یکپارچگی افقی بیمارستان ها
Abstract
1-Introduction
2-Analysis
3-Conclusion and discussion
References
Abstract
The aim of this paper is to discuss the effect of horizontal integration of hospitals on efficiency of hospitals. Whereas Czech hospitals use about 50% of all expenditure on healthcare, it is necessary to focus on their thriftiness and efficiency. Hospitals must work with limited economic resources and it is essential to know how to use these resources efficiently. In the last two decades we can see strong trends of hospitals integration. We now have five holdings and the last one was founded in January 2015. Annual reports were used for analysis from each hospital from 2004 to 2013, and also information from the Institute of Health Information and Statistics of the Czech Republic. Parts of the annual reports include economic and also non-economic results. This data was statistically analyzed and examined according to whether there was a significant improvement in values after integration. For example, a linear trend was used for evaluation by using a coefficient correlation and a t-test was used for statistical significance. One of the limitations of the research was that the research was based on only two specific samples existing in the Czech Republic. Other holdings have either a very short or a very long period of being integrated and therefore it is very difficult to find specific comparable information. Other limitations of this research were the choice of appropriate financial and also non-financial indicators. Results from analysis were compared with results of other published studies in other countries.
Introduction
In the Czech Republic until 1991 there was a system of financing health care by means of the state budget, but in 1992 the system was replaced, whereby health care is financed by health insurance. From this year on, public health insurance financed health care by means of payment according to performance. Hospital performance was shown in points and the value of points was derived from income and expenses of the health insurance. This unfortunately led to the pursuit of points, unnecessarily long hospital stays and of course also to a lack of financial resources for health care. From 1. 1. 1997 the Department of Health introduced a new system list of health performance, whereby the points value directly determined the charge in Koruns. In 2007 there was another fundamental change to the system and hospitals were financed by means of so-called across-the-board payments. The amount of this acrossthe-board payment was based on the assumption that the vast majority of hospital expense is fixed i.e. it is not determined by the number of patients or the number of actions undertaken. According to Gladkij et al. (2003), these expenses formed about 75 % of total hospital expenses. The amount of this across-the-board payment was established on the basis of actual performance done in the previous year.