Search results

1

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

100%

Cygańska M., Thoene M., Silva A.

Olsztyn Economic Journal

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2017

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vol. 12

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issue 4

451-464

EN

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.

2

Is There a Border Between the Public and Private Sectors in Health Care?

100%

Nojszewska E.

Problemy Zarządzania

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2018

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issue 5/2018 (78)

11-21

EN

Diseases and their treatment affect the economy and the society by means of complicated transmission mechanisms. They include costs of treatment, i.e. direct costs, and indirect costs, i.e. lost GDP. Their impact on public finance revenues and expenditures should also be taken into account. Due to the importance of the problem of health as well as the quality and efficiency of the operation of the health care system, additional measures like a deadweight loss and a loss of wellbeing are considered. The effects of the mutual interaction of health and economic growth cannot be overlooked. The complexity of the on-going processes is further exacerbated as a result of the influence of the public and private sectors, which cannot be clearly demarcated in health care.

3

Social costs of loss in productivity-related absenteeism in Poland

86%

Genowska A., Fryc J., Pinkas J., Jamiołkowski J., Szafraniec K., Szpak A., Bojar I.

International Journal of Occupational Medicine and Environmental Health

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2016

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vol. 30

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issue 6

917-932

EN

Objectives The aim of this study was to estimate indirect costs associated with losses in productivity due to sickness absence among registered workers in Poland. Material and Methods Data on sick leave durations in 2013 was obtained from the Social Insurance Institution (SII) (Zakład Ubezpieczeń Społecznych – ZUS). Based on the number of assumptions, this data was used for calculating absence durations. The costs of lost productivity were estimated on the basis of the measure of gross value added. Results Estimated losses in productivity due to absenteeism in 2013 together accounted for 4.33% of gross domestic product (GDP) (17.09 billion euro). In the female population, the total value of losses amounted to 9.66 billion euro, but excluding the costs of pregnancy, childbirth, and puerperium (2.96 billion euro), it was 6.7 billion euro. In the male population, the loss amounted to 7.43 billion euro. The highest overall costs of sickness absence based on age were found in the age group of 30–39 years (5.14 billion euro, including pregnancy, childbirth, and puerperium – 1.474 billion euro; respiratory diseases – 0.632 billion euro, injuries and poisonings – 0.62 billion euro). In the group of people aged > 40 years, the highest cost was generated by bone-muscular diseases (1.553 billion euro) and injuries and poisoning (1.251 billion euro). Higher losses in the productivity of women in addition to pregnancy, childbirth, and puerperium were due to mental and behavioral disorders (0.71 billion euro), diseases of the genitourinary system (0.38 billion euro), and neoplasms (0.35 billion euro). At the same time, in men, compared to women, we observed higher losses due to injuries and poisoning (1.65 billion euro), and diseases of musculoskeletal (1.26 billion euro), nervous (0.79 billion euro), circulatory (0.65 billion euro), and digestive (0.41 billion euro) systems. Conclusions Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917–932

4

The indirect costs of allergic diseases

86%

Stróżek J., Samoliński B., Kłak A., Gawińska-Drużba E., Izdebski R., Krzych-Fałta E., Raciborski F.

International Journal of Occupational Medicine and Environmental Health

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2019

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vol. 32

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issue 3

281-290

EN

It is estimated that every third person living in Europe suffers from allergic diseases. Allergies are a growing health problem in Poland where 40% of the population have allergy symptoms, including 12% afflicted with asthma. The actual cost of allergic diseases is difficult to estimate due to the lack or incompleteness of the relevant data. The aim of this review is to present estimates of the indirect costs of allergic diseases in Poland and globally, using asthma, allergic rhinitis and atopic dermatitis as examples. The analysis also includes the impact of allergic diseases on the costs to the social welfare system and employers. The literature review of the indirect costs of allergic diseases shows that the indirect costs of a disease, which substantially exceed the direct costs, increase with the disease activity and severity. Interestingly, some studies have found that the indirect costs of lost productivity due to hours missed from work to take care of a sick child could be threefold higher than those of absence due to a worker’s own illness. The indirect costs of a disease can be significantly reduced by early diagnosis and appropriate treatment. Int J Occup Med Environ Health. 2019;32(3):281–90

5

Włączenie aspektów klinicznych w proces kalkulacji pośrednich kosztów procedur medycznych

72%

Cygańska M., Kludacz-Alessandri M.

Zeszyty Teoretyczne Rachunkowości

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2018

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issue 98(154)

87-105

PL

Celem badań była ocena wpływu wybranych metod alokacji kosztów pośrednich na koszty procedur medycznych wykonywanych na bloku operacyjnym w szpitalu. Przy ich rozliczaniu uwzględniono: sumę kosztów bezpośrednich, czas wykonywania zabiegów i punkty odzwierciedlające m.in. złożoność procedury, intensywność leczenia (Kliniczne Punkty Pacjenta). W tym celu wykorzystano koncepcję ilościowego opisu charakterystyk pacjentów i przebiegu hospitalizacji opierając się na zidentyfikowanych czynnikach kosztotwórczych procedur medycznych. Analizie poddano koszty bezpośrednie wykonania 428 zabiegów operacyjnych, pogrupowanych w 17 kategorii w ramach ICD-9, oraz koszty pośrednie procedur medycznych wykonanych na bloku operacyjnym w okresie od stycznia do czerwca 2017 roku. Uzyskane wyniki wskazują, iż koszty pośrednie rozliczone na pacjentów proporcjonalnie do kosztów bezpośrednich w sposób istotny statystycznie różnią się od pozostałych metod w przypadku wszystkich rozpatrywanych grup ICD. Różnice w alokowanych kosztach pośrednich przy wykorzystaniu czasu trwania zabiegu i klinicznych czynników kosztotwórczych są dla większości grup ICD-9 istotne statystycznie. Uzasadnia to rezygnację z tradycyjnych, uproszczonych metod alokacji kosztów pośrednich i ponoszenie dodatkowych nakładów związanych z bieżącym monitorowaniem parametrów charakteryzujących pacjenta i przebieg hospitalizacji. Wyniki przeprowadzonego badania można wykorzystać do opracowania standardów w zakresie zalecanych metod kalkulacji kosztów jednostkowych usług medycznych na potrzeby podejmowania decyzji w szpitalu oraz finansowania usług medycznych na poziomie centralnym.

EN

The aim of the study is to assess the effect of selected methods of allocating indirect costs to operating room medical procedures. When allocating indirect costs of operating room medical procedures, the following factors were taken into consideration: total direct costs, time of providing treatments and points reflecting, among others, procedure complexity and treatment intensity. For this purpose, the concept of quantitative description of patients' characteristics and hospitalization process was used based on the identified cost-generating factors of medical procedures. The conducted analysis included direct costs of 428 surgical procedures, grouped into 17 categories according to ICD-9, and indirect costs of operating blocks for the period from January 2017 to June 2017. The obtained results indicate that indirect costs allocated to patients proportionally to direct costs differ in a statistically significant way from other methods for all considered ICD groups. The differences in allocated indirect costs when using treatment duration and clinical cost-generating factors are statistically significant in the vast majority of the ICD-9 groups. This justifies the abandonment of the traditional, simplified methods of indirect costs allocation and incurring additional expenses related to the ongoing monitoring of patients' parameters and the course of hospitalization. The results of the conducted study may be used to develop standards related to the recommended methods of calculation of costs of specific medical services for the purpose of making decisions in hospitals and financing medical services at the central level.

6

Production lost due to cervical cancer in Poland in 2012

58%

Dubas-Jakóbczyk K., Kocot E., Seweryn M., Koperny M.

Medycyna Pracy

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2016

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vol. 67

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issue 3

289-299

PL

Wstęp Polska ma jeden z najwyższych w Europie wskaźników umieralności kobiet z powodu nowotworu szyjki macicy. Niewiele kobiet uczestniczy w programach przesiewowych, a u wielu choroba jest późno diagnozowana. Celem badania było oszacowanie produkcji utraconej z powodu występowania nowotworu szyjki macicy w Polsce w 2012 r., a tym samym ocena wpływu choroby na zdolność populacji do pracy. Analizę można traktować również jako przykład metodyki szacowania strat produkcyjnych z powodu występowania określonej jednostki chorobowej przy wykorzystaniu dostępnych w Polsce danych. Materiał i metody Wykorzystano metodę kapitału ludzkiego i oszacowano produkcję utraconą z 4 powodów – 1) czasowej niezdolności do pracy, 2) trwałej niezdolności do pracy, 3) opieki członków rodziny nad osobą chorą i 4) umieralności – w kategoriach monetarnych i ilościowych (dni utraconej produkcji). Wyniki Nowotwór szyjki macicy spowodował w 2012 r. utratę 702 964 dni produkcji z powodu chorobowości i 957 678 dni z powodu umieralności. Całkowitą produkcję utraconą oszacowano na 111,4 mln euro, z czego ponad 66% było spowodowanych zgonami osób chorych na nowotwór. Wnioski Oszacowanie produkcji utraconej z powodu nowotworu szyjki macicy dostarcza silnych argumentów w procesie alokacji zasobów w sektorze zdrowia na rzecz prewencji nowotworów. Należy zintensyfikować również działania z zakresu promocji badań przesiewowych, m.in. z uwzględnieniem roli pracodawcy. Med. Pr. 2016;67(3):289–299

EN

Background Poland has one of the highest cervical cancer mortality rates in Europe. It is related to the problem of late diagnosis and low attendance rate in screening programs. The objective of the study has been to assess the annual production loss due to the cervical cancer morbidity and mortality in Poland in 2012. The outcomes have been to provide comprehensive information on cervical cancer’s influence on population’s ability to work and its overall economic burden for the society. The study has also provided the methodological framework for disease-related production losses in Polish settings. Material and Methods The human capital method was used. The production losses were calculated in both monetary and quantitative terms (working days lost) due to 4 following reasons: 1) temporary disability to work, 2) permanent disability, 3) informal care, and 4) mortality. Results Cervical cancer resulted in approx. 702 964 working days lost in 2012 due to absence at work for both patients and care givers and a total number of 957 678 working days lost due to patients’ mortality. The total value of production lost was assessed at 111.4 million euros. More than 66% of this value was attributed to women’s mortality. Conclusions The calculation of production lost due to cervical cancer burden provides strong evidence to support adequate health promotion and disease prevention actions. Actions promoting cervical cancer screening should be intensified including workplace health promotion activities. Med Pr 2016;67(3):289–299

7

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

44%

Fornalczyk M.

internetowy Kwartalnik Antymonopolowy i Regulacyjny

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2013

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vol. 2

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issue 2

72-77

PL

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.

EN

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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