Transcript Economic approach to OHS in Poland. New economic

Economic approach to OHS
in Poland.
New economic observations.
BSN, Tallin, November 2002
Izabela Rydlewska-Liszkowska
NIOM, Lodz, Poland
New economic observations: OHS in Poland
Selected economic characteristics of OHS in
Poland:
1. Present state of OHS financing
 legal regulations
Occupational Health Services Act from 1997
Public Finance Act from 1999
Labour Code Act with the amendments from 1991
Health Care Organizations Act from 1991
New economic observations: OHS in Poland
1. Present state of OHS financing (cont.)
 Two levels of financing:


regional level (Regional Occupational Health
Services Centers-23 units)
and primary level (OHS primary units – 8829)
2. Supply side of OHS:


public sector (regional units and given number of
primary units ),
and private sector (primary units only )
New economic observations: OHS in Poland
3. Demand side of OHS:
 enterprises registered in REGON system
(different forms) – 434 523
 Enterprises without legal personality and
partnerships
 economically active persons - 17 300 thous.
 Employed persons - 15 000 thous.
 Persons working in hazardous conditions 143 per 1000 paid employees
 .....
New economic observations: OHS in Poland
4. Economic tools (legal regulation or good practice)
 Cost accounting
 Pricing of OHS services
 Financial planning (business plans)
 Financial analysis
 Economic appraisal
New economic observations: OHS in Poland
5. Sources of economic information on OHS
 National Health Account (results of
implementation)
 Programme of statistical studies in public
statistics field for 2002 (Main Statistical Office)
 Financial reports from OHS units
 Research projects carried out in NIOM, Lodz
(results)
New economic observations: OHS in Poland
Examples/results
OHS funding
The structure of funding sources in Regional OHS
Centers in 2001 (%)
- Central government:
14,0 – 45,5
- Local self-governments:
7,4 – 97,0
- Employers:
3,0 – 56,0
- Health insurance institutions:
8,0 – 52,0
- Other:
0,4 – 18,0
New economic observations: OHS in Poland
Examples/results
OHS funding


Why companies play such important role in financing
ROHSC if preventive examinations are obligatory
activity of OHS primary units
financed by
companies?
The answer is simple: ROHSCs provide, partly, the
same activities like primary units do. Are they
supervising bodies for themselves?
New economic observations: OHS in Poland
Examples/results
OHS funding




Participation of social health insurance in OHS
financing.
OHS units have independent status
The OHS providers referring to their legally
institutional independence combine the statutory
functions with other activities going beyond the first
one (e.g. curative medicine) .
That is why the specialists have suspected that it may
reduce the quality of the statutory OHS functions
New economic observations: OHS in Poland
Examples/results
OHS providers


OHS market: supply side
first analysis in Poland for 2001- different legal forms
of providers:
public OHS units – 25% (ROHSC – 4%)
private OHS units – 75% (private practice – 31%)
New economic observations: OHS in Poland
OHS providers
Structure of unit cost of occupational disease
diagnosis (%) - first analysis in Poland for 2001
ROHSCs
Person. cost
A
14,99
B
95,96
C
15,50
D
24,49
E
61,40
F
51,11-21,15
Material cost
0.98
2,64
2,41
1,55
0,47
9,34-4,62
Overhead cost
84,43
1,40
82,09
73,96
38,13
39,95-74,23
New economic observations: OHS in Poland
OHS providers
Structure of unit cost of consultation (%) - first
analysis in Poland for 2001
ROHSCs
A
B
C
D
E
F
Person. cost
14,60
38,65
15,50
84,84
62,26
79,00-30,18
Material cost
0,97
7,58
2,41
12,56
20,88-10,69
Overhead cost
84,43
53,77
82,09
15,16
22,18
9,12-59,13
New economic observations: OHS in Poland
Economic tools




Cost accounting
Pricing of services
Financial planning and analysis
Economic appraisal
New economic observations: OHS in Poland
Implementation/examples


Financial planning on case mix basis
Best practice in cost accounting



Cost centres
Services standards
and …
New economic observations: OHS in Poland
Implementation/examples


information system on OHS as the component of
the National Health Account according to OECD
standards;
economic appraisal of OHS activities (SMEs)
New economic observations: OHS in Poland
Thank you for your attention.
Questions and remarks are welcome