Title Financijsko organizacijska analiza Zavoda za hitnu medicinu u Republici Hrvatskoj
Title (english) Financial organizational analysis of the Institute of emergency institute in the Republic of Croatia
Author Slobodan Manović
Mentor Ivo Mijoč (mentor)
Committee member Dubravka Pekanov Starčević (predsjednik povjerenstva)
Committee member Ivo Mijoč (član povjerenstva)
Committee member Martina Briš Alić (član povjerenstva)
Granter Josip Juraj Strossmayer University of Osijek Faculty of Economics and Business in Osijek Osijek
Defense date and country 2018-07-18, Croatia
Scientific / art field, discipline and subdiscipline SOCIAL SCIENCES Economics Finance
Abstract Uredbom o osnivanju Hrvatskog zavoda za hitnu medicinu započelo je osnivanje
zavoda za hitnu medicinu na teritoriju cijele Republike Hrvatske. Od samoga početka
svoga postojanja, zavodi se bore s organizacijsko financijskim problemima. Svrha rada
empirijsko je istraživanje različitih poteškoća i problema Zavoda za hitnu medicinu s
kojima se susreću u svom poslovanju, a temeljem zaključaka istraživanja pružiti
preporuke za njihovo rješenje i unapređenje.
Od ukupno 21 Zavoda koji djeluju na teritoriju Republike Hrvatske u uzorak
istraživanja odabrano je njih deset. Okvir uzorka kreiran je prema geografskom kriteriju te
kriteriju veličine Zavoda promatran kroz broj zaposlenika i ukupan iznos prihoda na
godišnjoj razini. Za odabrane Zavode analizirani su njihovi financijski izvještaji za 2015. i
2016. godinu prema sljedećim karakteristikama: financijski rezultat, obveze, potraživanja,
stanje kratkoročne imovine, zaposlenici te organizacijska struktura sukladno ugovoru koji
imaju potpisan s Hrvatskim zavodom za zdravstveno osiguranje.
Rezultati istraživanja pokazali su kako većina zavoda, čak njih 90%, ostvaruje
višak prihoda u odnosu na rashode u obje analizirane godine. Iako prihod od Hrvatskog
zavoda za zdravstveno osiguranje čini približno 90% prihoda, ovaj višak rezultat je drugih
izvora prihoda: sredstva pomoći izravnanja za decentralizirane funkcije, ostali i
izvanredni prihodi te prihodi od ostalih korisnika koji se najvećim dijelom sastoje od
pomoći županije, gradova i raznih ministarstava. Prihodi iz ugovora s Hrvatskim zavodom
za zdravstveno osiguranje u čak polovici (50%) Zavoda nisu dostatni niti za pokriće
redovnih rashoda poslovanja te samim time niti za investiranje u novu, suvremeniju i
kvalitetniju opremu. Zahvaljujući spomenutim drugim izvorima financiranja, zavodima je
osigurano redovito podmirivanje obveza. Sama analiza Zavoda u ovom radu donosi
dovoljno dokaza za sumnju u mogućnost praćenja konstantnog rasta troškova.
Uz spomenute financijske probleme, istraživanje je pokazalo kako se Zavodi bore s
nedostatkom liječnika. Ovaj organizacijski problem moguće je riješiti reformom hitne
medicine u kojoj bi liječnici iz zavoda prešli na objedinjene hitne prijeme, a u zavodima bi
veću ulogu i odgovornost preuzeli medicinski tehničari/sestre specijalisti hitne medicine.
Kao što je i vidljivo, problemi postoje no nikako nisu nerješivi. Gledajući ukupan
zdravstveni sustav u Republici Hrvatskoj te uspoređujući zavode s ostalim zdravstvenim
ustanovama, zaključak je kako je budućnost hitne medicine, a onda i zavoda kao pružatelja te
usluge neupitna.
Abstract (english) The establishment of the Croatian Institute for Emergency Medicine started with the
establishment of the Institute for Emergency Medicine in the Republic of Croatia. From the
very beginning of their existence, the institute faces organizational financial problems. The
purpose of this paper is to provide an empirical study of the various difficulties and problems
of the Emergency Medical Service that they face in their everyday work. The conclusions of
the research conducted are the basis for making recommendations for their solution and
improvement.
Of the 21 Emergency Medicine Institutes operating in the territory of the Republic of
Croatia, ten Institutes were selected in the selected research. The sample frame was created
according to the geographic criterion and size criterion of the Institute. For selected Institutes,
the financial statements for the years 2015 and 2016 are analyzed according to the business
characteristics: financial result, liabilities, receivables, short-term assets, employees and
organizational structure in accordance with the contract signed by the institutes with the
Croatian Health Insurance Institute.
The results of the research have shown that most of the Institutes, even 90% of them,
have a surplus of income over expenditures in both analyzed years. Although the income from
the Croatian Health Insurance Institute accounts for approximately 90% of revenues, the
surplus of income is the result of other sources of income: decentralized functions of
equalization funds, miscellaneous and extraordinary income and revenues from other
beneficiaries, largely consisting of counties, cities and various ministries. Revenues from the
Croatian Health Insurance Fund contract with even half (50%) of the institutes are insufficient
to cover the regular operating expenses and therefore to invest in new, more modern and
quality equipment. With the help of the mentioned other sources of funding, the institutions
have been provided with regular payments of liabilities. The Institute's analysis alone in this
paper provides sufficient evidence for suspicion of the possibility of monitoring the constant
increase in the costs of the contractual arrangements with the Croatian Institute for Health
Insurance.
With financial problems, research has shown that the Institutes are struggling with a
lack of doctors also. The potential to solve the identified organizational problem is reflected in
the creation and implementation of emergency medicine reform. Work has suggested
guidelines that could serve as a basis for creating a new reform policy for the Emergency
Medicine Institution, whereby doctors from the Institutes would be redistributed to a unified
emergency response, and medical staff / medical nurses would take on a greater role and
responsibility in the institutes.
Overall, observing the health system in the Republic of Croatia, we can conclude that
the future of emergency medicine and institutes as providers of this service is unquestionable.
Keywords
Zavodi za hitnu medicinu
HZZO
financiranje zdravstva
decentralizirana sredstva
kolektivni ugovor
manjak liječnika
Keywords (english)
Emergency Medical Institutes
HZZO
Health Financing
Decentralized Funds
Collective Contract
Medical Lack
Language croatian
URN:NBN urn:nbn:hr:145:541069
Study programme Title: Postgraduate Specialist Studies Accounting, Auditing and Analysis Study programme type: university Study level: postgraduate specialist Academic / professional title: Sveučilišni specijalist/specijalistica računovodstva, revizije i analize (Sveučilišni specijalist/specijalistica računovodstva, revizije i analize)
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Created on 2018-11-28 17:47:39