Competition in public procurement in the Czech healthcare system and its impact on the final price

The efficiency of the public finance system is conditioned also by the efficiency of public procurement processes. The Slovak healthcare system has been under pressure to increase long-term efficiency. With respect to achieve the efficiency in healthcare system, the efficient public procurement is necessary condition. It is important to examine the factors influencing the public procurement system in the health sector as well as the causal relationships that would provide a valuable platform for the evaluation mechanisms aimed at the effectiveness of the planned purchases. The healthcare sector is specific because it is difficult to consider the effectiveness of the medical equipment in public procurement as well as its long-term effects, the total cost of the treatment and the individual requirements of the patient. The aim of the study is to clarify, whether the use of GPA impact the occurrence of savings within the public procurement process and if application of GPA induces the competition among tenders, thus whether the use of GPA increase number of offers. We use data on public procurement in healthcare sector in Slovak republic in 2019. The focus of analysis is on the Agreement on Government Procurement use by Slovak public procurement bodies and its impact on competition and creation of savings in public procurement process. Our findings suggest that the use of Agreement on Government Procurement induce emergence of savings in public procurement and increases the level of competition. Analysis also indicates that there exists relatively tight correspondence between competition and emergence of savings within public procurement process. It holds that higher the number of offers is, the higher savings are.

Download Full-text

VP70 Structuring The Process Of Innovation Uptake In Tunisia

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317003452 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 181-182

Author(s):

Mouna Jameleddine ◽

Asma Ben Brahem ◽

Hela Grati ◽

Hella Ouertatani ◽

Wafa Allouche ◽

...

Keyword(s):

Decision Making ◽

Clinical Practice ◽

Healthcare System ◽

Medical Devices ◽

Public Procurement ◽

Flow Chart ◽

Hospital Level ◽

Specific Flow ◽

Health Technologies ◽

The Impact

INTRODUCTION:Tunisia recently implemented a Health Technology Assessment (HTA) agency (INASanté) to inform decisions around health technologies and to improve clinical practice by means of the elaboration of Clinical Practice Guidelines (CPG). However many decisions on new and emerging technologies, their implementation and coverage in the health care system are still taken at the hospital level without any structured process that informs the decisions. The aim of this project was to improve the methods and flow-chart of decision-making processes on innovation uptake in the Tunisia Healthcare System.METHODS:By means of the toolkit of EuroScan for the implementation of an early awareness and alert system (EAAS), and its checklist, it was discussed specifically within INASanté the characteristics of the Tunisia Healthcare System and its specificities regarding decisions on drugs and medical devices. The analysis included the process of innovation uptake at the hospital level and its specific flow-chart. In depth interviews and a devoted workshop were performed with personal in INASanté: two physicians (one involved in CPG elaboration and the second in accreditation), three pharmacists (HTA), one nutritionist (HTA), two librarians and other stakeholders, including the Directorate of Hospitals.RESULTS:The uptake of innovations in Tunisia does not follow a structured process. In fact, there is no central purchase of medical devices in Tunisia and most medical devices are purchased by hospitals within a tender process in accordance with the Tunisian public procurement law. The main pitfalls are: lack of awareness around innovations that could impact the system, non-structured process of information sharing among the different decision-makers that promotes inequity in access to technologies and services, and lack of explicit criteria that determine decisions around health technologies.CONCLUSIONS:Tunisia requires a structured and informed process on decisions around innovation uptake in the healthcare system. The principles that should govern this system are: anticipation of the impact of new health technologies, establishing priorities and criteria for decision making in all places of decision. The decisions should be recorded and publicly shared to avoid inequities in the access to technologies.

Download Full-text

Inoculation of Safety in Healthcare

Medicine Law & Society ◽

10.18690/24637955.10.1.19-31(2017) ◽

2017 ◽

Vol 10 (1) ◽

pp. 19-31

Author(s):

Bojan Dobovšek ◽

Boštjan Slak

Keyword(s):

Healthcare System ◽

Conflicts Of Interest ◽

Negative Impact ◽

Public Procurement ◽

Informal Institutions ◽

Healthcare Sector ◽

Business Practices ◽

Preventive Action ◽

Informal Networks

The purpose of this paper is to analyse - through a prism of informal institutions - the role and importance of security in healthcare and the manner in which healthcare sector copes with security threats in postmodern society. We note that bad informal institutions are differently reflected in Slovenia. In the forefront are the problems of systemic corruption, various forms of clientelism and nepotism. This is (in)directly reflected in the (lack of) quality of Slovenian healthcare system. Inadequate public procurement system and conflicts of interest in healthcare sector are causing inferior quality of the healthcare system, while informal institutions in politics and economics are weakening Slovenian economy, consequently affecting the funding of Slovenian healthcare system which is also undermined by the financial crisis. Additionally, globalisation, which has a (negative) impact on human health, has caused the importation of improper business practices into healthcare system. It is therefore necessary to develop a preventive action that will inoculate the idea of a safe country for the benefit of people and not for the benefit of bad informal networks.

Download Full-text

The efficiency of public procurement in the health sector – the platform on sustainable public finances

ADMINISTRATIE SI MANAGEMENT PUBLIC ◽

10.24818/amp/2020.35-02 ◽

2020 ◽

Vol 1 (35) ◽

pp. 21-39

Author(s):

Beata GAVUROVA ◽

Matus KUBAK ◽

Martin MIKESKA

Keyword(s):

Healthcare System ◽

Slovak Republic ◽

Multinomial Logistic Regression ◽

Public Procurement ◽

Health Sector ◽

Public Hospitals ◽

Categorical Variables ◽

The European Union ◽

The Public ◽

Study Results

At present, public procurement processes and their efficiency represent one of the key determinants of public finance system. Many countries of the European Union work intensively on reforming public procurement processes. The main aim of public procurement is to create an open competition in order to achieve the most efficient use of public funds. The Slovak hospitals, that have been inefficiently managed in the long run, are the weakest segment of the healthcare system. Also, the public hospitals continue to generate substantial losses even if many reforms had been implemented to increase cost efficiency. However, medical debt consolidation did not help the hospitals to set optimal functioning of the economic processes in order to improve their management permanently. The primary aim of the study is to examine an impact of selected determinants on an efficiency of public procurement processes in the healthcare system of the Slovak Republic during the 2014 – 2017. The data were obtained from the registers of the Public Procurement Office of the Slovak Republic. The multinomial logistic regression was used to determine the following findings: in case of zero, or positive savings, the number of offers, year of public procurement, type of public procurement procedure, NUTS level of procurement and participation of a subcontractor in procurement process are significant categorical variables. The study results enable a creation of multi-dimensional analyses and support models in order to make effective public procurement processes in the healthcare system. Similarly, these results enable to create comparative benchmarking analyses, and may lead to a creation of new agencies and institutions.

Download Full-text