Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Sources and Variables
- generation/existence of gross profit (profit before tax); yes—there is gross profit, no—there is no gross profit, the hospital generated gross loss
- generation/existence of arrears (overdue liabilities); yes—there are overdue liabilities, no—there are no overdue liabilities
- gross profit margin (profit or loss before tax per total revenues);
- debt ratio (total liabilities per total assets);
- the share of arrears (overdue liabilities) in total liabilities.
2.3. Statistical Analyses
3. Results
3.1. Participants’ Descriptive Statistics
3.2. Financial Performance per Hospital Owners
3.3. Financial Performance per Hospital Organizational Form
3.4. Factors Associated with Hospitals’ Financial Performance
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Legal Form | Legal Consequences of Financial Deficit | Owners | Share of Units in Total Number of Public Hospitals Beds in 2018c |
---|---|---|---|
Independent health care units (samodzielny publiczny zakład opieki zdrowotnej—SPZOZ) | • Do not have bankruptcy capacity; • If the hospital cannot cover the financial lossa the owner has to cover it or make a decision about hospital liquidationb | • Local governments (counties/cities; voivodships) • Medical universities • Ministries | 80.2% (per owner: 29.9% counties/cities; 34.5% voivodeships; 11.5% medical universities; 4.3% ministries) |
Research institutes | • Do not have bankruptcy capacity; • In case of liquidation the liabilities are taken over by the state | • Ministry of Health (supervisory body) | 3.5% |
Corporatized public hospitals (commercial companies with the majority of/all shares belonging to public body) | • Subject to regulations applicable to commercial code companies (incl. bankruptcy capacity) | • Local governments (counties/cities; voivodships) | 16.3% |
Hospitals Classification: | n | Median (q1–q3), Million PLN | ||||||
---|---|---|---|---|---|---|---|---|
Total Assets | Total Revenues | Total Costs | Gross Profit/Loss | Total Liabilities | Arrears | |||
Owner | County or city County | 309 | 24.7 (7.7–49.0) | 36.5 (11.9–62.7) | 37.4 (11.9–63.8) | −0.2 (−2.4–0.2) | 8.0 (1.4–17.9) | 0.0 (0.0–1.5) |
Voivodeship | 236 | 34.0 (10.8–82.4) | 36.8 (12.3–121.2) | 36.2 (12.2–121.4) | 0.4 (−2.6–0.3) | 5.6 (1.2–26.3) | 0.0 (0.0–0.06) | |
Medical university | 40 | 138.2 (81.6–211.3) | 224.4 (115.1–353.8) | 231.6 (117.5–358.7) | −0.5 (−6.9–0.7) | 42.6 (16.4–85.6) | 0.0 (0.0–11.7) | |
Ministry | 91 | 22.2 (6.1–80.4) | 19.3 (6.6–60.8) | 18.7 (6.3–65.5) | 0.9 (−0.6–0.4) | 2.3 (0.5–12.2) | 0.0 (0.0–0.0) | |
ALL owners | 676 | 28.4 (9.4–70.2) | 36.3 (12.1–87.3) | 36.6 (12.2–89.8) | 1.4 (−2.6–0.3) | 6.7 (1.3–22.6) | 0.0 (0.0–1.0) | |
Legal form | SPZOZ | 659 | 27.9 (9.2–68.3) | 35.9 (11.5–85.6) | 35.9 (11.5–86.8) | 0.0 (−2.4–0.3) | 6.4 (1.2–21.3) | 0.0 (0.0–0.9) |
Research institute | 17 | 141.9 (34.2–282.8) | 133.9 (35.0–281.2) | 137.8 (35.5–284.8) | −3.1 (−7.3–(−0.7)) | 40.7 (6.5–92.4) | 4.3 (0.0–11.6) | |
Corporatized public | 129 | 26.0 (10.7–50.2) | 33.9 (20.1–60.3) | 35.0 (21.3–61.6) | −0.7 (−3.7–0.2) | 5.9 (2.9–14.7) | 0.0 (0.0–0.9) | |
ALL legal forms | 805 | 27.9 (9.8–68.2) | 35.8 (12.8–81.1) | 36.5 (12.9–84.5) | −0.1 (−2.8–0.3) | 6.4 (1.4–20.9) | 0.0 (0.0–1.0) |
Variable (Percentage, Median, q1-q3)/Owner | ‘A’ County or City County | ‘B’ Voivodeship | ‘C’ Medical University | ‘D’ Ministry | H-Value | p-Value |
---|---|---|---|---|---|---|
n | 309 | 236 | 40 | 91 | ||
Gross profit margin | −1.2 (−5.6–1.2) | 0.0 (−4.1–0.9) | −0.7 (−2.8–0.4) | 1.0 (−1.3–3.6) | 23.3 | <0.001 |
Debt ratio | 24.5 (14.2–51.2) | 17.9 (9.9–33.7) | 30.6 (19.1–51.5) | 9.8 (5.1–19.5) | 60.9 | <0.001 |
Share of arrears in total liabilities | 0.0 (0.0–10.4) | 0.0 (0.0–2.3) | 0.0 (0.0–13.6) | 0.0 (0.0–0.1) | 22.3 | <0.001 |
Variable (Percentage, Median, q1-q3)/Organizational Form | ‘A’ SPZOZ | ‘B’ Research Institute | ‘C’ Corporatized Public | H-Value | p-Value |
---|---|---|---|---|---|
n | 659 | 17 | 129 | ||
Gross profit margin | 0.0 (−4.0–1.4) | −2.5 (−7.9– (−0.4)) | −2.1 (−9.1–0.9) | 17.2 | <0.001 |
Debt ratio | 19.6 (10.6–39.8) | 26.1 (15.1–73.5) | 28.0 (13.5–48.3) | 9.3 | 0.01 |
Share of arrears in total liabilities | 0.0 (0.0–5.6) | 6.5 (0.0–20.4) | 0.0 (0.0–7.8) | 9.2 | 0.01 |
Variable | Generation/Existence of Gross Profit | Generation/Existence of Arrears | ||
---|---|---|---|---|
Adjusted OR (95% CI) | p-Value | Adjusted OR (95% CI) | p-Value | |
Ownership group: | ||||
Country or city | 1 | 1 | ||
Voivodeship | 1.73 (1.21–2.47) | 0.003 | 0.38 (0.26–0.55) | <0.001 |
Medical university | 4.05 (1.74–9.46) | <0.001 | 0.30 (0.13–0.70) | 0.005 |
Ministry | 3.29 (1.94–5.60) | <0.001 | 0.34 (0.20–0.58) | <0.001 |
Revenues (10 million PLN) | 0.93 (0.90–0.95) | <0.001 | 1.08 (1.05–1.10) | <0.001 |
AUC | 0.70 (0.66–0.74) | 0.71 (0.67–0.75) |
Variable | Generation/Existence of Gross Profit | Generation/Existence of Arrears | ||
---|---|---|---|---|
Adjusted OR (95% CI) | p-value | Adjusted OR (95% CI) | p-Value | |
Organizational form: | ||||
SPZOZ | 1 | 1 | ||
Research institute | 0.31 (0.08–1.13) | 0.077 | 2.31 (0.75–7.09) | 0.144 |
Corporatized public | 0.46 (0.31–0.68) | <0.001 | 1.17 (0.79–1.73) | 0.446 |
Revenues (10 million PLN) | 0.94 (0.92–0.96) | <0.001 | 1.06 (1.04–1.08) | <0.001 |
AUC | 0.69 (0.65–0.72) | 0.71 (0.67–0.74) |
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Dubas-Jakóbczyk, K.; Kocot, E.; Kozieł, A. Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers. Int. J. Environ. Res. Public Health 2020, 17, 2188. https://doi.org/10.3390/ijerph17072188
Dubas-Jakóbczyk K, Kocot E, Kozieł A. Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers. International Journal of Environmental Research and Public Health. 2020; 17(7):2188. https://doi.org/10.3390/ijerph17072188
Chicago/Turabian StyleDubas-Jakóbczyk, Katarzyna, Ewa Kocot, and Anna Kozieł. 2020. "Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers" International Journal of Environmental Research and Public Health 17, no. 7: 2188. https://doi.org/10.3390/ijerph17072188