|
|
Cost Analysis of Health Care of Outpatient Providers Employing Risk-adjustment
Jandová, Pavlína ; Tulejová, Henrieta (advisor) ; Paulus, Michal (referee)
The aim of this thesis is to investigate ways of assessing economic efficiency of outpatient health care providers. It analyzes feasibility of employment of risk-adjustment and profiling in the Czech Republic using administrative data reported to health insurance company in the field of otorhinolaryngology. First, the thesis provides an overview of economic profiling methods. Out of these, indirect standardization of costs with risk-adjustment on patient level was used in the empirical part. Next, methods addressing specific problems of health care data (in particular, skewness, excess of zero values and non-negativity) are explored. Using OLS on logarithms on positive part of the distribution, three representations of costs were estimated, based on selected risk-factors. Several patient factors proved significant in final models (specifically, age, gender, number of hospitalizations, region of residence and chronic conditions asthma, COPD and depression), however, the quality of the model is extremely poor. Reasons for dissatisfactory fit of models are various. We conclude that data-selection process is not appropriate to perform economic comparison. And care of outpatient otorhinolaryngology is extremely specific to be captured by information provided. Still, profiling of providers is performed...
|
|
|
Behavioral economics and motivating patients to take care about their health: the case of hemodialysis patientes
Kučová, Petra ; Tulejová, Henrieta (advisor) ; Bryndová, Lucie (referee)
Imperfect patient adherence to treatment leads to adverse individual and social outcomes: it has negative effect on patient health and, consequently, it increases health care costs. The adherence is low particularly in chronically ill patients with complex regimen, such as hemodialysis. This thesis provides an in-depth study of the phenomenon and presents a survey targeted at hemodialysis patients in the Czech Republic. The survey assesses prevalence of nonadherence, identifies predictors of nonadherence, and analyzes patients' attitude to a hypothetical incentive program to promote adherence. Then, an optimal design of an intervention to promote adherence is discussed. Results show that 72% of patients do not adhere to one or more areas of hemodialysis treatment. Prevalence of nonadherence is highest for following fluid restrictions (62.8%) and diet guidelines (55.7%). On the contrary, medication and appointment nonadherence is not frequent. Strongest predictors for nonadherence are: young age, male sex, treatment for depression, number of prescribed pills, and length of dialysis treatment. Most of patients (83%) indicated that they would change their behavior when involved in an incentive program to promote adherence. With regard to broad prevalence of nonadherence, an intervention targeted at...
|
|
|
Long-term financial sustainability of health care system in Czech republic
Lukešová, Zuzana ; Tulejová, Henrieta (advisor) ; Kvaček, Jan (referee)
1 Abstract The aim of diploma thesis is searching for solution of long-term sustainability for health care financing in Czech Republic with respect to future demographic development of Czech population and with respect to development of other factors influencing income and expenditure of health care system. After introduction there is the second chapter that describes evolution and current state of Czech health care system. The third chapter deals with historical progress of income and expenses on health care in Czech Republic and adds an international comparison. The chapter four identifies main motives for future change of Czech health system financing. The chapter five shows inspiring examples how health care financing works in Netherlands, Switzerland and Germany. The sixth chapter describes basic aspects, advantages and disadvantages of introducing nominal premium to Czech health insurance system. In chapter seven there is a summary of process of introducing nominal premium and results of model of future income from reformed health insurance for year of nominal premium introduction - 2015. The basic outcome of model is fact that nominal premium introduced in amount of 725 CZK per month per person can bring additional finance to health care system in amount of 31 505 bil. CZK in despite of replacing...
|
|
|
Changes in Hospital Financial Performance after Legal Form Conversion
Jankura, Adam ; Votápková, Jana (advisor) ; Tulejová, Henrieta (referee)
This thesis examines the effect of corporatization, i.e. pure legal form conversion of contributory organizations into joint-stock companies, on financial performance of 77 Czech non-privatized general hospitals during 2001-2011. Using differences-in-differences estimation the effect on overall financial performance was not confirmed. Regarding individual performance components different changes in revenues and costs per inpatient day (relative to non-corporatized hospitals) were recognized after different corporatizations periods. Both revenues and costs measures either increased or decreased after 2003 & 2004 and 2005 corporatization respectively; and were maintained after 2006 & 2007 period. Ambiguous effect of corporatization on financial performance is consistent with the principal-agent theory developed in this thesis. JEL Classification C51, G32, I11, I18, L20, L32 Keywords financial performance, hospitals, panel data analy- sis, Czech Republic Author's e-mail adam.jankura@gmail.com Supervisor's e-mail jana.votapkova@gmail.com 1
|
|
|
Health Systems in Transition: Priorities, Policies and Health Outcomes
Borisova, Liubov ; Tulejová, Henrieta (advisor) ; Bryndová, Lucie (referee) ; Nivorozhkin, Eugene (referee)
The dissertation deals with the links between health care systems and health outcomes in the so-called 'transition' countries. The main questions to be addressed are: ''Do health care systems and their transitions influence health outcomes in the transition area and i f they do - how?" The combination o f qualitative techniques and econometric methods allowed for a creation o f the structural classifications o f the health care systems in transition and produced important findings. Firstly, health care transitions, and especially their structural component, are found to be significant in determining health status in the CEE and CIS countries. Secondly, however, the socio-economic determinants o f health were established to also play a major role in determining health inequalities in the transition area. Powered by TCPDF (www.tcpdf.org)
|
guest ::
