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Analysis of Total, Direct and Indirect Cost Outliers in a Polish Specialist Hospital

100%

Cygańska M., Thoene M., Silva A.

Olsztyn Economic Journal

2017

vol. 12

issue 4

451-464

The purpose of this study is to analyze the factors facilitating the identification of the three categories of cost outliers. They are known as total cost outliers (TCO), direct cost outliers (DCO), and indirect cost outliers (ICO). 4,570 patients have been analyzed. To evaluate the factors that influence the patient being a cost outlier in a hospital; age, length of stay, gender, type of admission, reason for discharge, and type of department were considered. Multivariable logistic regression was used in the study. In our research TCO comprised 9% of the study sample. The percentage of DCO was slightly higher (10%) and ICO was slightly lower (8%). Total cost outliers accounted for almost 37% of total hospital costs, 40% of direct costs, and 34% of indirect costs. The direct cost outliers accounted for 44.39% of direct costs, and indirect cost outliers accounted for 34.91% of indirect costs. It was discovered that, in terms of gender, men are positively correlated with higher cost utilization. The risk of being a cost outlier increases risk in terms of death and referral for further treatment. The type of admission factor can only be a predictor of being an ICO. The risk of a patient being a length of stay outlier increases far more for the ICO (more than 580 times) than in the case of a DCO (3.81 times) or a TCO (13.79 times). The analysis suggests that not only TCO, but also DCO and ICO, should have high priority for hospital managers concerned with variations in the costs of care.

Ekonomiczne przesłanki opłat dodatkowych oraz zagadnienie eliminacji z rynku w działalności sieci handlowych

44%

Fornalczyk M.

internetowy Kwartalnik Antymonopolowy i Regulacyjny

2013

vol. 2

issue 2

72-77

Podejście stosowane obecnie na gruncie art. 15 ust. 1 pkt 4 ustawy o zwalczaniu nieuczciwej konkurencji (uznk) powinno być zmienione, albowiem opłaty pobierane przez sklepy wielkopowierzchniowe stanowią zwykle integralna część łańcucha wartości danego towaru. Nie mogą więc być automatycznie traktowane jako dodatkowy i nieuczciwy dochód generowany sieci przez dostawcę. Opłaty te są niczym innym jak wynagrodzeniem za usługi świadczone dostawcy przez sieć. Nie mogą być uznawane za nielegalne, jeżeli pokrywają koszty bezpośrednie i pośrednie zarządzania i sprzedaży dostarczonych towarów. W konsekwencji, konieczne jest zastąpienie obecnego legalistycznego fundamentalizmu podejście bardziej ekonomicznym (bazującym na paradygmacie wolnego rynku.

It is truly necessary to tilt the approach that has been applied nowadays towards Article 15(1)(4) of the Combating Unfair Competition Act because the charges collected by retail chains (large-format stores) constitute usually an integral part of the value chain of the given product as well as a reflection of the price policy of such store. This fact suggests that such charges cannot by automatically deemed as an additional and unfair income generated by the purchaser (retail chain) from the seller. Charges collected from sellers (which can look dubious at first glance) can be nothing more than a retail chain’s remuneration for services rendered to the supplier. If those services are connected to the value chain and the ‘slotting fees’ cover costs of managing and selling acquired stock (direct and indirect costs), than the retail-chain does not impose any illegal charges. It should also be noted that even if a retail-chain plays a significant role as a commercial partner, it cannot be seen as an unavoidable link between the producer (importer) and customers. If that was indeed so than every action taken by such retail chain would be subject to an antitrust analysis. Going down this path, it would be necessary to verify the actual legalistic fundamentalism in favour of a more economic approach (based on free market paradigm). One must note that economics is used more extensively nowadays in antitrust proceedings, contributing substantially thereto.

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1 Olsztyn Economic Journal

1 internetowy Kwartalnik Antymonopolowy i Regulacyjny

1 Cygańska M.

1 Fornalczyk M.

1 Silva A.

1 Thoene M.

1 2017

1 2013

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Analysis of Total, Direct and Indirect Cost Outliers in a Polish Specialist Hospital

Ekonomiczne przesłanki opłat dodatkowych oraz zagadnienie eliminacji z rynku w działalności sieci handlowych