Theoretical and perceived balance of power inside Spanish public hospitalsReport as inadecuate

Theoretical and perceived balance of power inside Spanish public hospitals - Download this document for free, or read online. Document in PDF available to download.

BMC Health Services Research

, 1:9

First Online: 04 September 2001Received: 01 August 2001Accepted: 04 September 2001DOI: 10.1186-1472-6963-1-9

Cite this article as: Salvadores, P., Schneider, J. & Zubero, I. BMC Health Serv Res 2001 1: 9. doi:10.1186-1472-6963-1-9


BackgroundThe hierarchical pyramid inside Spanish public hospitals was radically changed by the Health Reform Law promulgated in 1986. According to it, the manpower of the hospitals was divided into three divisions Medical, Nursing, General Services-Administration, which from then on occupied the same level, only subject to the general manager. Ten years after the implementation of the law, the present study was designed in order to investigate if the legal changes had indeed produced a real change in the balance of power inside the hospitals, as perceived by the different workers within them.

Materials and MethodsA questionnaire was administered to 1,027 workers from four different public hospitals two university-based and two district hospitals. The participants belonged to all divisions, and to all three operative levels staff, supervisory and managerial within them. The questionnaire inquired about the perceived power inside each division and hierarchical level, as well as about that of the other divisions and hierarchical levels.

ResultsEvery division attributed the least power to itself. The Nursing and the Administrative division attributed the highest power to the physicians, and these attributed the highest power to the General Services-Administrative division.

All hierarchical levels including the formal top of the pyramid attributed significantly more power to the other than to them.

ConclusionsMore than ten years after the implementation of the new law, the majority of workers still perceive that the real power within the hospitals is held by the physicians whereas these feel that it has shifted to the administrators. No division or hierarchical level believes it holds any significant degree of power, and this carries with it the danger of also not accepting any responsibility.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-1-9 contains supplementary material, which is available to authorized users.

Download fulltext PDF

Author: Paloma Salvadores - José Schneider - Imanol Zubero


Related documents