Abstract
Background
there is growing evidence of a positive association between health care providers' financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives were: (1) to compare the financial performance of public hospitals, depending on the ownership and organizational form; (2) to analyze whether there is an association between financial performance and the chosen variables (e.g., total assets, revenues).
Methods
we conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805 (659 classic public hospitals, 17 research institutes and 129 corporatized). The hospitals' financial outcomes were measured by several variables and compared between the hospital groups; Spearman's rank correlation was calculated and a multivariable logistic regression model was performed.
Results
in 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Also, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. All three variables which can be used as proxy indicators of hospital size (total assets, revenues or costs) were positively correlated with the value of overdue liabilities and the debt ratio, and negatively correlated with the gross profit margin.
Conclusions
there is high diversity in public hospital financial standing in Poland, with numerous units facing liquidity problems in 2018. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care.
Key messages
The instable financial situation and growing debt of public hospitals in Poland has been a source of concern for more than two decades now. In 2018, local hospitals owned by counties as well as highly-specialized university clinics and research institutes were in the most disadvantageous financial situation.