Comparison of horizontally integrated hospitals in private and public sectors of Czech Republic

This article presents the results of the research undertaken at the Faculty of Management and Economics, Tomas Bata University in Zlin. The research focuses on the efficiency of the healthcare system. One of the goals was to compare the efficiency of private horizontally integrated hospitals and horizontally integrated hospitals owned by county, town or municipality. To evaluate the efficiency the Data Envelopment Analysis method was used, which is a benchmarking method applied to measure the efficiency of homogeneous organisational units. When undertaking such measuring it is crucial to assume that inputs are minimalised and outputs are maximised, i.e. outputs must bring a positive result while inputs must be as low as possible. Even though the research did not prove that either private horizontally integrated hospitals or horizontally integrated hospitals owned by the county, town or municipality to be more efficient than the others, the results are valuable as they point at specific options for increasing the efficiency of individual hospitals

Horizontal integration of hospitals - Does it have an impact on their effectiveness?

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. (C) 2016 Published by Elsevier B.V

The reducing hospital costs through horizontal integration

Background: This paper investigated the impact of hospitals' horizontal integration in the Czech Republic on the cost behavior. The aim of the research was to examined the hospitals costs in specific environment of region hospitals at NUTS 3 level (Nomenclature of Units for Territorial Statistics) – Administrative Regions. Methods: The survey was conducted in the period from April to August 2016 in the Czech Republic. The research was divided into two parts. The first part was based on data obtained from the Institute of Health Information and Statistics of the Czech Republic. We used Statgraphics Centurion XVII for the descriptive statistics and data visualization. Second part of the results was obtained through a survey research focused on managers of the horizontal integrated hospitals and their experiences with the cost behavior. Results: The results from statistical survey showed that up to 80 percent of the observed region hospitals at NUTS 3 level, the cost of treatment for a patient per day has decreased after integration into an association. Based on primary survey, 73% hospital managers confirm these results and see one of the advantages that it is possible to reduce costs through integration of hospitals. The largest savings, according to hospital managers, are due to central purchasing and investments, together and they have a better negotiation position with suppliers. Conclusion: We can confirm that horizontal integration of hospitals can lead to reduction of costs and higher efficiency, in the specific environment of region hospitals at NUTS 3 level. © 2019, Iranian Journal of Public Health. All rights reserved

Efficiency comparison of integrated and independently managed hospitals: A case study of central bohemia

This paper discusses the issues concerning the efficiency of integrated and independently managed hospitals in a selected region of Czech Republic -Central Bohemia. A DEA method was used to evaluate the efficiency for both. The subjects of the analyses are 5 hospitals which are part of one holding and 7 other hospitals in the same region, managed independently. © Petra Vrbova, Vaclav Cempirek, Jiri Alina, 2016

A comparison of economic and non-economic efficiency of private and public hospitals in the Czech Republic

This article found the answer to the question whether the ownership is a factor influencing hospital effectiveness. One of the goals of the research was to compare the efficiency of private hospitals and public hospitals. The research was focused on all the 188 hospitals in the Czech Republic. There was a comparison of economic efficiency indicator (economic outcome) and comparison of non-economic efficiency indicators (bed usage in days and average duration of stay). For comparison of effectiveness of public and private hospitals, the two-sample t-test for equal means, the statistical program SPSS was used. Since the P-values are greater than the significance level (0.05), we cannot reject the null hypothesis for the following factors of effectiveness: economic outcome and bed usage in days. According to the research results, we can confirm that there are differences in effectiveness measured by indicator 'bed usage in days' between public and private hospitals. © 2020 Inderscience Enterprises Ltd

Comparison of managerial implications for utilization of variable costing and throughput accounting methods

The aim of the paper is to compare the principles, information outputs and consequent managerial implications of the variable costing method and throughput accounting, according to their different perceptions of cost variability. These two approaches could give rise to various product mix decisions and findings relating to effect on profitability. The paper also provides a practical example of limitations experienced on two production lines for certain items. Comparison is made between these two approaches as to which elicits a relevant decision on production mix. Both the variable costing method and throughput accounting represent very similar methods based on variable costs that do not reflect fixed costs. Variable costing methods examine costs that change in accordance with volume of output. On the contrary, throughput accounting merely acknowledges total variable costs, and focuses on limitations which exist in a given company. © 2016, Institut za Istrazivanja. All rights reserved.GACR, Grantová Agentura České Republik

Measuring diagnosis and patient profitability in healthcare: Economics vs ethics

Th is paper focuses on issues relating to gauging profi tability under circumstances in Czech healthcare organizations. At present, the trend in healthcare management is for more frequent utilization of advanced economic and cost accounting tools. Th ese qualitatively improve the decision- making process in healthcare establishments, as well as aiding provision of accurate data on the cost and revenue of the outputs of hospital organizations, such as the various diagnoses and types of patients. Herein the authors present analysis of the profi tability of such patient and diagnose- types (DRG) in selected hospital departments of Czech regional hospital. Revenue from insurance payments is compared with costs calculated via the Activity-Based Costing method so as to discern more accurately the proceeds of a given DRG and patient. Th e results of the study highlighted crucial diff erences between the income generated by individual cost objects (i.e. patients and DRGs). Utilizing such information could greatly benefi t decision-making and enhance cost eff ectiveness of the hospital services. However, any healthcare establishment worldwide is strictly curtailed in this by the ethical standards it must uphold when making decisions on potentially raising profi tability. Th e fi nal part of the study discusses the fi ndings of the profi tability analysis performed by the authors in the given context of general healthcare organizations management. © 2015, Economics and Sociology. All rights reserved

Performance measurement in a transitional economy: unfolding a case of KPIs

Purpose The purpose of this paper aims to make contributions to the debate on “performance measurement in practice” focussing on how organisational participants respond to the “new regime” of key performance indicators (KPIs) and whether KPIs materialise as intended in a transitional economy. Design/methodology/approach Inspired by the epistemological instruction of Schatzki's practice theory, this paper draws on qualitative data collected through face-to-face interviews, observations and documentary analysis of a single organisation. Findings KPIs were introduced at PK (a manufacturing concern in Czech Republic) but widely seen as contradictory, inconsequential, top-down and unrealistic. These lead organisational participants to adopt a pragmatic approach towards PM embracing KPIs' subjective assessment and manipulation, common sense or doing the job as given, and superficial compliance (symbolism). Research limitations/implications The paper would be interesting to researchers because of its explanation of performance measurement practice in a distinct empirical setting, for its application of a practice theory inspired by Schatzki, and for inspiring new research agendas in transitional economies. Practical implications The paper recommends the mobilisation of artefacts, such as various forms of bottom-up discussions, to encourage interactions between organisational members and influence individual beliefs and practical understandings of the intended managerial projects. Originality/value The paper has focussed on “organisations of practice” to unravel the “doings” of organisational participants to explore the micro-processes of PM which otherwise would have been ignored. These “doings” and “sayings”, linked by pools of understanding, rules or instructions, and a teleoaffective structure, enabled the authors to unmask inherent tensions and contradictions in a new regime of performance measures such as KPIs

The amount of excise tax and its effect on the consumption of alcohol and cigarettes in European countries

BACKGROUND: Tobacco smoking and alcohol consumption are widespread practices that are legal and socially accepted in many societies. One of the common tools to reduce the consumption of these legal drugs is increasing prices. The prices for customers include taxes (value added tax and excise tax). Hundreds of studies from around the world are interested in the impact of taxes and prices on the demand for tobacco products. This topic is also relevant for governments of all countries trying to regulate consumption. AIM: The aim of the paper is to describe the amount of excise tax on legal drugs (alcohol, cigarettes) and compare their consumption in Europe and the countries of the European Union. METHODS: The sources of data for this research were publicly available from the World Health Organization (WHO), Global Information System on Alcohol and Health (GISAH), Tax Foundation, and Eurostat. In the paper selected scientific methods are used (analysis, synthesis, induction, and deduction). For the literature review Scopus and Web of Science (WoS) were used. SAMPLE: Data from Europe was used to examine alcohol and its taxation; a total of 31 countries were examined. All 27 countries of the European Union were examined for the assessment of cigarette consumption and its taxation. RESULTS: The overview shows that low taxation can lead to high alcohol consumption (Estonia, France). On the other hand, even relatively high taxation may not lead to low alcohol consumption (Germany, Slovenia, Czechia, and Austria). However, a very high excise tax can lead to a reduction in alcohol consumption, for example in Norway, Iceland, Sweden, and also in Finland. In Finland and Denmark, it was confirmed that a high excise tax (Finland €6.14 and Denmark €5.27) leads to lower consumption of cigarettes (Finland 9.9% and Denmark 11.7%). In Bulgaria the data shows that a low excise tax (€1.81) leads to a large number of people who smoke cigarettes daily (28.7%). As many as 12.9% of people smoke more than 20 cigarettes a day, which is the highest value in the European Union. If we compare it with the average (6%), it is a very high value. CONCLUSIONS: In many countries, e.g. Finland, Bulgaria, Sweden, Denmark, Norway, and France, it has been confirmed that the amount of consumption tax leads to greater or lesser consumption of legal drugs (alcohol, cigarettes)

A comparison of efficiency of hospitals in the individual regions of the Czech Republic

The main goal of this paper is to compare the efficiency of health care in the individual regions of the Czech Republic. Key consideration is given to the efficiency of hospitals for these subjects account for more than half of the health care expenses. The DEA method, precisely the input-oriented CCR, was chosen for the analysis. This method allows for the evaluation of several inputs and outputs. For the purpose of our research, we utilized one output, i.e. the number of hospitalized patients, and on the other hand, we examined several inputs, i.e. the number of beds, operating costs and the number of physicians. The analysis showed that the Královehradecký region is the least efficient and, on the other side of spectrum, there are 4 efficient regions - Karlovarský, Ústecký, Vysočina and Zlínský. The level of efficiency in other regions varies between 79,4 % and the above-mentioned 100%. Looking at the structure and the number of hospitals in the regions, we cannot see any significant correlation so we cannot say that efficiency is correlated to the number or structure of hospitals in any given region