title: [Performance and costs of services provided by physicians in selected regional occupational health care centers].
abstract: Collecting accurate data on performance and costs of services is recognized as the most difficult managerial problem because of limited application of medical standards and procedures as well as the different methods for costs calculation. The report presents the implementation of standardized medical procedures for referral examination, diagnosing occupational disease; and consultation in Regional Occupational Health Care Centers (ROHCC). Data on procedures were related to those on costs in cost centers and to cost structure--the time required for each task. Direct normative costs were analyzed in 6 ROHCC for managerial goals and selling the products as well. The results revealed important differences among different physicians' paid worktime spent on the same types of services. At 2 ROHCC time measurements and estimation of time gave similar results, in contrast to the rest ROHCC where those times were more prolonged. In contrast to commonly accepted opinions, the cost of physicians' work time amounted just several percent of total cost of the service. Such differences were noted not only among different ROHCC but even inside the same single ROHCC. The highest costs of production and of selling referral examinations and diagnosing occupational diseases resulted from the high percentage of indirect costs and overhead costs. The possible reasons of differentiated data on .rapid" and "slow" ROHCC were discussed. The need of right use of medical, organizational and financial data in evaluation of occupational health care efficiency is stressed.
authors.affiliation: Zakladu Organizacji Ochrony Zdrowia Instytutu Medycyny Pracy im. prof. dr. med. Jerzego Nofera w Lodzi. jmzoz@imp.lodz.pl
authors.forename: Jacek
authors.initials: J
authors.lastname: Michalak
authors.forename: Izabela
authors.initials: I
authors.lastname: Rydlewska-Liszkowska
mesh_terms: D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D005102:Health Expenditures; D006801:Humans; D009784:Occupational Diseases / Q000191:economics* / Q000517:prevention & control; D009786:Occupational Health Services / Q000191:economics* / Q000592:standards; D011044:Poland; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000191:economics*; D011795:Surveys and Questionnaires