Dominican Public Hospitals Set for Greater Autonomy

The National Health Service (SNS) is targeting greater administrative and financial autonomy for 150 public hospitals by the end of 2027, or within a maximum of two years, as part of a broader effort to strengthen management across the Dominican Republic’s public health network.

The initiative begins with a pilot program involving 22 hospitals and the Ozama Regional Health Service during 2026–2027. The program is being developed by the SNS in coordination with the General Directorate of Government Accounting (Digecog), which oversees government accounting standards and financial reporting.

Hospital Management Pilot Begins With 22 Facilities

The pilot will focus on hospitals that have sufficient administrative and financial capacity to take greater control of their internal processes while remaining under the supervision and technical guidance of the SNS.

SNS Executive Director Julio Landrón said health authorities are identifying facilities that have reached the necessary level of administrative and financial maturity to begin the transition. The objective is to allow hospitals to respond more quickly to operational needs while maintaining centralized oversight of the public health system.

The new approach is also intended to strengthen the management of public funds. Authorities say greater autonomy could streamline administrative and financial procedures, improve hospitals’ capacity to respond to local needs and make resource management more efficient.

Four-Phase Plan for Financial Management

The pilot program will be implemented in four stages: collecting information from participating hospitals, conducting institutional assessments, training administrative and financial personnel, and introducing a harmonized accounting system.

The accounting component is designed to produce standardized and reliable financial information that can be used to support management decisions. The process will follow the requirements established by Law 126-01 on Government Accounting and its implementing regulation, No. 526-09.

Digecog officials said the success of the initiative will depend on institutional commitment and strict compliance with accounting and transparency standards. The agency is supporting the transition as hospitals take on greater responsibility for their administrative and financial processes.

Autonomy Will Remain Under SNS Oversight

Greater autonomy will not mean that hospitals operate independently of the national health system. The SNS will continue to provide oversight and technical support, while participating hospitals assume greater responsibility for managing their resources and internal procedures.

For patients, the practical impact will depend on how effectively the new management model improves hospital operations. The authorities’ stated goal is to reduce administrative delays and strengthen the ability of public facilities to respond to their needs while maintaining transparency in the use of government funds.

The 22-hospital pilot and the inclusion of the Ozama Regional Health Service will provide the initial testing ground for the model. If the process advances as planned, the experience could support its expansion to a much larger share of the Dominican Republic’s public hospital network over the following two years.