Utjecaj promjena u načinu plaćanja bolnica na promjene u poslovanju bolničke zdravstvene zaštite u Republici Hrvatskoj

professional thesis

• Title (english): Impact of hospital payment methods on hospital care performance in Republic of Croatia
• Author: Dubravka Pezelj Duliba
• Mentor: Aleksandar Džakula (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2018-10-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Public Health

Abstract

Zbog visokih troškova bolničke zdravstvene zaštite, odnosno značajnog udjela troškova
za bolnice u troškovima ukupne zdravstvene zaštite, financiranje bolnica je ne samo jedan od
najvećih izazova zdravstvene politike i zdravstvene ekonomike, već sustava zdravstva i
pojedine države u cijelosti.
Kako bi se razjasnilo jesu li i na koji način promjene u načinu - metodama plaćanja
bolnica utjecale na poslovanje bolničkog zdravstvenog sustava Republike Hrvatske, analizirane
su administrativne i organizacijske promjene bolničkog zdravstvenog sustava, promjene
financijskih i naturalnih pokazatelja, te reformske promjene koje su mogle utjecati na
poslovanje bolnica.
Utvrđeno je da je način plaćanja bolnica utjecao na poslovanje bolnica no ne u značajnoj
mjeri osim u dijelu izvan limitnih stavki (transplantacije, eksplantacije, intervencijska
kardiologija, intervencijska neurologija), međutim značajan utjecaj imale su administrativne
mjere koje nisu bile isključivo usmjerene na bolnice, vezane uz udio sudjelovanja u cijeni
bolničke zdravstvene zaštite.
Na poslovanje bolnica značajan utjecaj imaju demografske promjene osobito starenje
stanovništva koje dovodi do promjene strukture pacijenata u bolnicama, kao i promjene
zdravstvene tehnologije.
Način plaćanja po slučaju, može se koristiti za usporedbu bolnica, praćenje
učinkovitosti i nadzor izvedbe bolnica.

Abstract (english)

Due to the high expenses of hospital health care and the significant share of hospital
spending in total health care expenditures, funding hospitals is not only one of the major health
care challenges, but of overall health system and state as a whole.
In order to clarify whether and how the changes in the way the hospitals are paid,
influenced the performance of the hospital health system of the Republic of Croatia, the
administrative and organizational changes of the hospital health system, the change of financial
and natural indicators, and the reform changes that could have influenced hospital business have
been analyzed.
It has been found that methods of hospital payment did not significantly affected the
hospital's performance, except in the case of targeted activities payed above the hospital budget
ceiling e.g. organ transplantation, organ harvesting, interventional cardiology and
interventional neurology. Significant impact had administrative measures that were not
exclusively directed at hospitals i.e. co-payment in the price of hospital health care.
Significant impact on hospital performance have demographic changes, particularly the
aging of the population, which results in a change in structure of hospital patients, as well as
changes in health technology.
The method of payment per case can be used for hospital benchmarking, and for monitor
hospital performance.

• Keywords: bolnička zdravstvena potrošnja; plaćanje bolnica; financiranje bolnica; poslovanje bolnica; korištenje bolničke zdravstvene zaštite
• Keywords (english): hospital care expenditures; paying hospitals; financing hospitals; hospital performance; hospital care use
• Language: croatian
• URN:NBN: urn:nbn:hr:105:074117
• 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
• Created on: 2021-05-10 07:24:46