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Hospital management has experienced significant progress with the evolution of the Romanian health system reform, it has made strides in terms of resource allocation and cost control, new systems for classification, evaluation and monitoring (DRGs, SIUI, CaPeSaRo) were implemented, some taken from other countries and adapted to local conditions, but not always integrated with the other components and sometimes incompletely implemented and developed. This material does not offer definite solutions to current problems. It only briefly addresses the main aspects of hospital activity, and points out some failures with whom hospital managers are presently faced. Once the problems are identified it creates prerequisites for solving them, it opens channels of research and development of new methodologies or correlation of the existing deficient workflows that can be corrected.