Zemba Mladen, Djulepa Davorko
Zavod za anesteziologiju i intenzivno lijecenje, Opća bolnica Sveti Duh, Sveti Duh 64, 10 000 Zagreb.
Lijec Vjesn. 2002 Oct;124(10):296-300.
The reform of government financing of health services has caused a lot of significant changes in hospitals. The main points of the reform are limited hospital expenses, and reduced financial calculation. The following three factors are influencing upon hospital expenses is the only factor that hospital management can effectively influence upon. Therefore, management and running of financial services are the most responsible and significant for hospital prosperity. The most convenient and prospective way of payment restriction is expenses accounting according to the case of treatment. Furthermore, general expenses should be reduced too. However, economic evaluation should include the analysis of alternative therapeutic possibilities in the framework of expenses, and the outcome of treatment. Following all these, it has been shown how it is possible to reduce the expenses at the Department of Anesthesiology. There are potential factors of savings such as low-flow anesthesia, ABC-analysis of expenses etc. Other ones are staff expenses, that include improvement of working process and adaptable time-table. Pharmaco-economical evaluation of the new drugs has shown how analysis of expenses structure could be acceptable in the scope of anesthesiology. Because of the permanent deficit of financial resources, permanent decentralized control is indispensable.
政府医疗卫生服务融资改革给医院带来了诸多重大变化。改革要点在于限制医院费用并简化财务核算。影响医院费用的以下三个因素是医院管理能够有效影响的唯一因素。因此,财务服务的管理与运营对医院的繁荣最为关键且责任重大。最便捷且具前瞻性的支付限制方式是按治疗病例进行费用核算。此外,一般费用也应削减。然而,经济评估应涵盖在费用框架内对替代治疗可能性的分析以及治疗结果。综合所有这些,已表明如何在麻醉科降低费用。存在一些潜在的节省因素,如低流量麻醉、费用的ABC分析等。其他因素包括员工费用,这涉及工作流程的改进和灵活的时间表。对新药的药物经济学评估表明,在麻醉学范围内分析费用结构是可行的。由于财政资源长期短缺,持续的分散控制必不可少。