Influence of the interest groups on healthcare reimbursement decree in Czech Republic
| Název práce v češtině: | Vliv zájmových skupin na úhradovou vyhlášku zdravotnictví České republiky |
|---|---|
| Název v anglickém jazyce: | Influence of the interest groups on healthcare reimbursement decree in Czech Republic |
| Klíčová slova: | Zdravotnictví, Úhrada nákladů, Zájmové skupiny, Státní rozpočet |
| Klíčová slova anglicky: | Health care, Reimbursement of costs, Interest groups, State budget |
| Akademický rok vypsání: | 2014/2015 |
| Typ práce: | diplomová práce |
| Jazyk práce: | angličtina |
| Ústav: | Institut ekonomických studií (23-IES) |
| Vedoucí / školitel: | Mgr. Michal Paulus |
| Řešitel: | skrytý - zadáno vedoucím/školitelem |
| Datum přihlášení: | 17.06.2015 |
| Datum zadání: | 17.06.2015 |
| Datum a čas obhajoby: | 16.09.2019 00:00 |
| Datum odevzdání elektronické podoby: | 08.08.2019 |
| Datum proběhlé obhajoby: | 16.09.2019 |
| Oponenti: | PhDr. Lucie Bryndová |
| Kontrola URKUND: | |
| Zásady pro vypracování |
| Dle norem FSV. |
| Seznam odborné literatury |
| EUROPEAN OBSERVATORY ON HEALTH SYSTEMS AND POLICIES. Diagnosis-Related Groups in Europe, 2011, http://www.euro.who.int/__data/assets/pdf_file/0004/162265/e96538.pdf
EUROPEAN OBSERVATORY ON HEALTH SYSTEMS AND POLICIES. Financing healthcare in the European Union, 2009, http://www.euro.who.int/en/about- us/partners/observatory/publications/studies/financing- health-care-in-the-european-union FIALA, P; SCHUBERT, K. Moderní analýza politiky. Uvedení do teorií a metod policy analysis. 2000, Brno: Barrister& Principal. FIALA, P; SCHUBERT, K. Zájmové skupiny a zprostředkování zájmů v moderních demokraciích. 1993, In Politologický sborník III. Brno: Mezinárodní politologický ústav. FUCHS, V. Economics, Values and Health Care Reforms, The American Economic Review, Vol. 86, No. 1, 1996, pp. 1-24 MALÝ, I. Problém optimální alokace zdrojů ve zdravotnictví. 1998 Brno: Masarykova univerzita MCPAKE, B., KUMARANAYAKE, L., NORAND, C. Health Economics: An International Perspective, 2005, Routledge MINISTERSTVO ZDRAVOTNICTVÍ. Health System Financing in the EU: Current Practices and the Aging Challenge, 2009 MINISTERSTVO ZDRAVOTNICTVÍ. Úhradová vyhláška, http://www.mzcr.cz/obsah/uhradova-vyhlaska_2904_3.html POTŮČEK, M; LELOUP, L. T; JENEI, G; and VÁRADI, L. Public Policy in Central and Eastern Europe: Theories, Methods, Practices. 2003, Bratislava: NISPAcee POTŮČEK, M a kol. Veřejná politika. 2010, Praha: Sociologické nakladatelství (SLON). VESELÝ, A; NEKOLA, M. Analýza a tvorba veřejných politik. 2007, Praha: Sociologické nakladatelství (SLON). |
| Předběžná náplň práce |
| Topic Characteristics:
Goal of this master thesis is to chart the influence groups behind approval of the reimbursement edict of the Czech Ministry of Health. Reimbursement edict determines every year how much money the providers of health care will get from the the insurance company. Despite the fact that it is not a law forming the basic framework of health care legislature it influences significantly the way the large amounts of money are allocated each year. Every year it is the outcome of bargaining between various interest groups. Reimbursement edict is something like the Law on State Budget in the health care environment and at the same time it is one of the least stable documents. When we look at the last decade, its form changed several times. There is an effort to introduce DRG payments (diagnostic-related groups) what is a system of classifying hospital cases into several groups. It supposes that patients in the same categories use approximately the same amount of hospital resources. On the other hand there are also efforts to keep the flat rate payments that are in general more preferable for hospitals. I assume that every year this process is the result of conflict between the interest groups which fight for more profitable allocation of resources for themselves. This work will identify the best principles of allocation for different groups. This map of interest groups will be the first of its kind in Czech Republic. In the discussion I will put the results into context using the examples of financing from different European countries where I can expect similar conditions as in the Czech environment. I will focus on the countries using the Beveridge model of healthcare financing which puts more emphasis on the role of the state. The outcome of this work will be better understanding of the influences behind the allocation of big amount of public resources. It is in correspondence with public demand for higher transparency and fight against the clientelism. Working hypotheses: 1. Each year the form of reimbursement edict is the outcome of struggle between various interest groups. 2. The form of reimbursement edict reflects who won the bargaining between the interest groups. 3. In year 2014 hospitals won this fight and for 2015 the Ministry of Health is not using the DRG-based system. Methodology: The base for this paper is qualitative analysis and public policy theory of actors generating agendas in arenas. Actors are interest groups, arena is healthcare system financing and agenda the reimbursement edict. This way I can analyse how various actors form the edict which consequently allocates public resources in correspondence or against their interests. According to Potůček (2010), the concept of political arenas helps to theoretically and empirically understand the processes influencing the formation of public policy. These processes are competition, cooperation, conflict and consensus between the actors. Various actors prefer different costs/benefits and outcomes. This way they define their political arena. Active political actors interact within the arenas but also form relations with the members of other arenas. After identification of the actors (patients, providers of health care, insurance companies) using the concept of actors generating agendas in arenas I can explain who and why want which form of the reimbursement edict. Outline: 1. Introduction 2. Public policy theory Actors generating agendas in arenas 3. Czech healthcare financing Legislature Actors 4. Reimbursement edict Forms of reimbursement in selected years Which allocation serves which actor 5. Discussion 6. Conclusion 7. Bibliography |
| Předběžná náplň práce v anglickém jazyce |
| Topic Characteristics:
Goal of this master thesis is to chart the influence groups behind approval of the reimbursement edict of the Czech Ministry of Health. Reimbursement edict determines every year how much money the providers of health care will get from the the insurance company. Despite the fact that it is not a law forming the basic framework of health care legislature it influences significantly the way the large amounts of money are allocated each year. Every year it is the outcome of bargaining between various interest groups. Reimbursement edict is something like the Law on State Budget in the health care environment and at the same time it is one of the least stable documents. When we look at the last decade, its form changed several times. There is an effort to introduce DRG payments (diagnostic-related groups) what is a system of classifying hospital cases into several groups. It supposes that patients in the same categories use approximately the same amount of hospital resources. On the other hand there are also efforts to keep the flat rate payments that are in general more preferable for hospitals. I assume that every year this process is the result of conflict between the interest groups which fight for more profitable allocation of resources for themselves. This work will identify the best principles of allocation for different groups. This map of interest groups will be the first of its kind in Czech Republic. In the discussion I will put the results into context using the examples of financing from different European countries where I can expect similar conditions as in the Czech environment. I will focus on the countries using the Beveridge model of healthcare financing which puts more emphasis on the role of the state. The outcome of this work will be better understanding of the influences behind the allocation of big amount of public resources. It is in correspondence with public demand for higher transparency and fight against the clientelism. Working hypotheses: 1. Each year the form of reimbursement edict is the outcome of struggle between various interest groups. 2. The form of reimbursement edict reflects who won the bargaining between the interest groups. 3. In year 2014 hospitals won this fight and for 2015 the Ministry of Health is not using the DRG-based system. Methodology: The base for this paper is qualitative analysis and public policy theory of actors generating agendas in arenas. Actors are interest groups, arena is healthcare system financing and agenda the reimbursement edict. This way I can analyse how various actors form the edict which consequently allocates public resources in correspondence or against their interests. According to Potůček (2010), the concept of political arenas helps to theoretically and empirically understand the processes influencing the formation of public policy. These processes are competition, cooperation, conflict and consensus between the actors. Various actors prefer different costs/benefits and outcomes. This way they define their political arena. Active political actors interact within the arenas but also form relations with the members of other arenas. After identification of the actors (patients, providers of health care, insurance companies) using the concept of actors generating agendas in arenas I can explain who and why want which form of the reimbursement edict. Outline: 1. Introduction 2. Public policy theory Actors generating agendas in arenas 3. Czech healthcare financing Legislature Actors 4. Reimbursement edict Forms of reimbursement in selected years Which allocation serves which actor 5. Discussion 6. Conclusion 7. Bibliography |