doktorska disertacija
Nejc Lamovšek (Author), Maja Klun (Mentor), Milan Skitek (Co-mentor)

Abstract

Laboratorijska medicina kot podsistem javne zdravstvene mreže nudi storitve, za katere ni znano, v kakšnem obsegu jih bodo bolniki potrebovali. Obseg laboratorijskih storitev je tako v popolni domeni naročnikov, vendar pa lahko medicinski laboratoriji vsaj deloma vplivajo na porabo njihovih virov. Medicinski laboratoriji se tako srečujejo z različnimi omejitvami, denimo z zaposlovanjem, naložbami in viri financiranja, vendar pa želijo kljub omejitvam ponuditi hitro izvedene kakovostne laboratorijske preiskave. Eden izmed poglavitnih izvorov neučinkovitosti je tako lahko tudi neoptimalna velikost procesa v laboratorijih. Namen doktorske disertacije je opredeliti tehnično in stroškovno učinkovitost biomedicinskih laboratorijev z vidika doseganja njihove optimalne velikosti. Vpliv konsolidacije laboratorijske dejavnosti ugotavljamo z oceno razlik v učinkovitosti medicinskih laboratorijev. Z opredelitvijo Malmquistovega indeksa produktivnosti dodatno opredelimo vpliv inovacij na učinkovitost medicinskih laboratorijev. V empiričnem delu doktorske disertacije poglobljeno analiziramo dvajset medicinskih laboratorijev, ki izvajajo vse tri skupine laboratorijskih preiskav ter dodatno tudi enaindvajset laboratorijev primarne ravni zdravstvenega varstva. V analizo dodamo tudi dva tuja medicinska laboratorija, s katerima izvedemo mednarodno primerjavo učinkovitosti. Za analizo učinkovitosti uporabimo metodo ovojnice podatkov, tj. DEA metodo. Ugotavljamo, da je neučinkovitost, ki izhaja iz velikosti laboratorijev, do 1,2-krat večja, kot pa je procesne neučinkovitosti. Konsolidirana laboratorijska dejavnost je v naši analizi ocenjena kot bolj učinkovita. Upravljavske prakse naročanja in porabe laboratorijskih reagentov ter naložbe v opremo so se izkazale kot bistvene za doseganje stroškovne učinkovitosti medicinskih laboratorijev. Dodatno ugotavljamo, da DEA metoda, kadar se preverja kakovost dela laboratorijev, ni zadovoljiv samostojni kazalnik učinkovitosti. Z raziskavo tako prispevamo h korpusu DEA raziskav za področje zdravstva, ki na ta način še niso bile obravnavane, ter širimo področje uporabe metode s ciljem širšega metodološkega pokrivanja celotnega področja zdravstva. Opredelitev optimalne velikosti medicinskih laboratorijev z uporabo DEA metode ter upoštevanjem storitvenih modelov je tako prvič uporabljena na primeru medicinskih laboratorijev.

Keywords

zdravstvene storitve;laboratorijska medicina;optimalna velikost;tehnična učinkovitost;stroškovna učinkovitost;DEA;

Data

Language: Slovenian
Year of publishing:
Typology: 2.08 - Doctoral Dissertation
Organization: UL FU - Faculty of Administration
Publisher: [N. Lamovšek]
UDC: 616-074:005.336.1(497.4)(043.3)
COBISS: 22525187 Link will open in a new window
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Other data

Secondary language: English
Secondary title: AN ANALYSIS OF THE EFFICIENCY OF PUBLIC BIOMEDICAL LABORATORIES IN SLOVENIA FROM THE VIEWPOINT OF ACHIEVING THEIR OPTIMAL SIZE
Secondary abstract: Medical laboratories, as a part of the public healthcare network, offers services for which the extent of their need from users is as yet unknown. The scope of medical laboratory services is thus in the complete client's domain. However, medical laboratories can, at least partially, influence the consumption of their resources. Medical laboratories are currently facing a variety of challenges that restrict them in different domains such as staff shortages, investments and funds, resources etc. Despite these challenges, laboratories still want to provide quick and quality laboratory services. The non-optimal size of the process in a medical laboratory could be the main reason for inefficiency. The purpose of the doctoral dissertation is to define optimal size of medical laboratories from the viewpoint of technical and economic efficiency. The impact of the consolidation of laboratory activity is defined by the differences in the efficiency of medical laboratories. By defining the Malmquist Productivity Index, it is possible to further define the impact of innovation on the efficiency of medical laboratories. In the empirical part of the doctoral dissertation, twenty medical laboratories that perform all three groups of laboratory tests were analysed. In addition, twenty-one medical laboratories on the primary level of healthcare were also analysed. Two laboratories from abroad have been added to the analysis for the purpose of international comparison of efficiency. To analyse the efficiency, the data envelope analysis, i.e. DEA method, has been used. The findings indicate that the inefficiencies caused by non-optimal laboratory size are up to 1.2 times higher than the process inefficiency. Consolidated laboratory activity is estimated as more efficient in our analysis. Management of ordering and consuming laboratory reagents and investing in laboratory equipment have proven to be essential for achieving the cost-efficiency of medical laboratories. In addition to that, it was found that the DEA method is not a satisfactory stand-alone efficiency indicator when evaluating the quality of laboratory work. This research thus contributes to the DEA research corpus in the healthcare area, which has not been addressed in this way as yet. The estimation of the optimal size of medical laboratories using the DEA method, taking into account operating models, is thus used for the first time in the case of medical laboratories.
Secondary keywords: Medicinski laboratoriji;Disertacije;Učinkovitost;Slovenija;
Type (COBISS): Dissertation
Study programme: 1001019
Thesis comment: Univ. v Ljubljani, Fak. za upravo in Univ. na Reki, Ekonomska fak.
Pages: XVII, 271 str.
ID: 12057211