Governance of academic medical centres in changing healthcare systems: An international comparison

Ester Cardinaal, Katarzyna Dubas-Jakóbczyk, Daiga Behmane, Lucie Bryndová, Fidelia Cascini, Heleen Duighuisen, Nadav Davidovitch, Ruth Waitzberg, Patrick Jeurissen

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


We provide an explorative and international comparison of the governance models of academic medical centres (AMCs). These centres face significant challenges, including disruptive external pressures and enduring financial conflicts pertaining to patient treatment, research and education. Therefore, we covered 10 European countries (Cyprus, Czechia, Denmark, Germany, Italy, Latvia, the Netherlands, Norway, Poland and Spain) and one associated state (Israel) in our analysis. In addition, we developed an expert questionnaire to collect data on the governance of AMCs in these 11 countries. Our results revealed no standardised definition of AMCs, with countries combining patient care, education/teaching and research differently. However, the ownership of such institutions is significantly homogeneous and is limited to public or private, nonprofit ownership. Furthermore, significant differences are associated with the (functional) integration level between the hospital and medical school. Therefore, most experts believe that the governance of AMCs will evolve into a more functionally integrated model of patient care, research and education.

Original languageEnglish
Pages (from-to)613-618
Number of pages6
JournalHealth Policy
Issue number7
Early online date26 Apr 2022
StateE-pub ahead of print - 26 Apr 2022


  • Academic Medical Centres
  • Changing Healthcare System
  • European comparison
  • Functional integration
  • Governance

ASJC Scopus subject areas

  • Health Policy


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