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Management strategies in the institutions of healthcare system

Author: Niculiță Ana
Degree:doctor of economics
Speciality: 08.00.05 - Economy and Management (in branch)
Scientific adviser: Serghei Portărescu
doctor, associate professor (docent), Academy of Economic Studies of Moldova
Institution: Academy of Economic Studies of Moldova


The thesis was presented on the 19 December, 2022 at the meeting of the Scientific Council and now it is under consideration of the National Council.


Adobe PDF document0.64 Mb / in romanian
Adobe PDF document0.54 Mb / in english


CZU 005.21:614(478)(043)

Adobe PDF document 11.39 Mb / in romanian
237 pages


management strategy, strategic planning, strategic management, health system, regulation, public medical institutions, hospitals, management strategy-type model, medical services


Thesis structure: the thesis includes introduction, three chapters, general conclusions and recommendations, bibliography of 125 titles, 18 annexes, 134 pages of basic text (up to the Bibliography), 70 figures. The obtained results are published in 5 scientific papers.

The purpose of the paper: Evaluation of management strategies in the institutions of the health system, for the elaboration of a type-strategy model applicable in the conditions of the Republic of Moldova, which would improve the institutional strategic processes in the health system.

Research objectives: the delimitation of conceptual approaches to the notions of strategy, strategic planning and strategic management and the analysis of existing strategy models; analysis of the international experience and the national context regarding management strategies in health system institutions; evaluating the process of developing and implementing management strategies by elucidating the perception of managerial and operational personnel regarding the strategic process in health system institutions; the development of a model of management strategies for health system institutions in the Republic of Moldova; developing recommendations for improving strategic processes through the lens of the developed model of management strategies.

The scientific novelty and originality: resides in the research of management strategies through the prism of the role of the state in the process of regulating the activity of public medical institutions in the Republic of Moldova; conducting an empirical study on the experience of public hospital managers in the development and the implementation of management strategies and the involvement of employees of these institutions in the institutional strategic process; the elaboration and the proposal of a management type-strategy model, framed in the theoretical approach of H. Minzberg's School of Environment.

The result obtained that contribute to the solution of an important scientific problem: consists in the elaboration and the substantiation from a methodological point of view of the management strategy-type model for the institutions of the healthcare system in the Republic of Moldova, in order to facilitate and to optimize the institutional strategic processes, which leads to a better understanding by the managers of the healthcare system of the theoretical recommendations for the development and implementation of management strategies, in the context of the regulations of the activity of public institutions from the state.

The theoretical significance: consists in the conceptual delimitation of management strategies and its approach from the perspective of the specifics of the activity of public medical institutions and the local health system.

The applicative value of the thesis resides in the fact that the obtained results outline an overview of the situation regarding management strategies in public medical institutions and offer concrete ways to solve the problem identified by developing a management type-strategy model, which contains the explanation of all stages to be followed in order to achieve an effective institutional strategic process.

The implementation of scientific results: The research results were disseminated both in national and international conferences and in articles published in specialized journals. Based on the research carried out by the author and the developed management type-strategy model, the continuing medical education curriculum was updated in the Strategic Management discipline within the Public Health Management School of the Nicolae Testemițanu State University of Medicine and Pharmacy. A training course was developed for members of hospital Administrative Boards and other interested parties, available on an online learning platform. A training in the field of strategic planning was carried out by the author for the management and members of the Administrative Boards of the hospitals in the Northern region of the country (Balti, Edinet, Soroca, Floresti, Drochia), during which the management type-strategy model was presented and explained. The recommendations suggested by the author, as well as the management type-strategy model for health system institutions, were implemented by the National Medical Insurance Company, the National Public Health Agency and at least three hospital institutions.