Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public.

Stratégiai paradigmaváltás szervezeti verseny(képesség) és az Operations management központi szerepe (Central role of strategic paradigm change, corporate competitiveness and operations management)

Az elmúlt két évtized folyamán a menedzserek megtanultak a megújult szabályok szerint játszani. Tudatosították, hogy a vállalatuk eredményes navigálásához folyamatosan figyelniük és adaptálniuk kell a legújabb módszereket, elméleteket. Jelen tanulmányával a szerző ezt a folyamatot kívánja segíteni, valamint arra az alapvető kérdésre keresi a választ, hogy érdemes-e a rendkívül gyorsan változó világban hosszabb távú célok meghatározásával foglalkozni, és ha igen, akkor mire összpontosítsák a vállalatok erőfeszítéseiket. Milyen részletezettséggel, milyen módon határozzák meg az elképzeléseiket úgy, hogy közben megőrizzék a vállalat flexibilitását, a változások idején nélkülözhetetlen agilitást. A szerző arra vállalkozik, hogy feltárja a stratégiai paradigmaváltás fejlődését, a termelési stratégia, az operations management központi meghatározó szereppé válását, valamint áttekintse a termelési és szolgáltatási rendszervezetés (OM) elveinek, eszközeinek, módszereinek fejlődését, kölcsönhatását, összefüggéseit. _______ Change of paradigm has taken place in strategic planning. Fight for position turned into a fight of movement. Companies strive to achieve individual, not copyable organizational performance, as well as to realize their business strategies by means of value generating, proactive approach. Operative management now placed in the focus of production strategy is becoming the compass, the driving force of leadership. The management of production and service systems has grown into independent scientific disciplines. It yielded such principles, tools and methods which are present as world-renowned blueprints (scientific tools) in the field of maintaining and developing corporate performance. In the present study the author specifies and discusses the tools of operative management as criteria of value generation aiming at quality and cost efficiency. He analyses the backto- back character, interrelationship of quality, TQM (Total Quality Management), TPS (Toyota Production System) and JIT (Just in Time). He examines the effects thereof on corporate performance where significant and strong relationship can be demonstrated in case there is an ability to plan and develop new products. The current new OM (Operations Management) techniques increasingly rely upon the quality of human resources, the permanent improvement of procedures as well as focusing on tight cooperation with suppliers/customers. Supply chain management, core competence management, service management now represent a “new generation” of the OM methods, processes, serving at the same time as basis and starting point for expectable future techniques as well.