{"id":"https://openalex.org/W4408099717","doi":"https://doi.org/10.1108/jhom-08-2024-0358","title":"Consequences of centralized healthcare systems: changing role and autonomy of hospital managers \u2013 insights from a Hungarian case","display_name":"Consequences of centralized healthcare systems: changing role and autonomy of hospital managers \u2013 insights from a Hungarian case","publication_year":2025,"publication_date":"2025-02-28","ids":{"openalex":"https://openalex.org/W4408099717","doi":"https://doi.org/10.1108/jhom-08-2024-0358","pmid":"https://pubmed.ncbi.nlm.nih.gov/40029949","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/11884511"},"language":"en","primary_location":{"id":"doi:10.1108/jhom-08-2024-0358","doi":"https://doi.org/10.1108/jhom-08-2024-0358","is_oa":true,"landing_page_url":"https://doi.org/10.1108/jhom-08-2024-0358","pdf_url":null,"source":{"id":"https://openalex.org/S162934775","display_name":"Journal of Health Organization and Management","issn_l":"1477-7266","issn":["1477-7266","1758-7247"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-b","anvur-scientific","cwts-core","erih-plus","fnege-4","jufo-1","ki-jl-1","medline","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310319811","host_organization_name":"Emerald Publishing Limited","host_organization_lineage":["https://openalex.org/P4310319811"],"host_organization_lineage_names":["Emerald Publishing Limited"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health Organization and Management","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1108/jhom-08-2024-0358","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5062797401","display_name":"\u00c9va Kreny\u00e1cz","orcid":"https://orcid.org/0000-0003-0647-4736","observed_orcids":["https://orcid.org/0000-0003-0647-4736"]},"institutions":[{"id":"https://openalex.org/I163245316","display_name":"Corvinus University of Budapest","ror":"https://ror.org/01vxfm326","country_code":"HU","type":"education","lineage":["https://openalex.org/I163245316"]}],"countries":["HU"],"is_corresponding":true,"raw_author_name":"Eva Krenyacz","raw_affiliation_strings":["Corvinus University of Budapest , ,","Corvinus University of Budapest, Budapest, Hungary"],"raw_orcid":"https://orcid.org/0000-0003-0647-4736","affiliations":[{"raw_affiliation_string":"Corvinus University of Budapest , ,","institution_ids":["https://openalex.org/I163245316"]},{"raw_affiliation_string":"Corvinus University of Budapest, Budapest, Hungary","institution_ids":["https://openalex.org/I163245316"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5060593400","display_name":"\u00c9va R\u00e9v\u00e9sz","orcid":"https://orcid.org/0000-0001-5973-1009","observed_orcids":["https://orcid.org/0000-0001-5973-1009"]},"institutions":[{"id":"https://openalex.org/I163245316","display_name":"Corvinus University of Budapest","ror":"https://ror.org/01vxfm326","country_code":"HU","type":"education","lineage":["https://openalex.org/I163245316"]}],"countries":["HU"],"is_corresponding":false,"raw_author_name":"Eva Erika Revesz","raw_affiliation_strings":["Corvinus University of Budapest , ,","Corvinus University of Budapest, Budapest, Hungary"],"raw_orcid":"https://orcid.org/0000-0001-5973-1009","affiliations":[{"raw_affiliation_string":"Corvinus University of Budapest , ,","institution_ids":["https://openalex.org/I163245316"]},{"raw_affiliation_string":"Corvinus University of Budapest, Budapest, Hungary","institution_ids":["https://openalex.org/I163245316"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5062797401"],"corresponding_institution_ids":["https://openalex.org/I163245316"],"apc_list":null,"apc_paid":null,"fwci":3.4901,"has_fulltext":true,"cited_by_count":5,"citation_normalized_percentile":{"value":0.91272356,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":93,"max":97},"biblio":{"volume":"39","issue":"9","first_page":"177","last_page":"191"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":0.9926999807357788,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":0.9926999807357788,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14186","display_name":"Healthcare Systems and Practices","score":0.002400000113993883,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.002400000113993883,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hospital-managers","display_name":"hospital administrators","score":0.8220000267028809},{"id":"https://openalex.org/keywords/managerial-autonomy","display_name":"managerial autonomy","score":0.9179999828338623},{"id":"https://openalex.org/keywords/organizational-autonomy","display_name":"organizational autonomy","score":0.6899999976158142},{"id":"https://openalex.org/keywords/hospital-decision-making","display_name":"hospital decision-making","score":0.8059999942779541},{"id":"https://openalex.org/keywords/public-health-care","display_name":"public health care","score":0.5979999899864197},{"id":"https://openalex.org/keywords/hungarian-healthcare-system","display_name":"Hungarian healthcare system","score":0.7609999775886536},{"id":"https://openalex.org/keywords/health-care-reform","display_name":"health care reform","score":0.7919999957084656},{"id":"https://openalex.org/keywords/covid-19","display_name":"COVID-19 pandemic","score":0.9459999799728394},{"id":"https://openalex.org/keywords/administrative-burden","display_name":"administrative burden","score":0.7979999780654907},{"id":"https://openalex.org/keywords/financial-constraints","display_name":"financial constraints","score":0.7120000123977661},{"id":"https://openalex.org/keywords/strategic-management","display_name":"strategic management","score":0.6439999938011169}],"concepts":[{"id":"https://openalex.org/C65414064","wikidata":"https://www.wikidata.org/wiki/Q484105","display_name":"Autonomy","level":2,"score":0.7787938117980957},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.6857766509056091},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6609584093093872},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.5127476453781128},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.24876761436462402},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.1547597050666809},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.11343768239021301},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":true},{"descriptor_ui":"D006740","descriptor_name":"Hospital Administrators","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006814","descriptor_name":"Hungary","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007407","descriptor_name":"Interviews as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017009","descriptor_name":"Professional Autonomy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D019982","descriptor_name":"Organizational Case Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D024382","descriptor_name":"Professional Role","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D036301","descriptor_name":"Qualitative Research","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.1108/jhom-08-2024-0358","doi":"https://doi.org/10.1108/jhom-08-2024-0358","is_oa":true,"landing_page_url":"https://doi.org/10.1108/jhom-08-2024-0358","pdf_url":null,"source":{"id":"https://openalex.org/S162934775","display_name":"Journal of Health Organization and Management","issn_l":"1477-7266","issn":["1477-7266","1758-7247"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-b","anvur-scientific","cwts-core","erih-plus","fnege-4","jufo-1","ki-jl-1","medline","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310319811","host_organization_name":"Emerald Publishing Limited","host_organization_lineage":["https://openalex.org/P4310319811"],"host_organization_lineage_names":["Emerald Publishing Limited"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health Organization and Management","raw_type":"journal-article"},{"id":"pmid:40029949","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40029949","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of health organization and management","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11884511","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11884511/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Health Organ Manag","raw_type":"Text"},{"id":"pmh:oai:unipub.lib.uni-corvinus.hu:11005","doi":null,"is_oa":true,"landing_page_url":"https://orcid.org/0000-0003-0647-4736","pdf_url":"https://unipub.lib.uni-corvinus.hu/11005/1/10-1108_jhom-08-2024-0358.pdf","source":{"id":"https://openalex.org/S4306401216","display_name":"Corvinus Research Archive (Corvinus University of Budapest)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I163245316","host_organization_name":"Corvinus University of Budapest","host_organization_lineage":["https://openalex.org/I163245316"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Article"}],"best_oa_location":{"id":"doi:10.1108/jhom-08-2024-0358","doi":"https://doi.org/10.1108/jhom-08-2024-0358","is_oa":true,"landing_page_url":"https://doi.org/10.1108/jhom-08-2024-0358","pdf_url":null,"source":{"id":"https://openalex.org/S162934775","display_name":"Journal of Health Organization and Management","issn_l":"1477-7266","issn":["1477-7266","1758-7247"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-b","anvur-scientific","cwts-core","erih-plus","fnege-4","jufo-1","ki-jl-1","medline","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310319811","host_organization_name":"Emerald Publishing Limited","host_organization_lineage":["https://openalex.org/P4310319811"],"host_organization_lineage_names":["Emerald Publishing Limited"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health Organization and Management","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.5683000087738037}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4408099717.pdf","grobid_xml":"https://content.openalex.org/works/W4408099717.grobid-xml"},"referenced_works_count":23,"referenced_works":["https://openalex.org/W1640333426","https://openalex.org/W1971165651","https://openalex.org/W2053935476","https://openalex.org/W2092115535","https://openalex.org/W2119937008","https://openalex.org/W2125014478","https://openalex.org/W2169142165","https://openalex.org/W2807129904","https://openalex.org/W2889105617","https://openalex.org/W2898077187","https://openalex.org/W3017256962","https://openalex.org/W3048727081","https://openalex.org/W3161531446","https://openalex.org/W4206385989","https://openalex.org/W4223609209","https://openalex.org/W4248840111","https://openalex.org/W4253620663","https://openalex.org/W4287837545","https://openalex.org/W4288795700","https://openalex.org/W4293217774","https://openalex.org/W4296299099","https://openalex.org/W4315649448","https://openalex.org/W4319790580"],"related_works":["https://openalex.org/W7042134352","https://openalex.org/W2477756806","https://openalex.org/W3182473355","https://openalex.org/W7206170253","https://openalex.org/W4407024418","https://openalex.org/W3095408875","https://openalex.org/W2592068858","https://openalex.org/W4411168617","https://openalex.org/W7170783612","https://openalex.org/W2080439856"],"abstract_inverted_index":{"PURPOSE:":[0],"The":[1,38,61,232],"objective":[2],"of":[3,94,185,242,249],"this":[4,148],"paper":[5,233],"is":[6,150,157,194,208],"to":[7,35,84,114,255],"investigate":[8],"how":[9,26,41],"top":[10,59,190,244],"managers":[11,70,134,258],"in":[12,33,50,71,116,119,140,218,246],"public":[13],"healthcare":[14,169],"interpret":[15],"and":[16,25,29,44,64,74,91,97,106,122,128,142,156,200,228,259],"perceive":[17],"their":[18,27,144,205],"autonomy":[19,47,109,139,149,193,241],"within":[20],"a":[21,179,215,222,253],"highly":[22],"centralized":[23],"system":[24],"roles":[28],"attitudes":[30],"have":[31],"evolved":[32],"response":[34],"centralization.":[36],"DESIGN/METHODOLOGY/APPROACH:":[37],"research":[39],"examines":[40,166],"increased":[42],"centralization":[43,89,250],"reduced":[45,104],"organizational":[46,240,263],"affect":[48],"decision-making":[49],"hospitals,":[51],"employing":[52],"qualitative":[53],"analysis":[54],"through":[55],"in-depth":[56],"interviews":[57,77],"with":[58,221],"managers.":[60],"study":[62,165],"collected":[63],"analyzed":[65],"data":[66],"from":[67],"15":[68],"hospital":[69,133,219,243,257],"year":[72],"2015":[73],"2022":[75],"(eight":[76],"each":[78],"year,":[79],"one":[80],"person":[81],"interviewed":[82],"twice),":[83],"capture":[85],"changes":[86],"following":[87],"significant":[88,126],"efforts":[90],"the":[92,95,167,183,239,247],"effects":[93],"pandemic":[96],"health":[98],"sector":[99],"reforms.":[100],"FINDINGS:":[101],"Centralization":[102],"has":[103,123],"financial":[105,120,160,201,227],"operational":[107,152],"managerial":[108],"for":[110],"many":[111],"institutions,":[112],"leading":[113],"delays":[115],"decision-making,":[117],"especially":[118],"matters":[121],"also":[124,177],"brought":[125],"administrative":[127,199],"reporting":[129],"burdens.":[130],"Despite":[131],"this,":[132],"reported":[135],"retaining":[136],"some":[137],"professional":[138,192],"developing":[141],"managing":[143],"service":[145],"portfolios,":[146],"but":[147],"primarily":[151],"rather":[153],"than":[154],"strategic":[155,206],"limited":[158],"by":[159,172,197,261],"constraints.":[161],"RESEARCH":[162],"LIMITATIONS/IMPLICATIONS:":[163],"This":[164],"Hungarian":[168],"system,":[170],"influenced":[171],"unique":[173],"political":[174],"context,":[175],"which":[176],"presents":[178],"methodological":[180],"limitation":[181],"concerning":[182],"transferability":[184],"findings.":[186],"PRACTICAL":[187],"IMPLICATIONS:":[188,211],"Hospital":[189],"managers'":[191],"often":[195],"obscured":[196],"heavy":[198],"pressures;":[202],"thus,":[203],"enhancing":[204],"mindset":[207],"essential.":[209],"SOCIAL":[210],"Policymakers":[212],"should":[213],"adopt":[214],"comprehensive":[216],"perspective":[217],"maintaining,":[220],"particular":[223],"focus":[224],"on":[225,235],"balancing":[226],"medical":[229],"perspectives.":[230],"ORIGINALITY/VALUE:":[231],"focuses":[234],"an":[236],"under-explored":[237],"area:":[238],"management":[245],"context":[248],"efforts,":[251],"delivering":[252],"message":[254],"both":[256],"policymakers":[260],"emphasizing":[262],"aspects.":[264]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":2}],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2025-03-04T00:00:00"}