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Decentralization has become a popular management strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea; that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out...

What is the best way to structure primary care services? How can coordination between primary care and other parts of health care systems be improved? How should new technologies be integrated into primary care? There is considerable agreement among national policy makers across Europe that, in principle, primary care should be the linchpin of a well-designed health care system. This agreement, however, does not carry over into the organizational mechanisms best suited to pursuing or achieving this common objective. Across western, central and eastern Europe, primary care is delivered through...

This volume explores the central issues driving the present process of healthcare reform in Europe. More than 30 scholars and policy makers from various parts of Europe draw together the available evidence from epidemiology and public health, economics, public policy, organizational behaviour and management theory. Real world examples of policy making are used to lay out the options that health sector decision-makers confront.