Holonic Systems for Decision-Making in Hospital Mergers

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 effectively. In this context of improvement, governments in various countries 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. In this article, these different decision-making models have been applied to a specific GHT located in the Loire region of France. These scenarios are proposed through the incorporation of the agent concept into 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 considering various constraints. Before proposing these scenarios, this article first reviews the literature on GHTs from 1980 to 2021. The review shows that decentralized decision-making seems to be a key factor in the success of a GHT.