Identity – an Influential Factor in Modernization of Healthcare Systems in Hungary and Serbia

  • Ivana Kocsicska University of Miskolc, University of Public Service, Hungary
  • Aleksandra Varga-Kocsicska University of Miskolc, University of Public Service, Hungary
Keywords: Healthcare management, leadership, Hungarian, Serbian, identity, modernization, healthcare systems


The changing world and its economic trends are demanding adjustments in healthcare systems. The modernization of healthcare appeared as a global requirement, in connection with numerous changes in the healthcare sector, including the financing and providing funds for unallayed services. Also, one of the crucial elements of modernization is the development of healthcare leadership and the introduction of elements of shared leadership, in order to create an organizational culture, which can comply with the global changes, coming together with economic and business transformations. Leaders bring their life lessons, their past, and their culture into every possible perspective and context. Belonging to groups, families, and communities can empower leaders and increase commitment toward belonging. As well as cultural humility, leaders need to recognize and understand their own cultural self-identity and how this affects their leadership style. Recognizing that everyone has unique traditions, values, and beliefs (ethnic identity, language, religion, community, family ties) helps to understand how everyone is related to others and how it influences leadership decisions. Though there is a recognized need, opportunities for healthcare leadership development are limited both in Hungary and Serbia, including important limiting factors such as the fact that leaders are still skeptical about including modern business and management elements in healthcare. The ideal solution would be the combination of early and mid-to-late career development and the integration of both organizational and leadership development. Although there is insufficient data on the impact of social identity and social identification on behaviors, professional development, and commitment of leaders in the healthcare systems of Hungary and Serbia, both countries could be established a clear connection between recognizing the need for developing an effective social health protection system and effort to improve the leadership in healthcare. However, further research is needed in order to better define the phenomenon.


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1. Albert, Fruzsina: Hungary reforms its healthcare system: a useful step forward but which raises some concerns, ESPN Flash Report 2021/14, European Social Policy Network (ESPN), Brussels: European Commission
2. Aleksic Jovana, Ivan Stevanovic I., Milena Gajic-Stevanovic.: The Role of Managers in Improving the Health Care System in Serbia, Stomatoloski glasnik Srbije, (2014) 61 (3): 142-148
3. Augoustinos, Martha, & de Garis, S.: ‘Too black or not black enough’: Social identity complexity in the political rhetoric of Barack Obama. European Journal of Social Psychology, (2012) 42, 564–577. .
4. Barker GR.: Healthcare managers in the complex world of healthcare. Front Health Serv Manage (2001)18:23-32.
5. Barreto, Nicolas B., Hogg, M. A.: Evaluation of and support for group prototypical leaders: A meta-analysis of twenty years of empirical research. Social Influence, (2017) 12, 41–55.
6. Bennis, Warren G. (1993). An invented life: Reflections on leadership and change. Reading, Mass: Addison-Wesley Pub. Co.
7. Bezrukova, Katerina, S.M.B. Thatcher, K.A. Jehn, C.S. Spell, C. S.: The effects of alignments: Examining group fault lines, organizational cultures, and performance. Journal of Applied Psychology, (2012) 97 (1), 77-92.
8. Bjegovic-Mikanovic Vesna, Milena Vasic, DejanaVukovic, Janko Jankovic, Aleksandra Jovic-Vranes, Milena Santric-Milicevic, Zorica Terzic-Supic, Christina Hernández-Quevedo: Serbia: Health system review, Health Systems in Transition, (2019) 21 (3): i-211., Copenhagen: WHO Regional Office for Europe
9. Boal, K. B., & Hooijberg, R. (2001). Strategic leadership research: Moving on. The Leadership Quarterly, 11, 515–549.
10. Booth, T., Murray, A. L., Overduin, M., Matthews, M., & Furnham, A. (2016). Distinguishing CEOs from top level management: A profile analysis of individual differences, career paths and demographics. Journal of Business and Psychology, 31, 205–216.
11. Boyatzis, Richard: The competent manager: A model for effective performance, 1982, New York: Wiley.
12. Brien Dr. Stephen, Swalem B., MacDowall A.: Central and Eastern Europe Prosperity Report, The Lived Experience, 2019. Legatum Institute
13. Dinh, Jessica E., Robert G. Lord, Wiliam L. Gardner, Jeremy D. Meuser, Robert C. Liden, Jiny Hu, J. (2014). Leadership theory and research in the new millennium: Current theoretical trends and changing perspectives. The Leadership Quarterly (2014) 25, 36–62.
14. Drath, Wilfred H., McCauley, C. D., Palus, C. J., Van Velsor, E., O’Connor, P. M. G., and McGuire, J. B.: Direction, alignment, commitment: Toward a more integrative ontology of leadership. The Leadership Quarterly, (2008) 19 (6), 635–653.
15. Ellemers, Naomi, de Gilder, D., & Haslam, S. A.: Motivating individuals and groups at work: A social identity perspective on leadership and group performance. Academy of Management Review, (2004) 29, 459–478.
16. Finkelstein Sidney, Donals C. Hambrick, Albert A. Cannella: Strategic leadership: Theory and research on executives, top management teams, and boards, 2009. New York: Oxford University Press.
17. Freedman Lynn P.: Achieving the MDGs: health systems as core social institutions, In: Development .2005. 48 (1)19-24. p.
18. Gacevic Marijana et al.: The relationship between dual practice, intention to work abroad and job satisfaction: A population-based study in the Serbian public healthcare sector. Health Pol. (2018) 122(10):1132–1139. doi: 10.1016/j.healthpol.2018.09.004
19. Gajić-Stevanović M, Aleksić J, Stojanović N, Živković S. Health care system of the Republic of Serbia in the period 2004–2012. Serbian Dental Journal. 2014; 61(1):37-45.
20. Gemmill, Garry & Oakley, Judith (1992). Leadership: An Alienating Social Myth? Human Relations, 45(2), 113–129.
21. Granel Nina, Josep Maria Manresa-Domínguez, Anita Barth, Katalin Papp, Maria Dolors Bernabeu-Tamayo: Patient safety culture in Hungarian hospitals. Int J Health Care Qual Assur. 2019 Mar 11;32(2):412-424. doi: 10.1108/IJHCQA-02-2018-0048. PMID: 31017066.
22. Ham, Chris: Reforming the NHS from within. Beyond hierarchy, inspection and markets, Kings Fund, 2014, London.=
23. Harrison, Richard T., Claire Leitch, Maura McAdam: Breaking Glass: Toward a Gendered Analysis of Entrepreneurial Leadership. Journal of Small Business Management, (2015), 53(3), 693–713.
24. Haslam, S. A., Adarves-Yorno, I., Postmes, T., & Jans, L. (2013). The Collective Origins of Valued Originality: A Social Identity Approach to Creativity. Personality and Social Psychology Review, 17(4), 384–401.
25. Haslam, S.Alexander, Reicher, S.D., & Platow, M.J. (2020). The New Psychology of Leadership: Identity, Influence and Power (2nd ed.). Routledge., S Alexander, Stephen D. Reicher, Michael J. Platow: The new psychology of leadership: Identity, influence and power. 2011, London & New York: Psychology Press.
26. Hogg, Michael A. (2001). A social identity theory of leadership. Personality and Social Psychology Review, 5, 184–200.
27. Hogg, Michael A., van Knippenberg, D., Rast III, D. E. (2012). The social identity theory of leadership: Theoretical origins, research findings, and conceptual developments. European Review of Social Psychology, 23, 258 - 304.
28. Jakovljevic Mihajlo B.: Resource allocation strategies in Southeastern European health policy, Eur J Health Econ (2013) 14:153–159, Berlin Heidelberg: Springer-Verlag
29. Lantos, Zoltán (2010). A magyar egészségügy kész a megújulásra – Döntéshozói véleménytérkép a nemzetközi egészséggazdasági trend tükrében. IME -Az egészségügyi vzetők szaklapja, 2010/9, 5-8
30. Lord, Robert G., David V. Day, Stephen J. Zaccaro, Bruce J. Avolio, A.H. Eagly, A. H.: Leadership in applied psychology: Three waves of theory and research. Journal of Applied Psychology, (2017)102(3), 434–451.
31. Maas, Cora J. M., & Hox, Joop J. (2005). Sufficient Sample Sizes for Multilevel Modeling. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 1(3), 86–92.
32. Martinov-Cvejin Mirjana: Organizacija zdravstvenih ustanova. 2009. Banja Luka: Panevropski univerzitet Banja Luka
33. McDougall, W. (1921). (14th ed.). John W Luce & Company.
34. Meindl, J.R. (1993). Reinventing leadership: A radical, social psychological approach. In J.K. Murnighan (Ed.), Social psychology in organizations: Advances in theory and research (pp. 89–118). Englewood Cliffs, NJ: Prentice Hall.
35. Mitrović M., Gavrilovic A. (2013): Organizacija i menadžment u zdravstvu Srbije, FBIM Transaction, 1 (2): 145 – 158
36. Papadopoulos Irena, Runa Lazzarino, Koulouglioti C, Aagard M, Akman Ö, Alpers LM, Apostolara P, Araneda Bernal J, Biglete-Pangilinan S, Eldar-Regev O, González-Gil MT, Kouta C, Krepinska R, Lesińska-Sawicka M, Liskova M, Lopez-Diaz AL, Malliarou M, Martín-García Á, Muñoz-Salinas M, Nagórska M, Ngunyulu RN, Nissim S, Nortvedt L, Oconer-Rubiano MF, Oter-Quintana C, Öztürk C, Papp K, Piratoba-Hernandez B, Rousou E, Tolentino-Diaz MY, Tothova V, Zorba A. Obstacles to compassion-giving among nursing and midwifery managers: an international study. Int Nurs Rev. 2020 Dec;67(4):453-465. doi: 10.1111/inr.12611. Epub 2020 Aug 11. PMID: 32779196.
37. Pears, Iain (1994) The Gentleman and the Hero: Wellington and Napoleon in the Nineteenth Century', in Myths of the English, (Eds.), Roy Porter, Cambridge: Polity Press, pp. 216±36.
38. Santric-Milicevic Milena et al. (2015): Determinants of intention to work abroad of college and specialist nursing graduates in Serbia. Nurse Ed Today.(2015) 35:590–596
39. Stevens Mark, Rees Tim, Coffee Pete, Haslam S. Alexander, Steffens Niklas K., & Polman Remco (2018). Leaders promote attendance in sport and exercise sessions by fostering social identity. Scandinavian Journal of Medicine & Science in Sports, 28(9), 2100–2108.
40. Szócska Miklós K., János M. Réthelyi, Charles Normand: Managing healthcare reform in Hungary: challenges and opportunities, BMJ 2005; 331 doi:
41. Tajfel, Henri, Turner, John C. (1979). An integrative theory of intergroup conflict. In W. G. Austin, & S. Worchel (Eds.), The social psychology of intergroup relations (pp. 33-37). Monterey, CA: Brooks/Cole.
42. The Healthcare IT System in Eastern Europe, Imaging Management, (2008)3(5): 40-46
43. Thompson John M.: Health Services Administration, in S. Chisolm (Ed.), The Health Professions: Trends and Opportunities in U.S. Health Care, 2007
44. Turner, John C., Hogg, Michael A., Oakes, Penelope J., Reicher, Stephen D., & Wetherell, Margaret S. (1987). Rediscovering the social group: A self-categorization theory. Basil Blackwell.
45. Van Knippenberg, D. (2011). Embodying who we are: Leader group prototypicality and leadership effectiveness. The Leadership Quarterly, 22, 1078–1091.
46. West Michael A.: Leadership and leadership development in health care: the evidence base. FMLM, Center for Creative Leadership, The King's Fund, 2015
47. West, Michael A.: Creating a culture of high-quality care in health services. Global Economics and Management Review, (2013)18 (2), 40-44.
48. Worchel Stephen, Rothgerber Hank, Day Eric Anthony, Hart Darren, & Butemeyer John (1998). Social identity and individual productivity within groups. British Journal of Social Psychology, 37(4), 389–413.
49. Yin, Robert K.: Case study research: Design and methods. 2002, Thousand Oaks, CA: SAGE Publications
How to Cite
Kocsicska, I., & Varga-Kocsicska, A. (2022). Identity – an Influential Factor in Modernization of Healthcare Systems in Hungary and Serbia. European Scientific Journal, ESJ, 7(1), 224. Retrieved from
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