摘要：This study aims to emphasize the importance of a management contract signed at the moment of hiring the manager of a medical unit, especially in the case of the public ones. Many studies in this field spotlighted the fact that the Romanian health care system has confronted with numerous modifications along the 17 years of transition starting with 1989. The first significant modification has occurred in the field of the health policy, with the passage from a community medicine to one whose main concern is the individual. The second major modification is related to the general tendency, also manifested in Europe, to des-centralize some of the competences of the central administration and to assign autonomy to the local one. There also takes place a reconsideration of the role played by the hospital units within the health care system. In this context, there comes out the creation and the development of a health care services market, as a result of the fact that the demand for this kind of services proceed from an individual that has the possibility to choose between the numerous suppliers existent on the market nowadays. This option became possible since the legislation, that has been adapted to UE requests and to the Romanian economic context as well, allowed on the one hand, the passage to a new financing system of the medical services based on the health social insurance, and on the other hand, the occurrence of many types of private medical units. Simultaneously, the supply of new medical materials, apparatus and medicines has increased, which led to competition. As a result, the hospital, that used to represent the characteristic medical unit in the previous health-care system, and generally any public medical unit, is forced to rapidly adapt to the new circumstances: new types of diseases, the rapid evolution of medical technology, the populations’ ageing, the migration of the labor force, new budgetary restrictions. This rapid adaptation supposes the existence of an efficient management of these units and a careful supervision of the activities that take place within them and also of the economic flows they participate into. This paper analyzes the statistical data related to the types of expenditures and the results obtained within the Romanian hospital units. The result of the research consists in highlighting the main issues that must be solved by the intercession of the management contract. The study also calls the attention on the fact that the management contract has to become an active instrument in order to get the medical unit efficient, and not a passive instrument, coercive, in order to fulfil some parameters that may become in a short time counterproductive, given the current trend of the health-care service market.
关键词：private and public medical units; health management
