Usporedba utjecaja ustrojbenih modela rada u djelatnosti opće medicine na kvalitetu i učinkovitost zdravstvene zaštite

professional thesis

• Title (english): Comparison of the impact of organizational models of work in general medicine on the quality and efficiency of health care
• Author: Tatjana Bekić
• Mentor: Biserka Bergman-Marković (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2018-04-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Public Health

Abstract

Dva ustrojbena modela rada, dva radno prava statusa liječnika u djelatnosti opće /
obiteljske medicine (koncesionari i zaposlenici domova zdravlja), uz dvojni način
financiranja rada u kojem koncesionari ostvaruju dohodak prema učinjenom, a liječnici
zaposlenici domova zdravlja dobivaju plaću neovisno o rezultatu rada, utječu na
efikasnost i kvalitetu provođenja zdravstvene zaštite. Cilj rada je istražiti razlike u
uspješnosti postizanja pokazatelja provođenja zdravstvene zaštite iz obveznog
zdravstvenog osiguranja ovisno o organizacijskom obliku rada liječnika. Za prikaz su
korišteni podaci iz baze podataka Hrvatskog zavoda za zdravstveno osiguranje
(HZZO) ugovorenih timovima opće / obiteljske medicine (usporedni podaci o izvršenju
provedenih dijagnostičko-terapijskih postupaka (DTP) te podaci o pokazateljima
kvalitete i uspješnosti rada definiranih od HZZO. Rezultati rada ukazuju na statistički
značajnu razliku u pokazateljima kvalitete provedene zdravstvene zaštite, obzirom na
radno pravni status liječnika (koncesionari su uspješniji u postizanju ciljanih
pokazatelja). Na takve rezultate utječe osobno zadovoljstvo uvjetovano materijalnom
stimulacijom, dobna i obrazovna struktura timova u koncesiji, ali i oprema ordinacije
što vodi prema zaključku o nužnoj reorganizaciji obiteljske medicine, radi postizanja
ujednačena kvalitete rada na području cijele Republike Hrvatske.

Abstract (english)

Two organizational employment models, two different legal employment statuses of
physicians engaged in general practice / family medicine (concessionaires or
employees of state-owned health centres), along with a dual method of financing of
the work performed, within which physicians who are concessionaires receive income
based on performance and those who are employees of state-owned health centres
receive a fixed salary regardless of the results, affect the efficiency and quality of
healthcare services. The aim of this paper is to examine the differences in the level of
success in attaining indicators pertaining to healthcare services provided under
mandatory health insurance, depending on the organizational employment model of
physicians. For the purpose of the research, we used data from the database of the
Croatian Health Insurance Fund (HZZO) for contractual teams for general practice /
family medicine (parallel data on the performed diagnostic and therapeutic procedures
(DTP) and data on the quality and success indicators as defined by HZZO). Results
obtained point to a statistically significant difference in the quality indicators of provided
healthcare services with respect to the legal employment status of physicians
(concessionaires have more success in achieving the targeted standards). These
results are influenced by personal satisfaction dependent upon monetary incentives,
age and education-related structure of concession teams, and the quality of equipment
in the office facilities, all of which points to the conclusion that family medicine urgently
needs reorganization, in order to achieve a more harmonized quality level of services
on the territory of the whole Republic of Croatia.

• Keywords: ustrojbeni modeli rada; opća medicina; zdravstvena zaštita
• Keywords (english): organizational models of work; general medicine; health care
• Language: croatian
• URN:NBN: urn:nbn:hr:105:477491
• Study programme: Title: Leadership and management of health services; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra menadžmenta u zdravstvu (sveučilišni/a magistar/magistra menadžmenta u zdravstvu)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Ključne riječi oblikovao urednik.
• Created on: 2021-05-07 08:01:06