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Health administration

Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.

Iconographic Collections. Keywords: E. Walker; Florence Nightingale; W.J. Simpson

Terminology edit

Health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels.[1] In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management",[2] "healthcare management", or "health administration".

Health systems management ensures that specific outcomes are attained that departments within a health facility are running smoothly that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal for mutual development and growth[citation needed]

Hospital administrators edit

Hospital administrators are individuals or groups of people who act as the central point of control within hospitals. These individuals may be previous or current clinicians, or individuals with other healthcare backgrounds. There are two types of administrators, generalists and specialists. Generalists are individuals who are responsible for managing or helping to manage an entire facility. Specialists are individuals who are responsible for the efficient and effective operations of a specific department such as policy analysis, finance, accounting, budgeting, human resources, or marketing.[3]

It was reported in September 2014, that the United States spends roughly $218 billion per year on hospital's administration costs, which is equivalent to 1.43 percent of the total U.S. economy. Hospital administration has grown as a percent of the U.S. economy from .9 percent in 2000 to 1.43 percent in 2012, according to Health Affairs. In 11 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.[4]

Competencies edit

NCHL competencies that require to engage with credibility, creativity, and motivation in complex and dynamic health care environments.[5]

  • Accountability
  • Achievement orientation
  • Change leadership
  • Collaboration
  • Communication skills
  • Financial Skills
  • Impact and influence
  • Innovative thinking
  • Organizational awareness
  • Professionalism
  • Self-confidence
  • Strategic orientation
  • Talent development
  • Team leadership

Training and organizations edit

Associated qualifications edit

Health care management is usually studied through healthcare administration[6] or healthcare management[7] programs in a business school or, in some institutions, in a school of public health.

North America edit

Although many colleges and universities are offering a bachelor's degree in healthcare administration or human resources,[6] a master's degree is considered the "standard credential"[8] for most health administrators in the United States. Research and academic-based doctorate level degrees, such as the Doctor of Philosophy (PhD) in Health Administration and the Doctor of Health Administration (DHA) degree, prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice, teach, shape public policy and/or lead complex organizations. There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation.[citation needed]

The Commission on the Accreditation of Healthcare Management Education (CAHME) is the accrediting body overseeing master's-level programs in the United States and Canada on behalf of the United States Department of Education. It accredits several degree program types, including Master of Hospital Administration (MHA), Master of Health Services Administration (MHSA), Master of Business Administration in Hospital Management (MBA-HM), Master of Health Administration (MHA), Master of Public Health (MPH, MSPH, MSHPM), Master of Science (MS-HSM, MS-HA), and Master of Public Administration (MPA).(Master of Hospital Management) (MHM)[citation needed]

Professional organizations edit

There are a variety of different professional associations related to health systems management, which can be subcategorized as either personal or institutional membership groups. Personal membership groups are joined by individuals, and typically have individual skills and career development as their focus. Larger personal membership groups include the Healthcare Financial Management Association and the Healthcare Information and Management Systems Society. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include data sharing agreements and other medical related or administrative practice sharing vehicles for member organizations. Prominent examples include the American Hospital Association and the University Healthsystems Consortium.[citation needed]

System processes edit

A career in healthcare administration consists of organizing, developing, and managing medical and health services. These responsibilities are carried out at hospitals, clinics, managed care companies, public health agencies, and other comparable establishments. This job involves a lot of paperwork and minimal clinical engagement. Healthcare administrators make sure to promote excellence in patient care, patient satisfaction, and relationships with their physicians. In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients. The entire organization has a better experience when everything is organized and protocols are set into place. The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care. This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries.[9] Healthcare administrators might become overworked along with physicians feeling stressed from various protocols. However, both the parties of stakeholders and patients make up the backbone of a proper healthcare administration. These administrators make sure that the doctors, insurance companies, patients, and other healthcare providers have access to the files they need to provide appropriate treatments. Multiple hierarchies of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization.[9] A healthcare administrator has a long-term effect in improving the hospital's process operation systems. They play a vital role in the sustainability of the institution.

Funding of hospitals edit

Healthcare administrators are in charge of hospital finances and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like marketing, charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations.[10] The management administration carefully manages these funds due to a spending limitation. The healthcare administrators control the expenditures that the hospital allows in order to meet profits. Sometimes hospitals are limited on what they can do for patients. Administrators that run these hospitals strive to achieve goals within their financial limitations. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes.[11] When healthcare spending reduces, employment growth will start reducing as well. The healthcare administration is critical to the lives of the people in hospitals. It contributes to cost saving practices and making sure that the necessities are brought to the institution. Healthcare management makes sure that protocols and funds are properly organized for each department. They are responsible for keeping the healthcare industry afloat. Many hospitals host charity events and donate to them as well.[citation needed]

Overall goal edit

The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and cost-effective way possible. The United States leads the world in high quality and advanced level healthcare.[10] Everyone is working towards a common goal thanks to these mission statements. This improves the organization's efficiency and productivity. The mission statement establishes the organization's purpose and provides employees a sense of belonging and identity. This encourages management and stakeholders to put in more effort in order to obtain success. The ultimate purpose of health care is to help individuals regain their overall health and wellbeing.[citation needed]

Research edit

Health policy and systems research (HPSR) is a field of inquiry that studies "how societies organize themselves in achieving collective health goals, and how different actors interact in the policy and implementation processes to contribute to policy outcomes".[12] HPSR is interdisciplinary and brings together expertise in a variety of biomedical and social sciences such as economics, sociology, anthropology, political science, public health and epidemiology.

The Commission on Health Research for Development[13] and the Ad Hoc Committee on Health Research[14] both highlighted the urgent need for focusing research methods, funding and practice towards addressing health inequities and embracing inter-disciplinary and intersectoral thinking. These reports and other academic and activist voices linked to them argued for greater voice and participation of developing countries in defining research priorities.[15] Since then creation of the Alliance for Health Policy and Systems Research in 2000 and that of Health Systems Global in 2012 have consolidated the practice community of HPSR.

History edit

Early hospital administrators were called patient directors or superintendents. At the time, many were nurses who had taken on administrative responsibilities. Over half of the members of the American Hospital Association were graduate nurses in 1916. Other superintendents were medical doctors, laymen and members of the clergy. In the United States, the first degree granting program in the United States was established at Marquette University in Milwaukee, Wisconsin. By 1927, the first two students received their degrees. The original idea is credited to Father Moulinier, associated with the Catholic Hospital Association.[16] The first modern health systems management program was established in 1934 at the University of Chicago.[17] At the time, programs were completed in two years – one year of formal graduate study and one year of practicing internship. In 1958, the Sloan program at Cornell University began offering a special program requiring two years of formal study,[18] which remains the dominant structure in the United States and Canada today (see also "Academic Preparation").[citation needed]

Health systems management has been described as a "hidden" health profession[19] because of the relatively low-profile role managers take in health systems, in comparison to direct-care professions such as nursing and medicine. However the visibility of the management profession within healthcare has been rising in recent years, due largely to the widespread problems developed countries are having in balancing cost, access, and quality in their hospitals and health systems.[20]

See also edit

References edit

  1. ^ . Archived from the original on 2009-02-12.
  2. ^ "Bureau of Labor Statistics". from the original on 2013-04-23.
  3. ^ . Archived from the original on 2 July 2012. Retrieved 11 September 2012.
  4. ^ Kliff, Sarah (15 September 2014). "$1.43 of every $100 in America goes toward hospital administration". Vox. from the original on 15 September 2014. Retrieved 16 September 2014.
  5. ^ "Archived copy" (PDF). (PDF) from the original on 2017-01-18. Retrieved 2016-10-22.{{cite web}}: CS1 maint: archived copy as title (link)
  6. ^ a b "Bachelor's Degree in Healthcare Administration" 2013-02-08 at the Wayback Machine New England College
  7. ^ "Bachelor of Arts in Business Administration Healthcare Management - Online Healthcare Management Degree". Florida Tech Online. from the original on 2013-08-20.
  8. ^ "Bureau of Labor Statistics - Occupational Outlook Handbook entry". from the original on 2009-01-05.
  9. ^ a b McAlearney, Ann Scheck (2006). "Leadership Development in Healthcare: A Qualitative Study". Journal of Organizational Behavior. 27 (7): 967–982. doi:10.1002/job.417. ISSN 0894-3796. JSTOR 4093879.
  10. ^ a b GODIWALLA, YEZDI H.; GODIWALLA, SHIRLEY Y. (1991). "Strategic Management in Hospitals". Journal of Health and Human Resources Administration. 13 (3): 336–351. ISSN 0160-4198. JSTOR 25780452. PMID 10109843.
  11. ^ Pellegrini, Lawrence C.; Rodriguez-Monguio, Rosa; Qian, Jing (2014). "The US healthcare workforce and the labor market effect on healthcare spending and health outcomes". International Journal of Health Care Finance and Economics. 14 (2): 127–141. doi:10.1007/s10754-014-9142-0. ISSN 1389-6563. JSTOR 24571845. PMID 24652416. S2CID 12963343.
  12. ^ "What is Health Policy and Systems Research". WHO Alliance for Health Policy & Systems Research. Retrieved 2024-01-17.
  13. ^ Bennett, Sara; Adam, Taghreed; Zarowsky, Christina; Tangcharoensathien, Viroj; Ranson, Kent; Evans, Tim; Mills, Anne (November 2008). "From Mexico to Mali: progress in health policy and systems research". The Lancet. 372 (9649): 1571–1578. doi:10.1016/S0140-6736(08)61658-X. PMID 18984191. S2CID 21065572.
  14. ^ Lin, V (1997-12-01). "Resource review. Investing in health research and development: report of the ad hoc committee on health research relating to future intervention options. World Health Organization, Geneva, 1996". Health Promotion International. 12 (4): 331–332. doi:10.1093/heapro/12.4.331.
  15. ^ Weisz, George (2020-08-02). "What Happened to the Global Forum for Health Research?". Global Public Health. 15 (8): 1212–1224. doi:10.1080/17441692.2020.1752767. ISSN 1744-1692. PMID 32295489. S2CID 215793442.
  16. ^ Haddock, Cynthia Carter "A Brief History of Healthcare Management" 2012-09-04 at the Wayback Machine, 2002.
  17. ^ "University of Chicago - Graduate Program in Health Administration and Policy". from the original on 2010-06-20.
  18. ^ Stevens, R. (1999). "In sickness and in wealth: American hospitals in the twentieth century." Baltimore: The Johns Hopkins University Press.
  19. ^ Haddock, C. C., & McLean, R. D. (2002). "Careers in Healthcare Management: How to Find your Path and Follow It." Chicago: Health Administration Press.
  20. ^ Organisation for Economic Co-operation and Development (2006). "Rising health costs put pressure on public finances, finds OECD." Retrieved January 20, 2009 from the OECD Web site: "Rising health costs put pressure on public finances, finds OECD". from the original on 2008-05-03. Retrieved 2013-08-27.

Further reading edit

  • Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; ISBN 1446207633.

External links edit

  • Healthcare Financial Management Association
  • Healthcare Information and Management Systems Society
  • Healthcare Leadership Alliance
  • Organisation for Economic Co-operation and Development - Reviews of health systems

health, administration, management, health, information, systems, such, electronic, medical, records, health, information, management, hospital, administration, redirects, here, journal, hospital, administration, journal, examples, perspective, this, article, . For management of health information systems such as electronic medical records see health information management Hospital administration redirects here For the journal see Hospital Administration journal The examples and perspective in this article may not represent a worldwide view of the subject You may improve this article discuss the issue on the talk page or create a new article as appropriate April 2019 Learn how and when to remove this message Health administration healthcare administration healthcare management or hospital management is the field relating to leadership management and administration of public health systems health care systems hospitals and hospital networks in all the primary secondary and tertiary sectors Iconographic Collections Keywords E Walker Florence Nightingale W J Simpson Contents 1 Terminology 2 Hospital administrators 2 1 Competencies 3 Training and organizations 3 1 Associated qualifications 3 1 1 North America 3 2 Professional organizations 4 System processes 4 1 Funding of hospitals 4 2 Overall goal 5 Research 6 History 7 See also 8 References 9 Further reading 10 External linksTerminology editHealth systems management or health care systems management describes the leadership and general management of hospitals hospital networks and or health care systems In international use the term refers to management at all levels 1 In the United States management of a single institution e g a hospital is also referred to as medical and health services management 2 healthcare management or health administration Health systems management ensures that specific outcomes are attained that departments within a health facility are running smoothly that the right people are in the right jobs that people know what is expected of them that resources are used efficiently and that all departments are working towards a common goal for mutual development and growth citation needed Hospital administrators editHospital administrators are individuals or groups of people who act as the central point of control within hospitals These individuals may be previous or current clinicians or individuals with other healthcare backgrounds There are two types of administrators generalists and specialists Generalists are individuals who are responsible for managing or helping to manage an entire facility Specialists are individuals who are responsible for the efficient and effective operations of a specific department such as policy analysis finance accounting budgeting human resources or marketing 3 It was reported in September 2014 that the United States spends roughly 218 billion per year on hospital s administration costs which is equivalent to 1 43 percent of the total U S economy Hospital administration has grown as a percent of the U S economy from 9 percent in 2000 to 1 43 percent in 2012 according to Health Affairs In 11 countries hospitals allocate approximately 12 percent of their budget toward administrative costs In the United States hospitals spend 25 percent on administrative costs 4 Competencies edit NCHL competencies that require to engage with credibility creativity and motivation in complex and dynamic health care environments 5 Accountability Achievement orientation Change leadership Collaboration Communication skills Financial Skills Impact and influence Innovative thinking Organizational awareness Professionalism Self confidence Strategic orientation Talent development Team leadershipTraining and organizations editAssociated qualifications edit Health care management is usually studied through healthcare administration 6 or healthcare management 7 programs in a business school or in some institutions in a school of public health North America edit Although many colleges and universities are offering a bachelor s degree in healthcare administration or human resources 6 a master s degree is considered the standard credential 8 for most health administrators in the United States Research and academic based doctorate level degrees such as the Doctor of Philosophy PhD in Health Administration and the Doctor of Health Administration DHA degree prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice teach shape public policy and or lead complex organizations There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation citation needed The Commission on the Accreditation of Healthcare Management Education CAHME is the accrediting body overseeing master s level programs in the United States and Canada on behalf of the United States Department of Education It accredits several degree program types including Master of Hospital Administration MHA Master of Health Services Administration MHSA Master of Business Administration in Hospital Management MBA HM Master of Health Administration MHA Master of Public Health MPH MSPH MSHPM Master of Science MS HSM MS HA and Master of Public Administration MPA Master of Hospital Management MHM citation needed Professional organizations edit There are a variety of different professional associations related to health systems management which can be subcategorized as either personal or institutional membership groups Personal membership groups are joined by individuals and typically have individual skills and career development as their focus Larger personal membership groups include the Healthcare Financial Management Association and the Healthcare Information and Management Systems Society Institutional membership groups are joined by organizations whereas they typically focus on organizational effectiveness and may also include data sharing agreements and other medical related or administrative practice sharing vehicles for member organizations Prominent examples include the American Hospital Association and the University Healthsystems Consortium citation needed System processes editA career in healthcare administration consists of organizing developing and managing medical and health services These responsibilities are carried out at hospitals clinics managed care companies public health agencies and other comparable establishments This job involves a lot of paperwork and minimal clinical engagement Healthcare administrators make sure to promote excellence in patient care patient satisfaction and relationships with their physicians In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients The entire organization has a better experience when everything is organized and protocols are set into place The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries 9 Healthcare administrators might become overworked along with physicians feeling stressed from various protocols However both the parties of stakeholders and patients make up the backbone of a proper healthcare administration These administrators make sure that the doctors insurance companies patients and other healthcare providers have access to the files they need to provide appropriate treatments Multiple hierarchies of professionals on both the clinical and administrative sides of the organization generate special challenges for directing and coordinating the healthcare organization 9 A healthcare administrator has a long term effect in improving the hospital s process operation systems They play a vital role in the sustainability of the institution Funding of hospitals edit Healthcare administrators are in charge of hospital finances and advocate various strategies to improve their facilities and resources Hospitals provide funding for assets like marketing charity events equipment medicine payroll etc At the same time an institution should not be all things to people it has its own limitations 10 The management administration carefully manages these funds due to a spending limitation The healthcare administrators control the expenditures that the hospital allows in order to meet profits Sometimes hospitals are limited on what they can do for patients Administrators that run these hospitals strive to achieve goals within their financial limitations This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market s impact on healthcare spending and health outcomes 11 When healthcare spending reduces employment growth will start reducing as well The healthcare administration is critical to the lives of the people in hospitals It contributes to cost saving practices and making sure that the necessities are brought to the institution Healthcare management makes sure that protocols and funds are properly organized for each department They are responsible for keeping the healthcare industry afloat Many hospitals host charity events and donate to them as well citation needed Overall goal edit The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and cost effective way possible The United States leads the world in high quality and advanced level healthcare 10 Everyone is working towards a common goal thanks to these mission statements This improves the organization s efficiency and productivity The mission statement establishes the organization s purpose and provides employees a sense of belonging and identity This encourages management and stakeholders to put in more effort in order to obtain success The ultimate purpose of health care is to help individuals regain their overall health and wellbeing citation needed Research editHealth policy and systems research HPSR is a field of inquiry that studies how societies organize themselves in achieving collective health goals and how different actors interact in the policy and implementation processes to contribute to policy outcomes 12 HPSR is interdisciplinary and brings together expertise in a variety of biomedical and social sciences such as economics sociology anthropology political science public health and epidemiology The Commission on Health Research for Development 13 and the Ad Hoc Committee on Health Research 14 both highlighted the urgent need for focusing research methods funding and practice towards addressing health inequities and embracing inter disciplinary and intersectoral thinking These reports and other academic and activist voices linked to them argued for greater voice and participation of developing countries in defining research priorities 15 Since then creation of the Alliance for Health Policy and Systems Research in 2000 and that of Health Systems Global in 2012 have consolidated the practice community of HPSR History editEarly hospital administrators were called patient directors or superintendents At the time many were nurses who had taken on administrative responsibilities Over half of the members of the American Hospital Association were graduate nurses in 1916 Other superintendents were medical doctors laymen and members of the clergy In the United States the first degree granting program in the United States was established at Marquette University in Milwaukee Wisconsin By 1927 the first two students received their degrees The original idea is credited to Father Moulinier associated with the Catholic Hospital Association 16 The first modern health systems management program was established in 1934 at the University of Chicago 17 At the time programs were completed in two years one year of formal graduate study and one year of practicing internship In 1958 the Sloan program at Cornell University began offering a special program requiring two years of formal study 18 which remains the dominant structure in the United States and Canada today see also Academic Preparation citation needed Health systems management has been described as a hidden health profession 19 because of the relatively low profile role managers take in health systems in comparison to direct care professions such as nursing and medicine However the visibility of the management profession within healthcare has been rising in recent years due largely to the widespread problems developed countries are having in balancing cost access and quality in their hospitals and health systems 20 See also editHealth insurance Health Insurance Innovations Health Advocate Master of Health Administration NosokineticsReferences edit World Health Organization Management Archived from the original on 2009 02 12 Bureau of Labor Statistics Archived from the original on 2013 04 23 Health Care Administrator Archived from the original on 2 July 2012 Retrieved 11 September 2012 Kliff Sarah 15 September 2014 1 43 of every 100 in America goes toward hospital administration Vox Archived from the original on 15 September 2014 Retrieved 16 September 2014 Archived copy PDF Archived PDF from the original on 2017 01 18 Retrieved 2016 10 22 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link a b Bachelor s Degree in Healthcare Administration Archived 2013 02 08 at the Wayback Machine New England College Bachelor of Arts in Business Administration Healthcare Management Online Healthcare Management Degree Florida Tech Online Archived from the original on 2013 08 20 Bureau of Labor Statistics Occupational Outlook Handbook entry Archived from the original on 2009 01 05 a b McAlearney Ann Scheck 2006 Leadership Development in Healthcare A Qualitative Study Journal of Organizational Behavior 27 7 967 982 doi 10 1002 job 417 ISSN 0894 3796 JSTOR 4093879 a b GODIWALLA YEZDI H GODIWALLA SHIRLEY Y 1991 Strategic Management in Hospitals Journal of Health and Human Resources Administration 13 3 336 351 ISSN 0160 4198 JSTOR 25780452 PMID 10109843 Pellegrini Lawrence C Rodriguez Monguio Rosa Qian Jing 2014 The US healthcare workforce and the labor market effect on healthcare spending and health outcomes International Journal of Health Care Finance and Economics 14 2 127 141 doi 10 1007 s10754 014 9142 0 ISSN 1389 6563 JSTOR 24571845 PMID 24652416 S2CID 12963343 What is Health Policy and Systems Research WHO Alliance for Health Policy amp Systems Research Retrieved 2024 01 17 Bennett Sara Adam Taghreed Zarowsky Christina Tangcharoensathien Viroj Ranson Kent Evans Tim Mills Anne November 2008 From Mexico to Mali progress in health policy and systems research The Lancet 372 9649 1571 1578 doi 10 1016 S0140 6736 08 61658 X PMID 18984191 S2CID 21065572 Lin V 1997 12 01 Resource review Investing in health research and development report of the ad hoc committee on health research relating to future intervention options World Health Organization Geneva 1996 Health Promotion International 12 4 331 332 doi 10 1093 heapro 12 4 331 Weisz George 2020 08 02 What Happened to the Global Forum for Health Research Global Public Health 15 8 1212 1224 doi 10 1080 17441692 2020 1752767 ISSN 1744 1692 PMID 32295489 S2CID 215793442 Haddock Cynthia Carter A Brief History of Healthcare Management Archived 2012 09 04 at the Wayback Machine 2002 University of Chicago Graduate Program in Health Administration and Policy Archived from the original on 2010 06 20 Stevens R 1999 In sickness and in wealth American hospitals in the twentieth century Baltimore The Johns Hopkins University Press Haddock C C amp McLean R D 2002 Careers in Healthcare Management How to Find your Path and Follow It Chicago Health Administration Press Organisation for Economic Co operation and Development 2006 Rising health costs put pressure on public finances finds OECD Retrieved January 20 2009 from the OECD Web site Rising health costs put pressure on public finances finds OECD Archived from the original on 2008 05 03 Retrieved 2013 08 27 Further reading editJill Barr amp Lesley Dowding Leadership in Health Care 2012 Sage Publications Ltd ISBN 1446207633 External links editHealthcare Financial Management Association Healthcare Information and Management Systems Society Healthcare Leadership Alliance Organisation for Economic Co operation and Development Reviews of health systems World Health Organization Making Health Systems Work series Retrieved from https en wikipedia org w index php title Health administration amp oldid 1223445410, wikipedia, wiki, book, books, library,

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