Hospital Economics

A Primer on Resource Allocation to Improve Productivity & Sustainability

A. Heri Iswanto

• Publisher: Productivity Press
• Year: 2018
• ISBN:
  9781351172509
• Edition: 1
• Topic: Business
• Subtopic: Gestione
• Index: Business

The biggest issue of economics in a hospital are the resource issues. A resource issue in hospitals creates many problems such as the excessive number of patients, poor service quality, lack of diagnostic tools and equipment, dirty and worn out facilities, long queues at the outpatient clinic, lack of drugs and other medical supplies, low employee morale, and so on. Hospital economics mention three main resource issues in as problems including; (1) Resource allocation issue, (2) Resource management issue, and (3) Generation resources issue.

The main economic problem of resource allocation in hospitals are production and cost function. These two functions related to issues of equality and effectiveness of the hospital. This book specifically discusses on the aspect of hospital resource allocation by highlighting the productivity, competitiveness, cost components, economic burden of disease, and economic aspects of infectious diseases originating from the hospital. The resource management issue is related to the use of existing resources in terms of input and output. The main important economic concept is efficiency, both technical efficiency, economical, and scale, as well as the relationship between these concepts. The resource management issue highlight the economic scale, human resource development, quality development, and lean implementation. The issue of generation resources, includes how the hospital is able to get the resources to run operations without having to cover the access of stratum of community thus violating the principle of equality. This book will highlight the issue of generation resources by including a discussion of the revenue components of the hospital and the impact of DRGs.

Chapter 1

The Importance of Hospital Economics

Introduction

A health system in a country is a network that involves many parties that are interconnected to one another. In a comprehensive public health network, at least 23 organizations, each of which has contributed to the costs and benefits generated by public health, are involved. The institutions involved in a universal health care system include, among others (CDC, 2013: 49):

1.Schools. Schools play a role in providing knowledge and training on health to the community to help people stay healthy and avoid diseases, such as by providing information on healthy lifestyles, especially to student groups in the community. Some schools specifically focus on education in the health field, such as nursing schools, medical schools, and so on.

2.Mental health coaching institutions. Institutions such as self-development centers, both religious and not, play a role in maintaining good mental health in the community. The majority of health problems can have their source in mental problems (e.g., stress), and improvement in mental health quality can help reduce health problems.

3.Governments. Governments, both at the national and local levels, through the Ministry of Health and Health Service or nonministry institutions such as the National Agency of Drug and Food Control (BPOM), and even government agencies that are not directly related to health, have the role of regulation and supervision of aspects of public health related to the tasks and functions of each institution. For example, the Ministry of Housing has the role of ensuring houses occupied by people meet the standards of good health and do not cause disease for the residents. Overall, the role of the government is to build public health through health systems and partnerships with others in the health system through the principles of equality, solidarity, and justice-based human rights (WHO, 2006: 11).

4.Emergency medical services. These institutions include the Indonesian Red Cross (PMI) and various agencies of ambulance service providers that are able to respond quickly when people need emergency health care but are unable to reach the emergency room. These institutions provide first aid and emergency response in terms of housing, food, and health, including epidemic and mental health, for families and the whole community, in particular the vulnerable community, in order to return to normality after a crisis.

5.Civilian groups. Civilian groups are public institutions voluntarily established to provide health services in the community, as well as in the form of fundraising, such as cancer awareness groups, schizophrenia care groups, and so forth. The World Health Organization (WHO) registers at least 15 roles of civilian groups in the health sector, including service providers, who build a large public selection of health information, negotiate standards and public health approaches, promote pro-poor concerns and social equity in resource allocation, and supervise the responsiveness and quality of health services (WHO, 2001: 6).

6.Home care. Home care includes various types of institutions specializing in the treatment of specific groups in the community. There are at least 15 types of institutions that exist in the community: child sanatorium (barriers to learning), day care (toddlers from 3 months to under 5 years), child care (fatherless/motherless children or orphans who are underprivileged and homeless), bina remaja (abandoned children dropping out of school), nursing homes for elders (old/seniors), bina daksa (physically disabled, other physical problems, and orthopedics), bina netra (vision impairment), bina rungu/wicara (speech defects/hearing impairment), bina grahita (mental impairment), bina laras (deviant behavior from the norm/ex-psychotic), bina pasca laras kronis (handicapped due to chronic diseases), marsudi putra/putri (brat), pamardi putra/i (former victims of drug abuse), karya wanita (prostitute), and bina karya (homeless or abandoned people) (Decree of Minister of Health No. 50/HUK/2004 on Social Institution Standardization and Social Institution Accreditation Guidelines). Part of the responsibility of a nursing home is to provide health care to the community members in their care.

7.Association of physicians. This group, particularly the Indonesian Doctors Association (IDI), is responsible for the health of the Indonesian nation.

8.Law enforcement agencies. Both military and police and other law enforcement agencies provide human security in various forms; one of them is health.

9.Correctional facilities. These institutions have expertise in teaching skills to people who break the law, including expertise in the field of health. In addition, the correctional facility has a role in the coaching of mental health in prison.

10.Heads of state and local government are responsible for providing shelter and managing various public areas, including the health sector.

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