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Effective Executive Magazine:
Leadership in Challenging Times: Managing Hospitals in the Transitional Countries of Southeast Europe
 
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Managing healthcare, especially in transitional countries, is challenging. The first-named author was Managing Director of a leading Clinical Center in Sarajevo, facing the need for institutional and structural reform after the 1992-1995 war. Economic and sociopolitical transition has to also take into account major changes in the health of the population, linked to war, migration and overall demographic change. A different kind of leadership was needed in the context of falling industrial production, lack of investment, exclusion from global business, unemployment, poverty, corruption, dislocation of the infrastructure and catastrophic ecological conditions. Although the adjustment procedure has started, especially for the planned accession to European Union membership, the countries in the Balkans are lagging behind. In the context of hospitals, leaders and managers face a long-term uncontrolled increase in health protection expenditure, which has resulted in an increase of overall healthcare costs, with new pressures from the market economy. Accordingly, these countries have started comprehensive and deep reforms of health financing, which are now being implemented. Leaders in this area are struggling with a lack of practical experience and searching for benchmarks and comparisons with other countries which have already experienced these challenges and have now reached a higher level of stability.

   
Managing the health of the population in the world, especially in transitional countries such as in southeastern Europe, is currently undergoing a process of significant transition. The first-named author of this paper had (2000-2012) acted as Managing Director of the leading Clinical Center in Bosnia and Despite all these challenges, the governments of the region are looking for international economic cooperation, and these countries in the Western Balkans are primarily oriented to cooperation with industrially developed Western countries, especially with the EU. Accession to the EU is the ultimate priority of each of the countries in the region. This could help dramatically in reducing the challenging nature of the tasks such as those faced by the first-named author in hospital management here.