Problemy Zarządzania - Management Issues
ISSN / EISSN : 1644-9584 / 1644-9584
Published by: University of Warsaw (10.7172)
Total articles ≅ 627
Latest articles in this journal
Problemy Zarzadzania, Volume 2/2020, pp 29-48; https://doi.org/10.7172/1644-9584.89.2
Purpose: The objective of the paper is to review historical developments and the current setup of healthcare financing models in Central Europe. Methodology: A systematic narrative approach has been taken with the research emphasis on a critical literature review and analyses of healthcare spending statistical data. Findings: A comparison between different models currently in place seems to suggest the existence of patterns leading to improved quality of the healthcare service proposition that is critically impacted by a financing model. Implications: The findings have practical implications since different results have been achieved in countries choosing different models but starting from practically the same point. That realisation should serve as a foundation for further work on this subject, potentially leading to adjustments to financing models chosen by some countries. Value: The paper offers a comparative analysis of the healthcare system financing evolution in four Central European Countries and an overview of their current state.
Problemy Zarzadzania, Volume 2/2020, pp 67-83; https://doi.org/10.7172/1644-9584.89.4
Purpose: Changes in the health care system introduced in the fourth quarter of 2017 with the entry into force of the so-called “Hospital networks” constituted a huge challenge for managers of medical entities. The assumption of this work is to present, based on the example of the provincial hospital in Łódź, how the changes in legal regulations introduced over the last few years have influenced the financial condition of the institution and its organization. Design/methodology/approach: The financial results of the audited entity were analysed from 2014 to 2019. The most important legal changes (mainly the implementation of the hospital network) as well as their impact on the income from the National Health Fund (NFZ) are presented. The probable (expected) financial result for 2019 is estimated. Findings: From 2014 to 2016, there was a systematic increase in revenues from the NFZ and a positive financial result (about 10 million a year). From 2017, along with the Act on basic hospital security, there was a reduction in profits. Medical staff strikes (payroll claims) in the second half of 2018 additionally contributed to the reduction of revenues from the NFZ. As a consequence, it was necessary to implement, from 2019, a series of corrective actions aimed at reducing costs and increasing savings (employment reduction, organizational changes). Research limitations/implications: Implementation of cost-reducing measures.
Problemy Zarzadzania, Volume 2/2020, pp 151-169; https://doi.org/10.7172/1644-9584.89.9
Purpose: The purpose is to assess the level and quality of e-communication of Szczecin’s entities providing hospital care and to compare the results in order to determine the differences and to indicate the changes occurring over time. Design/methodology/approach: The analysis covered the contents of the websites of all hospitals in Szczecin in 2014 and 2018. The desk research was carried out in the form of expert method done on the basis of the assessment criteria important from the patient’s point of view, treating the hospital’s website as a communication channel. These included identification issues, legibility, usefulness of information, forms of contact and modern e-communication. Findings: The level of communication differs a lot. It is slightly higher than in the past, but given the real needs in this respect, is not satisfactory. The best evaluation results concern the issue of identification of the entity. The situation is bad as regards the possibility of communication and the use of modern forms of e-communication. Only some of the hospitals have developed in the field of e-communication with the patient in a noticeable way, the rest have achieved little compared to the previous research period. Research limitations/implications: The study only focused on hospitals in the city of Szczecin. To get a complete picture, the analysis should cover the content of other hospitals’ websites from various localisations – bigger and smaller, more and less known. In order to understand the situation in the whole healthcare sector, it would be worth looking at other medical service providers. Originality/value: The conducted research shows how poorly developed are modern communication tools in hospitals, at the same time indicating the development directions in this area. The defined criteria can be applied to the study of websites of various providers on the healthcare market.
Problemy Zarzadzania, Volume 2/2020, pp 49-66; https://doi.org/10.7172/1644-9584.89.3
Purpose: The main goal of the paper is to investigate the association between poverty and health and to assess the Polish NUTS-2 level differentiation with time points of the analysis set for 2013 and 2018. Design/methodology/approach: In order to collate poverty and health state, two separate data sets have been created, consisting of determinants that describe the various aspects of combined phenomena, differentiated among Polish regions. We use data on poverty and health across Polish voivodships. Our data sets are obtained from Local Data Bank (LDB) of the Polish Central Statistical Office (CSO). On the basis of the proposed indicators, the multidimensional character of the phenomena is examined, and the degree of their intensity and changes in tendencies over time are assessed. Health State Index (HIS) and Poverty Index (PoI) individual measures were further compiled in the development matrix. Findings: The results indicate a link between health and poverty at the regional level, while the usage of the development matrix technique allows the assessment of opportunities and threats for selected spatial units. The results confirm both positive as well as negative changes in indices levels in the analysed period. Moreover, the strength of this relationship decreases slightly over the selected time points. The identified changes originate mainly in recorded levels of poverty, while the situation of spatial objects in 2018 (compared to 2013) deteriorates mainly due to reasons related to the state of health. Research limitations/implications: Because of the design of the development matrix, it is not advised to use the technique for a high number of objects/units. The proposed approach could give certain information on the rate of changes, indicating the increases/decreases in the combined indicator levels. Although the results are summarised by an image of coordinates in the development matrix space diagram, the identification of a unique object might be limited. Hence, only overall tendencies, like for the correlation scatterplot, could be illustrated by the graph. However, this does not diminish the importance of this technique, and by applying appropriate sampling, the in-depth study of both poverty and health state could be easily achieved. Originality/value: The research study assumed to use several groups of indicators for the construction of synthetic indices. The proposed measures highlight a multidimensional concept of the analysed phenomena. The research can be an example of a supportive tool for planning regional strategies that are aimed at improving the health condition or reducing poverty intensity.
Problemy Zarzadzania, Volume 2/2020, pp 84-102; https://doi.org/10.7172/1644-9584.89.5
Purpose: The aim of the paper is to analyse the activity of medical companies operating in the Polish capital market through the analysis of their investment attractiveness. Two measures taking into account two different perspectives were used for efficiency evaluation: financial-internal (EVA) and external-market (TSR). Design/methodology/approach: Two measures of evaluation of financial and market results of medical companies were used to achieve the aim of the paper. These two measures take into account two different perspectives: financial-internal (EVA) and external-market (TSR). Economic value added (EVA) is based on a preconception that maximisation of the value of an enterprise is the best possible way to increase competitiveness. The second formula, Total Shareholder Return (TSR), measures shareholder value creation in the most direct way: not only shareholders’ value but also their wealth. The second part of the paper focuses on the characteristics of the private medical sector in terms of the family influence on the functioning of the selected companies. The Substantial Family Influence indicator proposed by S. Klein was used, which determines the level of ownership and the involvement of the family in the researched companies. Findings: The analysis of the results of the examined group of medical companies, using two different measures from two different perspectives, shows different results. Hence, it is difficult to determine which of the examined companies is an attractive investment – a reliable source of income from investment. The second part of the paper identifies the listed medical companies in terms of their family nature. The SFI index was used, in which the participation of family members in management boards and supervisory boards was additionally taken into account. The calculations allowed for identifying four family businesses, one of which, Enel-Med, may be specified as a company with a significant family impact. The EVA measure was used for comparison of the financial results obtained by the companies, dividing them into family and non-family enterprises; however, no differences have been observed between the groups. The findings obtained do not confirm that family businesses achieve better financial results. Research limitations/implications: The private medical market is going to develop and may be attractive from the point of view of investors not only for patients. Globalisation of the market, emergence of big businesses and, the need to consolidate the sector make it necessary for the Polish medical companies to search for external sources of financing and to enter the stock market. Hence the question whether investing in capital medical companies is profitable. The paper looked for the answer by conducting research on 19 companies and their financial results from 2016 and 2017. Two measures were used, taking into account two different perspectives: financial-internal (EVA) and external-market (TSR). The results obtained were different, so it is difficult to determine which of the examined companies is an attractive investment – a reliable source of income from investment. In light of this, it is worth considering whether the analysis carried out in the long term or with the use of other indicators would give more unambiguous results. Originality/value: The aim of the paper is to analyse the activity of medical companies operating in the Polish capital market through the analysis of their investment attractiveness, which is a new approach in the assessment of the operation of the private medical sector. Also, the analysis of the private medical sector, taking into account the influence of the family and using the SFI indicator on the functioning of individual companies, is an original approach.
Problemy Zarzadzania, Volume 2/2020, pp 103-120; https://doi.org/10.7172/1644-9584.89.6
Purpose: Some of the common diseases are the comorbidities of rare diseases and they impose a considerable economic burden on the national health care system and economy. We examined the economic burden of a rare disease (tuberous sclerosis complex – TSC) in Poland and its comorbidities (common diseases – epilepsy and status epilepticus) while taking into account a sensitivity analysis. Design/Methodology/Approach: This study is a prevalence-based top-down cost of illness study that analyzes the direct and indirect cost of TSC and its complications. The research was based on the data obtained from the National Health Fund (hereinafter referred to as “NFZ”, which is the abbreviation of the source language name of the institution), Social Insurance Institution (hereinafter referred to as “ZUS”, which is the abbreviation of the source language name of the institution), and Poland’s Central Statistical Office (hereinafter referred to as “GUS”, which is the abbreviation of the source language name of the institution) by using the human capital method. Findings: The total cost of TSC and its complications in Poland, when taking the sensitivity analysis into account, amounts to EUR 2.2 million – EUR 3.4 million, which has a prevalence of indirect costs (61%–83% of the total costs). The conducted analysis indicates that the higher costs of common diseases result from insufficient financing for research of rare diseases which in many cases have common diseases as a comorbidity. Research limitations/implications: The limitations of the research analysis result from the lack of registration of patients suffering from rare diseases in Poland and from the requirements for the billing codes in the documentation of NFZ and Polish health care providers. Therefore, the study includes a sensitivity analysis. Originality/value: This is the first attempt to evaluate the total economic burden of TSC in Poland. The study indicates that the indirect costs of diseases are often overlooked in health care planning in Poland.
Problemy Zarzadzania, Volume 2/2020, pp 11-28; https://doi.org/10.7172/1644-9584.89.1
Purpose: The submitted article focuses on how to solve the problems faced by the European healthcare systems. Design/Methodology: The article consists of two sections. The first one is theoretical and presents interdisciplinary achievements of researchers. The second section includes examples of solutions applied in Sweden, Germany and Great Britain. In the theoretical part, books and articles on the methodology of VBHC creation were reviewed. The empirical part is based on reports on the introduction of VBHC. Findings: The desire to improve cost and clinical effectiveness indicates the need for a value-based healthcare (VBHC). Thus, the concept of VBHC should contribute, according to experts, economists as well as finance and management specialists, to the economic efficiency and clinical effectiveness. Research limitations/implications: Unfortunately, this is a lengthy process to be preceded by many activities. Healthcare registers and databases belong to the most important ones. Thanks to them, it is possible to create the key performance indicators (KPI) allowing for a rational health policy. Original value: To the achievements contained in the publications, the submitted article adds the need to take into account appropriately selected KPIs analyzing the macroeconomic environment for the functioning of hospitals.
Problemy Zarzadzania, Volume 2/2020, pp 139-150; https://doi.org/10.7172/1644-9584.89.8
Purpose: The aim of the article was to show the impact of privatisation on the forms of employment of medical staff on the example of the poviat hospital. The proper functioning of any organisation, including a healthcare entity, requires having and maintaining the staff capable of guaranteeing the implementation of its objectives. Design/methodology/approach: The article uses the following research methods: a literature review, the method of economic analysis, qualitative and quantitative analyses and the method of deduction in the inference phase. Findings: The results of the research are the basis for the conclusions supporting the validity of introducing the possibility of concluding subcontracts with medical staff, which allows entities to flexibly organise work in the situation of a shortage of physicians. Research limitations/implications: This is associated with certain financial implications, but at the same time it is more efficient in terms of using the existing human resources and it gives greater opportunities to provide a higher quality of medical services to more patients. Originality/value: The privatisation process in the Polish healthcare sector seems to have been necessary and it has shown that it is worth undertaking such measures, if for no other reason than to improve patients’ treatment standards. The results of the research carried out in this field show that transforming hospitals into private institutions is a good move.
Problemy Zarzadzania, Volume 2/2020, pp 121-138; https://doi.org/10.7172/1644-9584.89.7
Management of the National Drug Administration Through the Use of Biosimilar Medicines. Expenditures, Numbers of Reimbursed Packages and Shares of Biosimilar Products in the Infliximab Market a Year Prior to and a Year after the Introduction of the National Drug Policy 2018–2022
Problemy Zarzadzania, Volume 2/2020, pp 11-33; https://doi.org/10.7172/1644-9584.88.1
Purpose: The paper seeks to demonstrate that genocide is not a phenomenon marginal to the world of management and organizations, but one from which these disciplines stand to learn a lot and one to which they must contribute their own insights. Approach: A historical and sociological review of some of the voluminous literature on genocide and the Nazi Holocaust. Findings: Genocide is a highly organized process, requiring bureaucratic resources to initiate, sustain and, often, cover it up. It generates resistance and compliance, it makes use of material and social technologies, it is imbued with its own cultural values and assumptions and calls for its own morbid innovations and problem solving. Genocide requires the collaboration of numerous formal organizations, including armies, suppliers, intelligence and other services, but also informal networks and groups. Limitations: Given the vast literature on genocide and the Nazi Holocaust, obviously only a small sample of crucial texts were reviewed and cited. All the same, they are enough to demonstrate that democide is not carried out by sadistic maniacs or by impersonal bureaucrats in line with the banality of evil hypothesis. It is carried out by organizational members, managing and problem-solving realities whose horrors do not impede them in their decision making. Practical implications: At the same time, the authors argue that genocide cannot be studied outside historiography and that doing so leads to all kinds of gravely mistaken conclusions, even when theorized by distinguished scholars like Arendt and Bauman. Originality: The article debunks some widely espoused theories of genocide, including the adiaphorization and banality of evil theses.