Holonic systems for decision-making in hospital mergers

Overview & Synopsis

Health crises, such as epidemics, require a precise decision-making and control process between the different components of the health system in order to manage patients well. In this context of improvement, governments in various coun- tries create GHTs, i.e., hospital mergers or, in French, “Groupement Hospitalier de Territoire”.The purpose of this article is to discuss three more or less (de-)centralised decision-making scenarios within a GHT. These different decision-making models will be applied to a specific GHT from the Loire region in France. We propose these scenarios by implementing the concept of agent in the decision-making system of this GHT, because the introduction of this concept through holonic systems is a way to efficiently integrate data into systems while taking account of various constraints. Before proposing these scenarios, this article first reviews the literature on GHTs from 1980 to 2021. This review shows that decentralized decision-making seems to be a key factor in the success of a GHT.