:Cost Savings D003695:Delivery of Health Care D004469:Economics, Hospital D005060:Europe D018166:Health Care Reform D006291:Health Policy D061889:Healthcare Financing D006739:Hospital Administration D006761:Hospitals D006801:Humans D011332:Privatization D011787:Quality of Health Care D012051:Reimbursement Mechanisms D012052:Reimbursement, Incentive
European hospitals Payment reform Privatization Cost-containment Governance Hospital business models Hospital management