The number of academic programs for healthcare executives has
grown over the years, and the programs have organized to continue to
improve the quality of health administration education. In 1948, several
early graduate programs in the field joined together to form the
Association of University Programs in Health Administration (aupha).
This association now includes both graduate and undergraduate health
administration programs and focuses its efforts on the development
and continuous improvement of health management education.
In 1968, the Accrediting Commission on Graduate Education for
Hospital Administration was incorporated as the accrediting agency
for graduate programs in health administration. The name of this
accrediting body was changed in 1976 to the Accrediting Commission
on Education for Health Services Administration (acehsa). Today,
acehsa is sponsored by a group of educational and professional associations
(including the American College of Healthcare Executives, the
American College of Medical Practice Executives, the American Hospital
Association, the American Public Health Association, the Association
of University Programs in Health Administration, the Blue Cross
Blue Shield Association, the Canadian College of Health Services Executives,
the Healthcare Financial Management Association, the Health
Information Management and Systems Society, and the Health Insurance
Association of America) devoted to accountability and quality
improvement in the education of health administration professionals
and serves as the recognized accrediting body for master’s programs
in health administration in the United States and Canada.
Over the course of the last century, the field of healthcare administration
and the organizations in which executives work have
changed dramatically. Hospitals have become large, complex organizations;
technology has advanced at an almost unbelievable rate; the
financing of healthcare has moved from self-pay to a complicated
third-party reimbursement system; and government has taken an
increasingly larger role in healthcare delivery (Rosenberg 1987).
Despite these increased complications, the field continues to sustain
three primary objectives.
First, healthcare administrators are responsible for the business
and financial aspects of hospitals, clinics, and other health services
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organizations, and are focused on increasing efficiency and financial
stability. Their roles include human resources management, financial
management, cost accounting, data collection and analysis, strategic
planning, marketing, and the various maintenance functions of the
organization. Second, healthcare administrators are responsible for
providing the most basic social service: the care of dependent people
at the most vulnerable points in their lives. Third, healthcare administrators
are responsible for maintaining the moral and social order of
their organizations, serving as advocates for patients, arbitrators in situations
where there are competing values, and intermediaries for the
various professional groups who practice within the organization. As
healthcare services have become increasingly expensive and as the
environment for the organizations that deliver these services has
become more turbulent and hostile, these three objectives seem more
and more contradictory (Rosner 1989). However, the three objectives
remain. The greatest challenge for health services executives and for
the educational programs that train them is to find the skills and competencies
needed to balance these objectives and to achieve them in a
continuously changing environment.
Today, the opportunities for healthcare administrators are increasing
and the challenges they face in ensuring effective, efficient healthcare
services for communities are many. Shortages of nurses and
other healthcare workers, concern for the safety and quality of healthcare
services, rising costs, a growing number of uninsured Americans,
an aging population, and rapidly changing medical technology
and practice all make the field of health administration a very big job
for those who are willing to accept the challenge. For those who do,
the rewards come in knowing that you are making a positive difference
in the lives of people and communities.