Financing Hospital Emergency Preparedness: A Leadership Framework for Sustained Readiness

Hospitals must maintain essential services during disasters, although routine funding rarely covers the staff, supplies, backup systems, and regional coordination required for readiness. This article examines emergency preparedness as a leadership and financing responsibility. A narrative review considered Canadian, United States, and international policy documents and research on hospital resilience, emergency management, coalitions, supply continuity, and preparedness investment. Preparedness requires recurring expenditures that compete with operating priorities, while benefits often extend beyond the hospital that pays for them. Leaders can strengthen readiness through governance, budgeting, lifecycle planning, workforce decisions, regional agreements, risk monitoring, and emergency spending authority. Public support remains necessary for shared capabilities and extreme events. Sustainable readiness combines hospital financing for core capability, regional arrangements for shared resources, public investment where community benefits are broad, and rapid access to funds when demand exceeds normal capacity.