Reshaping public accountability: Hospital reforms in Germany, Norway and Denmark

Mattei, Paola, Mitra, Mahima, Vrangbaek, Karsten, Neby, Simon and Byrkjeflot, Haldor (2013) Reshaping public accountability: Hospital reforms in Germany, Norway and Denmark. International Review of Administrative Sciences,, 79 (2). pp. 249-270.


The paper contributes to the literature of multi-level welfare governance and public accountability in the context of recent European hospital reforms. Focusing on the changing dynamics between regional and central governance of hospitals in Germany, Norway and Denmark, we raise concerns about the reshaping of traditional public accountability mechanisms. We argue that, triggered by growing financial pressures, corporatization and professionalization processes have increasingly removed decision making power from regional political bodies in hospital funding and planning. National
governments have tightened their control over the overall trajectory of their hospital systems, but they have also shifted significant responsibility downwards to the hospital level. This has reshaped public accountability relationships towards more managerial or professional types of accountability embedded within multi-level forms of governance.

Item Type: Article
Keywords: operations management
Subject(s): Operations management
Date Deposited: 26 Mar 2018 14:27
Last Modified: 26 Mar 2018 14:27
Funders: N/A

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