Understanding health management
Health management is complex, and its meaning can vary depending on local contexts. EHMA with our members have developed a definition that captures the needs of health systems all across Europe.
Health management provides guidance and leadership to administer health at the individual, organisational and systemic level. Health management embraces a holistic vision of health, in which health is impacted by behavioral, social, and environmental determinants. Health management includes and goes beyond healthcare management, which comprises community, primary, secondary, and tertiary care provision. It also happens outside of care settings and builds synergy with other related policy and societal areas in line with the ‘One health’ concept. Health management encompasses the entire health ecosystem in which health managers collaborate with patients, informal and formal caregivers, patient organisations, legislators, educators, policy makers and regulators, public health experts, researchers, health insurance experts, and pharmaceutical industries. Together, they aim to create a clear health vision and alignment strategy, as well as lay down the organisational, societal and technological conditions to achieve optimal health outcomes for individual patients and the entire community. Health managers are jointly responsible for establishing effective and holistic governance structures, built on a co-design and co-production model.
Healthcare management is the practice of providing leadership, management, and direction to organisations that provide healthcare services and to different units within those organisations. Healthcare management is centred around three main concepts: effectiveness, efficiency, and equity.
Healthcare management is an umbrella term and some of the job positions that fall within the scope of that term are Medical director, Clinical manager, Nursing home administrator, Laboratory manager and Office manager. Health managers carry out six core functions, namely planning, organising, staffing, controlling, directing, risk-assessing, and decision-making. Health care managers ensure that their organisation or department improves in efficiency, financial strength, and service quality to ultimately deliver the best possible care to patients.
Although healthcare facilities are essential in managing, maintaining, and improving the health of citizens, health does not only happen within care facilities. The Ottawa Charter for Health Promotion (1986) described health as being:
“…created and lived by people within the settings of their everyday life; where they learn, work, play and love. Health is created by caring for oneself and others, by being able to take decisions and have control over one’s life circumstances, and by ensuring that the society one lives in creates conditions that allow the attainment of health by all its members”.
With this vision of health in mind, health management and public health are closely intertwined. Effective health management at individual, facility, and community level will ultimately lead to better health outcomes and enhance public health.
Health management is therefore a practice that encompasses healthcare management yet has a wider approach. Health management is practiced from an individual to a population level. In fact, at an individual level, people can manage their health by monitoring their vital signs and taking their treatments as prescribed and act as a decision-maker in lifestyle choices. In addition, individuals who may have higher risk for developing a given disease can decrease their risk of diseases by engaging in prevention activities. Within the care system, patients can self-manage their wellbeing and care to reach desired health outcomes. Lastly, citizens can participate in initiatives and advocate for their health and the health of their fellow citizens at the community and policy level.
Beyond the individual responsibilities, health is impacted by personal, situational, societal, and environmental determinants. In this aspect, a health manager can be described as individuals and organisations that are working at different levels on those factors that have a direct, and sometimes indirect, impact on health. This comprises health (including healthcare) policy and decision-makers, social care professionals, and professionals in systems outside of healthcare.
The precise meaning of health management thus varies according to the perspective taken. While the terms of health management and healthcare management are often used interchangeably, the scope of the former is larger and encompasses a more holistic vision of health.
EHMA focuses on the wider healthcare ecosystem and works in a transdisciplinary manner on initiatives that involve a variety of stakeholders, including patients, informal and formal caregivers, patient organisations, hospital management representatives, legislators, policy makers, educators, public health experts, researchers, and representatives from the health insurance sector and pharmaceutical industries. EHMA’s engagement is therefore across the entire health ecosystem in line with the ‘One Health’ concept and is not limited solely to healthcare management. EHMA embraces a vision in which health can be managed at the individual, organisational, and systemic levels.
WHAT OUR MEMBERS SAY
I have been active in EHMA since the first years of the '90s and I have seen its evolution from a small association of members interested in sharing knowledge on health management practices to the current status of reference and advisory key player for EU, health systems and organisations, stakeholders associations, industry and universities. EHMA is now a unique knowledge hub, policy advisor, community of practice and network of best in class organisations involved in health policy and management. A place where health managers can build their competences, policy-makers and stakeholder associations envision how to implement and sustain change through health management, industry leaders understand how to engage more effectively with health organisations and systems. The right place to nurture and grow health management capabilities and capacity for every stakeholder of health systems.
Prof. Federico Lega, University of Milan, Italy
Health management has a crucial function in shaping public health and health system challenges. The Medical University of Varna, Bulgaria had success in collaborating with EHMA on EU-funded projects that has resourced us to create new health management competencies for the future workforce. In addition to all classical definitions, health management is a science dealing with individuals, groups, and society at large. It is an art contributing to the beauty of our lives and an interactive communication process at all levels of institutions and human energy. I have also had the pleasure to chair the South Eastern European Special Interest Group which gives members a space to discuss and tools to address how health systems are managed in our regions.
Prof. Todorka Kostadinova, Medical University of Varna, Bulgaria
I enjoy the high level of interaction and engagement in EHMA’s activities, in particular during the annual conference where the panel discussions are rich and well prepared. As a hospital manager and professor of health management, EHMA motivates and inspires me to be creative. You go back home feeling energised from seeing old friends and making new connections, as well as being convinced of serving as EHMA’s ambassador. It’s a strong feeling of interdisciplinary engagement, but it also feels like being part of family-like community.
Prof. Sandra C. Buttigieg, University of Malta, Malta
EHMA is a pre-eminent organisation for everyone working in planning, managing and delivering health services across Europe. As a long standing member of EHMA I have always been impressed by the vibrant community of managers, researchers and academics it has created and by the many opportunities for sharing knowledge and funding opportunities it has brought to its members. Its international scope is impressive and its impact is often felt in management and research across European and national health systems.
Prof. Axel Kaehne, Edge Hill University, UK
Health workforce has become more essential in operating, managing and maintaining health systems lately, particularly in crisis and emergency situations. European healthcare professions and the workforce need to be high on the agenda of managers and decision makers. The Health Services Management Training Centre, Semmelweis University in Hungary is a longstanding EHMA member, because it connects us with collaborators and experts, with whom we can have complex debates, from whom we can learn and at the end find solutions in various challenging fields of healthcare management.
Dr Eszter Kovács, Health Services Management Training Centre, Semmelweis University, Hungary
As a hospital administrator and health management professor, I see on a daily basis that the healthcare challenges require talented and skilled managers to transform it. the EHMA membership has been beneficial to bring healthcare management research and education to the demanding healthcare services world, promoting healthcare management competencies and knowledge creation.
Dr Alexandre Lourenco, APAH - Association of Portuguese Hospital Managers, Portugal
Many healthcare systems in Europe and beyond are facing similar challenges which require innovative and creative solutions. EHMA’s annual conference, webinars, Programme Directors’ group and other activities and resources provide incredible opportunities for networking, connecting and sharing experiences. A distinct feature of EHMA is the diversity of members with representation from many countries, sectors and different communities of practice – academic, policy-makers, practitioners, managers, leaders and students. The annual conference is a highlight in the calendar year, offering a friendly, fun and learningful environment for emerging and established members to engage, collaborate and meet up with old and new friends. I am proud to be a member of the EHMA Board.
Prof. Ann Mahon, University of Manchester, UK
Society evolution, pandemics and ageing modify health needs. So, health policies and services are to change dramatically. EHMA, through webinars, workshops and annual conference provides an excellent insight to a professional changing world, favouring closeness to management innovation and the protagonists of these changes. As a primary care services’ manager, participating in EHMA activities is really worth it and allows to involve oneself in the innovation processes.
Dr Antoni Peris Grao, Consorci Castelldefels Agents de Salut (CASAP), Spain