Public Administration Reform in Czechia after 2000 – Ambitious Strategies and Modest Results ?

Špaček, David

doi:10.2478/nispa-2018-0007

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…Regardless, the studies comparing the effi ciency of public and private hospitals in the Czech Republic provide contradictory results (Mastromarco et al 2019;Łyszczarz 2016;Papadaki and Staňková 2016) and thus the defi nitive example of practices leading to an effi cient hospital is yet to be identifi ed. Lastly, the EU requirements for the allocation of funds appear to be an important driver of the introduction of healthcare reforms leading to the introduction of elements of performance management (Dubas-Jakóbczyk et al 2020;Špaček 2018); nonetheless, this process is accompanied by challenges (e.g. political instability, uncertainty about reform eff ects) which are common among the countries in Central and Eastern Europe (Dubas-Jakóbczyk et al 2020).…”

Section: Issues Accompanying Performance Evaluation In Healthcarementioning

confidence: 99%

The Performance Management Design in Public Hospitals: A Case Study

Krupička

2021

NISPAcee Journal of Public Administration and Policy

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In response to the growing pressure on public budgets, many countries introduced various private-sector-inspired management practices to improve the performance of publicly funded health systems. Regardless, the non-negligible share of health-care spending is still considered wasteful, and the search for efficiency gains in healthcare is still relevant. The relevance even increases in the context of events related to the outbreak of the coronavirus disease in 2020, presenting new challenges for performance management in hospitals. Considering the gaps between the environmental settings of various countries, a finding of one universal theory of effective hospital management is unlikely. The contextual examination of hospital management on the national level and knowledge-sharing is then a more suitable approach to aid the practitioners in search of the most appropriate mix of management practices. This study employed a mixed methodological approach to examine individual aspects of performance management from the hospital management’s perspective to identify the areas of potential efficiency gains. The core research phase consisted of on-site visits in three public hospitals taking place since September 2019 with the respondents from various management levels and both clinicians and non-clinicians. During an approximately hour-long session the respondents were asked to fill out the questionnaire examining the aspects of the performance management system employed in their institution (e.g., the scope of measurement, reliability of data, communication of results, engagement of management) and interviewed to examine the rationale of provided responses. The on-site research stage resulted in 87 complete data sets further analyzed using statistical analysis with results interpreted using commentaries and rationales obtained from interviews. The findings were similar among all examined institutions and mostly consistent with similarly natured studies. While the performance measurement appeared to reflect the clinical performance better than the organizational one, it is also perceived as inadequate to the complexity of service. The management seemed to consider performance management for operational purposes rather than being incentive-oriented or exploratory, in line with the perceived lack of connection between the performance measurement and the organizational strategy. Combined with poor communication of performance management principles, this discrepancy appears to contribute to the potential tension between the hospital and clinical management in setting priorities between the economic performance and the quality of care. Overall, these findings should provide insight into aspects influencing performance management employed in public hospitals in the Czech Republic and present the evidence for the discussion of potential efficiency gains in practice.

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Section: Issues Accompanying Performance Evaluation In Healthcarementioning

confidence: 99%

The Performance Management Design in Public Hospitals: A Case Study

Krupička

2021

NISPAcee Journal of Public Administration and Policy

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“…This analysis provides interesting results and also draws attention to behaviour that is not typical of the better established and more advanced EU countries. According to Vesely [42] and some other authors, the source for this situation is, to a large extent, path-dependency-petty corruption was a typical feature of the so-called "socialist" society, and the change of the system opened the space for massive-systemic-large scale corruption, which is tolerated by citizens (Orviska and Hudson [43] or Hunady [44]) and exaggerated by limited accountability and responsibility of politicians and top civil servants (Thijs et al [45]) and also by a limited managerial culture in the "post-soviet" countries (see for example Spacek and Hornakova [46], Spacek and Pucek [47], Spacek [48] and Nemec [49].…”

Section: Discussionmentioning

confidence: 99%

Competition in Public Procurement in the Czech and Slovak Public Health Care Sectors

et al. 2020

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Sustainability of health financing is a critical issue for all countries, especially now in the COVID-19 period. The final level of achievements of critical public health goals is connected not only with the efforts of the people involved, but also with the availability of funding to cover the costs of the actions needed. One of the “internal sources” providing more resources to cover public health care costs is effective public procurement in the health care sector. According to existing scientific literature, a low rate of competition represents one important factor that has a direct negative impact on the efficiency of public procurement. The aim of our article is to examine the degree of competitiveness of public procurement in the Czech and Slovak health care systems and its impact on the final price of a contract. The research fully attested the findings of those studies carried out so far – the higher the number of tenderers, the lower the final price, even in the Czech and Slovak health sectors. However, the average number of tenderers is only around two and in the Czech Republic for more than half of the tenders only one bid was submitted.

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