Budgetoverskridelser på Herlev Hospital: Er der en logisk forklaring?

Lisa Bang & Anya Brandt

Student thesis: Master executive thesis


The Capital Health Region experienced a huge budgetary deficit in 2009 that resulted in layoffs of hospital employees by the hundreds. Herlev Hospital was the first to deal with budget related layoffs. With Herlev Hospital as case study, this master thesis focuses on the major question: What is the best explanation for the budgetary deficits at Herlev Hospital – focusing on the incentive management system? The following subsidiary questions will also be addressed: 1. How is the managerial budgetary system composed, and what incentives are given to comply with the hospital budget? 2. How can we explain the budgetary actions of senior consultants, the hospital, and regional CEO? This thesis applies a broad theoretical framework of institutionalism, substantiated with budget management theories, principal agent and behavioural theories, and theories of professions. The epistemological method relies on a qualitative approach with empirical data consisting of 6 semi structured interviews and a great amount of written material cached from web sites such as Herlev Hospital, Capital Health Region, Ministries of Heath and Finance, Danish Regions and The Danish Institute for Health Service Research. This Master’s thesis describes the budgetary management structure. By applying a budgetary management model it is explained that the institutional structure of the budget process at Herlev Hospital is passing on from the incremental phase over to the managerial phase. When the Capital Health Regions Hospital Plan 2007 is fully implemented and Herlev Hospital becomes fullfledged in 2017, the institution will probably pass on to a more stable strategic phase. The conclusion suggests that in spite of management incentives to constrain budgets, the senior consultants and hospital CEO increased spending activity. Other competing managerial schemes might have had an influence. Comprehensive mergers primarily resulting in increased activity at Herlev Hospital took place disregarding the lack of budgetary agreements.

EducationsMaster of Health Management, (Executive Master Programme) Final Thesis
Publication date2010
Number of pages85