Šárka Papadaki

Cost Analysis of Selected Patient Categories Within A Dermatology Department Using an ABC Approach

Background: Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. Methods: The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. Results: The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Conclusions: Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB).

Comparative analysis of perception of advantages and disadvantages of integration of hospitals

Integration and strategic alliances of companies represent a rapidly growing phenomenon in all industries. Also the integration and consolidation of healthcare organizations are not unusual themes in professional resources. The specialists observe especially a vertical and horizontal integration of hospitals and its infl uence to the increase of an effectiveness of healthcare provision. The results of these studies, however, do not conclusively prove the impact of all kinds of integration of hospitals to their effi ciency and effectiveness growth. The present article focuses on horizontal integrated hospitals in the Czech Republic and the perception of advantages and disadvantages of integration of the hospitals by hospital managers themselves. The main aim of the research was to answer following research questions: Does the perception of advantages and disadvantages of participation in integration depend on the length of integration´s lifetime? Does the perception of advantages and disadvantages of participation in integration depend on the kind of integration? Regarding the overall view of the trend of integration, hospital managers see integration as promising. Further, the research results revealed that based on the research sample, we cannot unequivocally confi rm a statistically signifi cant difference between the two studied types of integration (holding and mergers). A statistically signifi cant difference in the perception of the overall view of the advantages of integration also cannot be confi rmed given a length of involvement in holding or merger. Overall, the hospital sees as disadvantages particularly the reduction of autonomy, the increased diffi culty of promotion of changes and communication problems. As for the benefi ts, 93% of hospitals evaluated that the integration gives them a better negotiating ability with suppliers, 80% of hospitals noticed better negotiating ability with health insurance companies and about 80% report that there has been a reduction in costs.

The maturity of a budgeting system and its influence on corporate performance

In recent decades, the features making up corporate budgeting systems have been profoundly deliberated over by academics and professionals. Indeed, so-called traditional methods of budgeting have borne the brunt of severe criticism due to their inflexibility and the sheer amount of time they demand of employees. Nonetheless, several examples exist of budgeting systems that have somehow been transformed, and of organizations which have adopted advanced, flexible budgeting procedures based on evaluation of performance. In the study presented, the authors look into any relationships that may exist between the primary elements of corporate budgeting systems and their performance in the enterprise. The aim is to contribute towards existing knowledge by: 1) summarizing the latest advances that relate to budgeting and corporate performance; 2) reporting on current budgeting practices applied by companies in the Czech Republic, with analysis of how budgeting systems affect managerial behaviour; 3) evaluating any statistical dependence between selected features of corporate budgeting systems; i.e. utilizing a budget as a managerial tool, how enterprises express the added value of budgeting systems, endeavour on the part of management in implementing an effective budgeting system, the workload pertaining to individual components of a budgeting system, and the significance of a budgeting system in comparison with other tools designed for adapting to change in market conditions. In general, the study describes interconnections between the profit-based performance of firms and the majority of the factors and features of the budgeting systems examined.