IMPROVEMENT OF HOSPITAL HEALTH CARE SISTEM REPUBLIC OF CROATIA BY EFFICIENT HUMAN RESOURCE MANAGEMENT

Svaka bolnička zdravstvena ustanova nastoji pružiti što kvalitetniju i potpuniju uslugu zdravstvene zaštite. Kako bi postigla navedeno, ista treba imati, kao i kvalitetno upravljati ljudskim i materijalnim resursima. U svrhu praćenja i poboljšanja praćenja naturalnih i financijskih pokazatelja unutar svake bolničke zdravstvene ustanove, u istoj je potrebno omogućiti prikupljanje i distribuciju medicinskih i ekonomskih podataka odnosno poboljšati procese planiranja, upravljanja i prikupljanja informacija u svim segmentima redovnog poslovanja. Jačanje i bolje korištenje ljudskih resursa jedan je od strateških prioriteta definiran i Nacionalnom strategijom razvoja zdravstva za razdoblje 2012.-2020. kao jedna od reformskih mjera koje provodi Ministarstvo zdravlja Republike Hrvatske. Poboljšati koordinaciju ljudskih resursa moguće je aktivnim i sustavnim procesom proučavanja strukture s naglaskom na važnost učinkovitog organizacijskog planiranja, boljeg korištenja, objedinjavanja i racionalnijeg upravljanja ljudskih resursa, a sve u cilju unapređenja bolničke zdravstvene zaštite i uspješnog funkcioniranja svake bolničke zdravstvene ustanove. U kontekstu racionalizacije i konsolidacije troškova zdravstvenih usluga bolničke zdravstvene zaštite, naglasak možemo staviti na reorganizaciju liječenja koja se može usmjeriti na smanjenje korištenja bolničkih kapaciteta, prije svega stacionarnih, što bi ujedno i predstavljalo manji broj djelatnika unutar bolničke zdravstvene ustanove. Obzirom da još uvijek unutar bolničkih zdravstvenih ustanova nije uspostavljen sustav praćenja razvoja zaposlenih radnika u bolničkom zdravstvenom sustavu kao i poboljšanje položaja u cilju dosezanja europskih standarda, racionalizacija akutnih ležećih kapaciteta i formiranje regionalne i nacionalne mreže bolničke skrbi, s razlogom treba kao promjenu u sustavu raditi postupno. Naime, upravljati ljudskim resursima na efikasan i održiv način u današnje vrijeme zahtijeva prije svega kvalitetno planiranje te realizaciju koja treba biti usmjerena na unapređenje organizacije i realizacije svih poslovnih procesa unutar svake bolničke zdravstvene ustanove. Učinkovitost bolničkih zdravstvenih ustanova kroz upravljanje resursima iste ujedno pokazuje usmjerenost i doprinos uprave bolničke zdravstvene ustanove u provođenju postavljenih i utvrđenih ciljeva. Podaci koji su kao važan informacijski potencijal prikupljeni analizom dostupne literature kao i izvješća koja sadrže financijske i naturalne pokazatelje vezano za analiziranje bolničkog zdravstvenog sustava Republike Hrvatske prikazani su i promatrani pojedinačno po bolničkim zdravstvenim ustanovama (klinički bolnički centri, kliničke bolnice i opće bolnice), i po kategorijama sukladno kategorizaciji prema Pravilniku o uvjetima za razvrstavanje bolničkih zdravstvenih ustanova u kategorije (NN 95/10) odnosno prva do četvrta kategorija. Prepoznati problem te pronaći moguće putove za njihovo rješenje kao dio specifičnih ciljeva kroz sustav praćenja, analiziranja i upravljanja ljudskim resursima unutar svake bolničke zdravstvene ustanove s naglaskom na funkcionalnu operativnost, dostupnost i transparentnost zdravstvenih usluga predstavlja ujedno i rješavanje istog uz kvalitetnu strategiju razvoja zdravstvenog sustava. Time bi se u okviru ovog rada kroz sistematičan prikaz razmatrala organizacija i upravljanje bolničkim zdravstvenim ustanovama u okviru bolničkog zdravstvenog sustava Republike Hrvatske te ljudskih resursa koji kao temelj zdravstvenog sustava u sklopu sanacije i reorganizacije bolničkog zdravstvenog sustava doprinose strategiji razvoja istog. U radu su testirane sljedeće hipoteze: H1: Opće bolnice imaju manju iskorištenost kreveta u odnosu na kliničke bolničke centre H2: Prihodi po krevetu veći su u kliničkim bolničkim centrima u odnosu na opće bolnice H3:Istočna regija Republike Hrvatske s najviše bolničkih zdravstvenih ustanova po stanovniku ima najveći broj pacijenata po krevetu H4: Normu od 100 pacijenata po liječniku godišnje zadovoljavaju i prekoračuju zdravstvene ustanove koje imaju veći broj liječnika po krevetu H5: Bolničke zdravstvene ustanove sa većim učešćem nezdravstvenih radnika posluju neracionalnije u odnosu na bolničke zdravstvene ustanove sa manjim učešćem nezdravstvenih radnikaEvery hospital health institutions strives to provide the best and most complete health care service. To achieve this, it should have well manage human and material resources. In order to monitor and improve the monitoring of physical and financial indicators within each hospital health institutions, the same is necessary to enable the collection and distribution of medical and economic data and improve the planning, management and collection of information in all aspects of operating activities. Strengthening and better use of human resources is one of the strategic priorities defined by the National Strategy for Health Development for the period 2012.-2020. as one of the reform measures implemented by the Ministry of Health of the Republic of Croatia. It is possible to improve coordination of human resources by active and systematic process of studying the structure with an emphasis on the importance of effective organizational planning, better use, unifying and rational management of human resources, with the aim of improving hospital health care and the effective operation of a hospital medical institutions. In the context of rationalization and consolidation of the health care cost of hospital care, the emphasis we put on the reorganization of treatment that can be given to reducing the use of hospital capacity, primarily stationary, which would also constitute a small number of employees within the hospital medical institutions. Since it is still within the hospitals has not established a system for monitoring the development of employees in the hospital health care system and improve the position of the aim of achieving European standards, rationalization of acute recumbent capacity and the formation of regional and national network of hospital care, a reason to be a change in the system of work gradually. Specifically, manage human resources in an efficient and sustainable manner today requires first of all quality planning and implementation of which should be directed to the improvement of the organization and implementation of all business processes within each hospital health institutions. The efficiency of hospitals through resource management also shows the same focus and contribution to the administration of hospital health care institutions in the implementation of the set and established goals. It is possible to improve coordination of human resources through active and systematic process of studying the structure with an emphasis on the importance of effective organizational planning, better use, unifying and rational management of human resources, with the aim of improving hospital health care and the effective operation of a hospital medical institutions. In the context of rationalization and consolidation of the health care cost of hospital care, the emphasis is put on the reorganization of treatment that can be given to reducing the use of hospital capacity, primarily stationary, which would also constitute a small number of employees within the hospital medical institutions. Since one still has not established a system for monitoring the development of employees in the hospital health care system and improved the position of the aim of achieving European standards, rationalization of acute recumbent capacity and the formation of regional and national network of hospital care, the change in the system has to bed one gradually. Specifically, manage human resources in an efficient and sustainable manner today requires first of all quality planning and implementation of which should be directed to the improvement of the organization and implementation of all business processes within each hospital health institutions. The efficiency of hospitals through resource management also shows the same focus and contribution to the administration of hospital health care institutions in the implementation of the set and established goals. The data, being important information potential, are collected by analysis of the available literature and reports containing financial and natural indicators regarding the analysis of hospital health care system are presented and monitored except by individual health care facilities and by categories according to categorization according to the Regulations on the conditions for classification of hospitals in-class or first to fourth category (NN 95/10). Identifying the problem and finding possible ways for their solution as part of the specific objectives of the system of monitoring, analysis and management of human resources within each hospital health institution with an emphasis on functional operation, availability and transparency of health services is also the challenge to the quality strategy for the development of the health system. This paper would through a systematic presentation discuss the organization and management of health care facilities within the hospital health system and human resources as the foundation of the health system as part of the renovation and reorganization of hospital health care system contribute to the development strategy of the same. The paper tested the following hypotheses: H1:General Hospitals have a lower utilization of beds in relation to the clinical hospital centers H2: Revenues per bed increased in clinics and hospitals in relation to general hospitals H3:Eastern region of the Republic of Croatian with the most hospitals per capita has the highest number of patients per bed H4:This standard of 100 patients per doctor annually meet and exceed the medical institutions that have a higher number of doctors per bed H5:Hospital medical institutions with greater involvement of non-health workers operate more rationally in relation to hospital healthcare facilities with low participation of non-health workers