Evaluating the impact of national hospital plan on healthcare service performance in Albania: evidence from the regional Memorial Hospital in Fier

The establishment of a solid and well-organized hospital network represents a key step toward achieving universal health coverage and effectively addressing local health needs in transition countries of the Balkan region. In this context, the Albanian government enacted Law No. 55/2022, which introduced the reform of national hospital network with the aim of decentralizing and redistributing complex medical care from the capital city, Tirana, to peripheral areas and to promoting hospital autonomy. This study aimed to assess the impact of National Hospital Plan for autonomy in terms of healthcare service performance's improvement. A case study methodology was adopted, as the regional Memorial hospital in Fier. This hospital represented the first regional hospital already implemented in Albania that satisfied all criteria stipulated in the National Hospital Plan to achieve hospital autonomy. Higher volume of activity, better indices of resources management, and greater attractiveness of regional Memorial hospital from the South region of the country demonstrated the effectiveness of adopted managerial strategies, highlighting their positive impact on hospital's performance. This approach could be replicated within all the other Albanian regional hospitals involved by the reform contributing as well as in the other regional and university hospitals nationwide to improve widely the performance of the Albanian healthcare system. This reformative approach may also be of example to similar healthcare systems in the Balkan region and other low- and middle-income countries that have to manage the same issues, especially in terms of access to and performance of healthcare services.