Hospitals can be viewed as a logistical system in which integration is a critical factor for performance. This paper is the result of a scoping study that identifies the logistical parameters mentioned in international research on hospitals and indicates whether literature reflects system integration. With a total number of 106 logistical parameters that are applied in 92 subsystems of hospital, we found that logistics is highly fragmented. Studies also show integration, although this takes place mainly within the subsystems of hospitals.
A multi-agent perspective on hospitals is proposed, following the view that both integration and differentiation are essential for effective organizational performance. Given the rising cost of healthcare this calls for more research on integration and effectiveness of hospitals.
By Annelies van der Ham, Henri Boersma, Arno van Raak, Dirk Ruwaard and Frits van Merode