RESUMEN
The objective of this article is to compare the development of hospital systems in USA with multi-hospitals or other hospital association formulas that currently exist in Catalonia. Our purpose is to check if the theory, that has influenced the development of these hospital systems in US is consistent with the hospital systems in Catalonia, specifically in the cases of: Consorci Hospitalari de Catalunya, Unió Catalana d'Hospitals, future Consorci d'Hospitals de Barcelona, among others. In addition we analyze the consequences that would appear if the Public Hospital Network of Catalonia (xarxa hospitalaria d'utilització pública: XHUP) (1) is considered as a hospital system; that is, considering this Hospital Network as a hospital system in coexistence with other preexistent hospitals, could take advantage in the financial management as well as in the introduction in the market simulation systems to stimulate the efficiency in the provision of public hospitals.
