Comparison of Horizontally Integrated Hospitals in Private and Public sectors of Czech Republic

Abstract

(ProQuest: ... denotes formulae omitted.)IntroductionHealthcare economy in general and in particular increasing the efficiency in healthcare are currently largely discussed topics. Amongst the most frequently used terms in this context are effectiveness, economy, efficiency, profitability, expediency and prosperity. The efficiency of healthcare is in the interests of not only individual state governments and specific healthcare organisations but it is also widely discussed at the international level as well. One of the strategic goals set by the World Health Organisation is the development of fairer and more efficient health systems, which will be affordable for all people and will respond to their actual needs. This goal was also set by the Ministry of Health of Czech Republic which included it into the National Strategy - Health 2020 (Ministry of Health of Czech Republic, 2014).Integrating hospitals and other healthcare organisations appears to be a perspective trend from the viewpoint of efficiency. Integration can be characterised as the interlinking of individual organisations with the aim of mutual partnerships that will bring advantages to all parties.According to Matysiewicz (2011), healthcare services market is predisposed to integrate itself. This flows from the following reasons:* the structure of the healthcare sector is rather dispersed,* for a long time centres within the public sector were not independent and were not in competition with one another,* the structure of patients' needs and the restrictions in centres' resources are essential factors forcing them for mutual partnership,* system solutions in health protection take into consideration the possibilities of integrating small medical centres as well as private doctors' practices.Same as in other economy's spheres, two basic types of integration can be identified in the healthcare system:a) Horizontal integration - coordination of activities across operating units that are at the same stage of patient services delivering (Pan American Health Organization, 2008). These tendencies are described in many scientific articles, e.g., by Hernandez (2000); Ocampo-Rodriguez et al. (2013),b) Vertical integration - coordination of services among operating units that are at different stages in the process of delivering patient services (Pan American Health Organization, 2008). Vertical integration in healthcare is debated, for example, by Hernandez (2000); de Albuquerque et al. (2011); Byrne & Ashton (1999).The aim of the research conducted by the Faculty of Management and Economics at Tomas Bata University in Zlin was to compare the efficiency of private horizontally integrated hospitals and horizontally integrated hospitals owned by the county, town or municipality.The contribution consists of 5 basic parts. In the first part, the role of hospitals in the healthcare system and the basic typology of hospitals are presented. Statistical data were sourced mainly from the Institute of Health Information and Statistics of Czech Republic. The theoretical framework, mainly focused on healthcare efficiency and its measuring are presented in the second part. In this part, the findings published in prestigious international healthcare and economy journals are analyzed. Next follows the problem statement and then the research objective is defined. The research outcomes are presented in the Key Results chapter. At the end of this contribution, the research outcomes are subjected to discussion in which the emphasis is put on practical application of the findings and the research limitations.1.Hospitals and Their role in the Health Care SystemGladkij et al. (2003) define a hospital as inpatient medical facility which is licenced to provide health care with a certain amount of beds, an organised medical team with appropriate qualifications and is able to provide continuous medical and health care services. …