No abstract

Healthcare is a highly sophisticated segment of the public sector, which requires not only highly professional and competent staff, but also a properly set ratio of healthcare professionals. In the Czech Republic, the state, as the main guarantor of health care, applied strong control through price and volume control. The aim of the paper is to define the differences in the technical efficiency of public hospitals, with regard to the size of hospitals and partial types of human resources. An input-oriented Data Envelopment Analysis model (DEA model) was chosen for modeling the technical efficiency of 47 public hospitals. The personnel performance concept of the evaluation of technical efficiency was further implemented in eight specific models, from the perspective of individual input variables relative to output variables and according to different assumptions regarding the character of economies of scale. The results of technical efficiency were analyzed using correlation, regression analysis, and the Bootstrap method. The least efficient hospitals in terms of hospital size are large hospitals, and the most balanced results have been achieved by medium-sized hospitals. The average efficiency rate in models that include all selected input and output variables is highest in medium-sized hospitals, with a value of 0.866 for CRS and an efficiency rate of 0.926 for VRS. The rationalization of human resources should be implemented in order not to reduce the quality of care provided.

Background Providing hospital care is an essential objective of national health policies. The countries that share common history, when they emerged from the same health system and similar conditions in the early 1990s, after the division of Czechoslovakia, became the objects of evaluation of the development of technical efficiency of hospital care. The subsequent development of their health care system also was very similar, but no longer entirely identical. The article aims to identify the trends and disparities in the productivity of the capacities of hospital care on the regional level (NUTS III.) in the Czech Republic and the Slovak Republic in 2009–2018 before the COVID-19 pandemic using the multi-criteria decision methods. Methods The window analysis as a dynamic DEA method based on moving averages and also the Malmquist Index, that allows the evaluation of changes in relative efficiency and of changes in the production possibilities frontier have become the key methods for evaluating the over time efficiency evolution. To model technical efficiency, an output-oriented method assuming constant returns to scale was chosen. Aggregated input and output parameters for each region were the object of study. Results The results showed that differences in the efficiency trends in terms of the examined parameters among the individual regions are slightly greater in the Czech Republic than in the Slovak Republic. The least efficient regions are those where capital cities are located. Furthermore, the analysis showed that in 2018 all of the Slovak Republic regions improved its productivity compared to 2009 and that technological conditions had a significant impact on this improvement. The results of the Czech Republic regions show productivity improvement in 57% of the regions that, on the contrary, was due to changes in technical efficiency. Conclusions It should be recommended to the state- and regional-level governments to refrain from unilaterally preferring the orientation of public policies on the efficiency of the provision of hospital care, and rather focus on increasing the quality and availability of hospital care, especially in smaller, rural, and border regions, in the interest of population safety during pandemics and other emergencies.

This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR). The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic) were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

Social services in the Czech Republic are based on solidarity. Tomeš (2018) states that solidarity is one of the fundamental values of European civilisation. Its goals are seen in social development, efforts to preserve human dignity and the right to live freely and participate in social processes, social inclusion and prevention of social exclusion. The target group are the people to whom social services ensure the use of their social rights. These rights enable citizens to provide social protection against the consequences of adverse social events (i.e. social risks that threaten the existence of humans economically and socially). They strengthen the social and