Optimization of medical personnel’s wages and salaries in primary personal health care institutions

Aim of the work was to determine the position of medical personnel’s wages and salaries as well as that of finance allocated to maintain the institutional infrastructure in the scale of insti-tution’s expenditure; to indicate the possibilities to optimize a doctor’s wage while changing the order of finance management. Study methodology. In order to analyse and understand the revenue and expenditure of pri-mary personal health care institutions (PPHCI), the reports on usage of compulsory health insurance fund budget resources in health care institutions for the year 2007 were examined in 80 medical institutions. Statistical analysis of the obtained data was performed using SPSS software. When verifying statistical hypotheses, 0.05 level of significance was chosen. To evaluate group homogeneity, 2 criterion was applied. The distribution of quantitative vari-ables was verified using Kolmogorov-Smirnov test. Parametric and non-parametric disperse analysis (ANOVA and Kruskal-Walils test) was employed to compare group averages. Bon-ferroni test was applied to multiplex pair comparisons, whereas Mann-Whitney test was used to compare two groups. Results. PPHCI resources for services provided are received from compulsory health insur-ance fund and are spent on wages and salaries as well as on the maintenance of institutional infrastructure. Revenue and expenditure of some medical institutions for the year 2007 were balanced, i.e. institutions worked cost-effectively. Other institutions had more expenditure than revenue during 2007, i.e. their work was loss-making. Expenditure for wages and salaries (calculated wages + social insurance premium) varied from 68% to 89% depending on the revenue of a medical institution and there was no significant difference between medical institutions of different profitability. This matches the data found in literature, since in the EU countries, it is recommended to allocate about 70% of revenue to primary medical institutions’ wage fund. Having evaluated the expenditure of PPHCI of different profitability for their infra-structure maintenance, some significant differences were found between groups of medical institutions that allow to state that unreasoned usage of funds for medical institution infra-structure maintenance (and especially administrative expenditure) may increase credit indebt-edness, i.e. the institution works at a loss. Current PPHCI finance management model as well as revenue-expenditure reports present debts as a fact at the end of a year, yet there is no possibility to analyse the reasons of possible debts in detail. Debts of previous financial year, considerable expenditure for institu-tional infrastructure maintenance (administration in particular) and other expenditure pre-sented in a medical institution’s revenue-expenditure reports may have an impact on negative balance of the medical institution. The lack of reasons for determined loss in medical institutions of different profitabil-ity and evaluated reference data about finance management in medical institutions of EU countries force to frame a new model of institution finance management Payment from a Doc-tor which allows to analyse institution’s expenditure in theory and practice and to ascertain their reasoned usage while saving funds and increasing a doctor’s wage. Conclusions. Having evaluated PPHCI revenue-expenditure reports, wages of medical personnel did not differ significantly in the groups of institutions with different profitability. PPHCI works at a loss if it does not use funds rationally to maintain its infrastructure. The recommended finance management model Payment from a Doctor would help to administer the funds of medical institutions rationally in theory and practice