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Efficiency change in inpatient care provision under the DRG-based reimbursement mechanism in the Czech Republic
Jakubová, Barbora ; Bryndová, Lucie (advisor) ; Votápková, Jana (referee)
Expenses on inpatient care form the largest share of Czech health expendi- ture, which raises concerns about its efficiency. Efficiency improvement belonged to one of the motivations for the implementation of reimbursement mechanism based on diagnosis-related groups, under which hospitals are paid a fixed amount per hospital case. This thesis contributes to the existing literature on DRG by assessing the changes in efficiency of inpatient care under DRG in the Czech Republic, focusing on the length of stay as a measure of resource utilization as well as an indicator of hospital efficiency. Furthermore, it contributes to this topic by using a unique and relatively large dataset containing patient-level information from 15 Czech hospitals over 2015-2019. Employing models for count data, we observe the downward trend in length of stay over the examined period. This finding is in line with the intended effect of DRG. Moreover, the estimated result is robust when considering dif- ferent subsamples - based on hospital size (large and medium-sized) or severity level of a patient. The only group where the decline in length of stay was not estimated were the most severely ill patients with major complications and co- morbidities. Measured by the standard deviation of length of stay, the process of...
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Increasing Efficiency of Inpatient Care in the Czech Republic: ERAS Protocol Adherence in Colorectal Surgery
Hrušková, Barbora ; Bryndová, Lucie (advisor) ; Landovská, Petra (referee)
Barbora Hrušková Abstract Standardization of care is necessary to achieve more efficient inpatient care. En- hanced recovery after surgery (ERAS) protocols have proven to accelerate the recov- ery of patients, decrease lengths of stay and reduce complications. However, close adherence to the protocol is necessary to achieve the beneficial outcomes. The pur- pose of this study is to prove that higher adherence to ERAS protocol increases its efficiency by achieving lower expenses and higher productivity due to the decreased patient length of stay. De-identified dataset of patients who underwent colorectal surgery between April 2016 and March 2020 at Motol University Hospital was used for our analysis. Ordinary least squares (OLS) models were created to investigate the effect of adherence to individual items of the protocol as well as the different levels of total adherence on the length of stay. We proved that seven items of ERAS protocol are independent predictors of the length of stay. Moreover, we found an inverse relationship between the ERAS protocol adherence and the length of stay. Finally, after assigning monetary values to our results we could conclude that higher adherence to ERAS protocols provides more efficient inpatient care and contributes to cost savings in the Czech Republic.
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Integration of the Vietnamese in the Czech Republic
Kučera, Petr ; Šebesta, Karel (advisor) ; Macurová, Alena (referee)
KUČERA, Petr. Integration of the Vietnamese in the Czech Republic. Prague, 2014. Dissertation. Charles University in Prague, Faculty of Arts, Institute of Czech Language and Theory of Communication. This thesis deals with the integration of the Vietnamese community in the Czech Republic which has its specifics and significantly differs from the integration of other foreigners living in the Czech Republic. The characteristics of the Vietnamese community are for example the high percentage of those who live here on the permanent residence permit, then very low unemployment and at last the majority of the community is doing their own business on the trade licence. The other important part is the issue of the acquisition of knowledge of the Czech language. The theoretical part of the thesis firstly defines the number of Vietnamese living in the Czech Republic, historical development of this community and their characteristics. Then the thesis deals with the term of integration; this term is properly defined and the particular dimensions of integration are described as well. The end of the theoretical part describes the particular types of residences, which foreigners can obtain. The empirical part of this thesis attempts to answer the question concerning the integration of Vietnamese living in the...
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Effect of physiotherapy to reduce the length of hospital stay in patients with total hip arthroplasty: a literature review
Brůža, Miroslav ; Vilímek, Miloslav (advisor) ; Pavlů, Dagmar (referee)
Title: Effect of physiotherapy to reduce the length of hospital stay in patients with total hip arthroplasty: a literature review Objective: The purpose of this thesis is to research and compare available studies investigating the effect of extra physiotherapy in reducing the length of stay for patients with total hip arthroplasty. In addition, to make a compilation of available sources about issue of the hip, total hip arthroplasty in terms of anatomy, kinesiology and biomechanics and length of hospital stay. Methods: This diploma thesis has descriptively-analytical character and is structured in the form of literary review. Results: Physiotherapy decreases length of stay in patients with total hip arthroplasty. Future research could address a specific group of subjects and the issue of cost-effectiveness in reducing the length of hospital stay by physiotherapy. Key words: Hip joint, total joint replacement, THA, physiotherapy, length of stay
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Econometric analysis of effects of regulatory fees on length of stay in hospital
Junga, Přemysl ; Zouhar, Jan (advisor) ; Školuda, Václav (referee)
The thesis analyses the influence of reimbursement regulatory fee for hospitalization which was introduced in regional hospitals in 2009 in Czech Republic. The difference in differences analysis was used to study the possible relationship between reimbursement of the fee for length of hospitalization in acute care hospitals and in after-care facilities. In acute care the influence was 0,5-1 % of the length and in after-care facilities between 8-12 %. This relationship may be biased because of introduction of DRG system which may decrease the length of stay and may be differently distributed between the treatment and control groups.
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The analysis of influence of reimbursement regulatory fee in regional hospitals on the length of stay.
Junga, Přemysl ; Bolcha, Peter (advisor) ; Bartoň, Petr (referee)
The thesis analyses the influence of reimbursement regulatory fee for hospitalization which was introduced in regional hospitals in 2009 in Czech Republic. The difference in difference analysis was used to research the possible relationship between reimbursement of the fee and length of hospitalization in acute care hospitals and in after-care facilities. In acute care the influence was 0,5-1 % of the length and in after-care facilities between 8-12 %. This relationship may be biased because of introduction of DRG system which may decrease the length of stay and may be differently distributed between treatment and control group.
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