Financial situation and challenges for management of SME hospitals: evidence from Poland

  • Aleksandra Szewieczek University of Economics in Katowice, Poland
Keywords: management, hospital, health care, finance, analysis, SME

Abstract


The hospital represents a specific organisation, operating in a turbulent environment and financed to a large extent by public funds. The health sector is exposed to constant political and social pressure. This causes significant problems with maintaining its financial stability, which particularly affects hospitals in the SME sector.
The aim of this paper is to examine the relationship between selected financial indicators and some environmental phenomena that affect the financial situation and future financial stability of a selected group of hospitals from the SME group. The results will also be compared to the situation of other SME entities. The research is based on descriptive analysis, descriptive statistics, and correlation analysis of selected data.
The results indicate that the financial situation of hospitals belonging to the SME group differs significantly from the overall SME sector, and does not bode positively for their future development. The current financial situation presents particular challenges for managers in balancing financial streams and ensuring economic sustainability. At the same time, this situation should encourage decision-makers to ensure an adequate level of revenues for these public service providers, as well as face other challenges related to operational management.

References

Ates, A., & Bitici, U. (2009). Strategy Management in Small to Medium-Sized enterprises: Evidence from UK manufacturing SMEs. Proceedings of the 16th annual EUROMA Conference, Göteborg, Sweden, June 14-17.

Augurzky, B., & Schmitz, H., (2010). Is There a Future for Small Hospitals in Germany? Ruhr Economic Paper, 198, 1-17.

Babczuk, A., & Kachniarz M. (2012). Sources of Soft Budget Constraints in the Structure of Autonomous Public Healthcare Centres. Argumenta Oeconomica, 1 (28), 181-214.

Bazzoli, G., Chen, H-F., Zhao, M., & Lindrooth, R.C. (2008). Hospital Financial Condition and Quality of Patient Care. Health Economics, 17 (8), 977-995.

Bem, A., Prędkiewicz, K., Prędkiewicz, P., & Ucieklak-Jeż P. (2014). Determinants of Hospital’s Financial Liquidity. Procedia Economics and Finance, 12, 27-36.

Bem, A., Prędkiewicz, P., Ucieklak-Jeż, P., & Siedlecki, R., (2015). Impact of Hospital’s profitability on structure of its liabilities, Business Ethics and CSR. Strategica, 657-665.

Bem, A., Predkiewicz, P., Ucieklak-Jeż, P., & Siedlecki R. (2015a). Profitability versus debt in hospital industry, European Financial Systems. Proceeding of the 12th International Scientific Conference, 20-27.

Bem, A., Siedlecki, R., Prędkiewicz, P., Gazzola, P., Ryszawska, B., & Ucieklak-Jeż P. (2019). Hospitals’ Financial Health in Rural and Urban Areas in Poland: Does it Ensure Sustainability?. Sustainability, 11, 1932.

Bem, A., Siedlecki, R., Prędkiewicz, P., & Ucieklak-Jeż, P. (2018). Determinants of hospital’s financial distress. Central European Conference in Finance and Economics (CEFE2018), Herlany, Slovak Republic, 04-06.09.2018, 27-34.

Breyer, F., Costa-Font, J., & Felder, S. (2010). Ageing, health and health care. Oxford Review of Economic Policy, 26(4), 674-690.

Canadian Insitute for Health Information (2011). Health Care Cost Drivers: The Facts. Ottawa, Ont.: CIHI.

Collum, T.H. (2013). Hospital Financial Performance: A Look at Governance and Hit Strategies. A Dissertation, University of Alabama at Birmingham, Birmingham, Alabama, 2013.

Coyne, J.S., Ricgards, M., Short, R., Shultz, K., & Singh S. (2009). Hospital Cost and Efficiency: Do Hospital Size and Ownership Type Really Matter? Journal of Healthcare Management, 54 (3), 163-175.

Creixans-Tenas, J., & Arimany-Serrat N. (2018). Influential variables on the profitability of hospital companies. Intangible Capital, 14 (1), 171-185.

Darvas, Z., Moes, N., Myachenkova, Y., & Pichler, D. (2018). The macroeconomic implications of healthcare. Policy Contribution, 11, 1-22.

Doeksen, G.A, Johnson, T.G., Biard-Holmes, D., & Schott, V. (1998). A Healthy Sector is Crucial for Community Economic Development. The Journal of Rural Health, 14 (1), 66-72.

Etizoni, A. (1964). Modern organizations. New Jersey, USA: Prentice-Hall.

Final report: study on the representativeness of business organisations for SMEs in the European Union. https://ec.europa.eu/DocsRoom/documents/2480/attachments/1/translations/en/renditions/pdf

Gapenski, L., & Pink, G. (2007). Understanding healthcare financial management. Chicago, USA: Health Administration Press.

GlobalInsight. (2002). Hospital Compensation Costs:

An Analysis Of Escalation In ECI Wage And Benefit Cost Indices Relative To PPS Proxies. Global Insight Inc., https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareProgramRatesStats/Downloads/wagestudyfinal.pdf

Health and Health Care in 2016. (2017). Statistics Poland, https://stat.gov.pl. (in Polish)

Health and Health Care in 2017. (2019). Statistics Poland, https://stat.gov.pl. (in Polish)

Health at a Glance 2015. (2015). OECD Indicators. Paris, Fr: OECD Publishing.

Health at a Glance 2017 (2017). OECD Indicators. Paris, Fr: OECD Publishing.

Hollingsworth, B. (2008). The measurement of efficiency and productivity of health care delivery. Health Economics, 10, 1107-1128.

Horgan, D., van Kranen, H.J., & Morré, S.A. (2018). Optimising SME Potential in Modern Healthcare Systems: Challenges, Opportunities and Policy Recommendations. Public Health Genomics, 21, 1-17.

Holmes, G.M., Kaufman, B.G. & Pink G.H. (2017). Predicting Financial Distress and Closure in Rural Hospitals. Journal of Rural Health, 33 (3), 239-249.

Horwitz, J.R. (2005). Making Profits and Providing Care: Comparing Non-profit, For-Profit, And Government Hospitals. Health Affairs, 3, 790–801.

Janati, A., Valizadeh, S., & Asghari-Jafarabadi, M. (2014). Development of Financial Indicators of Hospital Performance. Journal of Clinical Research & Governance, 3, 92-98.

Kalman, N.S., Hammil, B.G., Schulman, K.A., & Shah, B.R. (2015). Hospital Overhead Costs: The Neglected Driver of Health Care Spending? Journal of Health Care Finance, Spring, 41 (4), 1-15.

Kazahaya, G. (2005). Harnessing technology to redesign labor cost management reports: labor costs typically represent over 50 percent of a hospital's total operating expenses. Can the data management process be harnessed to create meaningful labor cost management tools? Healthcare Financial Management, 59 (4), 94-100.

Kaur, D., & Srivastava, S. (2017). Corporate Debt Restructuring and Firm Performance: A Study of Indian Firms. Serbian Journal of Management, 12 (2), 271-281.

Kirshbaum, M.N., Dent, J., Stephenson, J., Topping, A.E., Allinson, V., McCoy, M., & Brayford, S. (2017). Open access follow-up care for early breast cancer: a randomised controlled quality of life analysis. European Journal of Cancer Care (Engl), 26 (4): e12577.

Koval, O., Nabareseh, S., Stankalla, R., & Chromjakova, F. (2019). Continuous Improvement and Organizational Pracitices in Service Firms: Exploring Impact on Cost Reduction. Serbian Journal of Management, 14 (1), 177-191.

Locke, R.R., & Spender, J.C. (2011). Confronting managerialism: how business elite and their schools threw our lives out of balance. London, UK: Zed Books.

Meyer, V.Jr., Pascuci, L., & Mamedio, D. (2014). Managerialism in non-profit Hospitals: Experiencing strategic practices in complex and hybrid organizations. Proceedings of 30th Annual Colloquium of European Group of Organisation Studies EGOS 2014, Rotterdam, Holland.

Mills, J., Neely A., Platts, K., & Gregory, M. (1998). Manufacturing strategy: a pictoral representation. International Journal of Operations & Production Management, 18 (11), 1067 -1085.

Milosevic, I., Mihajlovic I., Stojanovic, A. (2019). Dominanct factors of SMEs failure – multigropu confirmatory factor analysis. Serbian Journal of Management, 14 (20), 345-360.

Mohanty, B., & Mehrotra, S. (2018). Relationship between Liquidity and Profitability: An Exploratory Study of SMEs in India. Emerging Economy Studies, 4 (2), 169-181

Muneer, S., Ahmad, R.A., Ali, A. (2017). Impact on Financial Management Practices on SMEs Profitability with Moderating Role of Agency Costs. Information Management and Business Review, 9 (1), 23-30.

Nyabwanga, R.N., Ojera, P., Otieno, S., Nyakundi, F.N. (2013). An Empirical Analysis of the Liquidity, Solvency and Financial Health of Small and Medium Sized Enterprises in Kisii Municipality. European Journal of Business and Management, 5 (8), 1-15.

Odit, M., & Gobardhun, Y.D. (2011). The Determinants Of Financial Leverage Of SME's In Mauritius. International Business & Economics Research Journal (IBER), 10 (3), 113-126.

Pascuci, L.M., Junior, V.M., & Crubellate J.M. (2017). Strategic Management in Hospitals: Tensions between the Managerial and Institutional Lens. Brazilian Administration Review, 14 (2), e160092

Pink, G.H., Holmes, M., D’Alpe, C., Strunk, L.A., McGee, P., & Slifkin, R.T. (2006). Financial Indicators for Critical Access Hospitals. The Journal of Rural Health, 22 (3), 229-236.

Report on Support to SMEs in Developing Countries Through Financial Intermediaries, (2011). Dallberg, https://www.eib.org/attachments/dalberg_sme-briefing-paper.pdf

Rudawska, I. (2012). Epidemiologic and demographic trends as a challenge for European health care systems. Problemy Zarządzania, 11 (41), 34-52.(in Polish)

Ryć, K., & Skrzypczak, Z. (2012). Health care financing in turbulent global economy. Problemy Zarządzania, 11, 2 (41), 9-23. (in Polish)

Schumann, T.M. (2008). Hospital financial performance trends to watch. Healthcare Financial Management, 62 (7), 59-66.

Smythe, M.S, Koerber, J.M., Fitzgerald, M., & Mattson J.C. (2009). The financial impact of heparin-inducted thrombocytopenia. Chest, 134 (3), 568-573.

Statistical Yearbook of the Republic of Poland 2017 (2018). Warszawa, Poland: GUS (in Polish)

Street, A., Scheller-Kreinsen, D., Geissler, A., & Busse R. (2010). Determinants of hospital costs and performance variation: Methods, models and variables for the EuroDRG project. Working Papers in Health Policy and Management, vol. 3, Berlin, DE: Technische Universitat Berlin.

Szewieczek, A. (2018). The analysis of health care market development in Poland – its directions and threats, FIKUSZ - Symposium for Young Researchers. Proceedings, Obuda University, Budapest, Hungary, 409-424.

Thanasas, G. L. (2013). Factors’ Affecting the Hospital’s Cost Structure: the Case of a Greek University Hospital. Universal Journal of Accounting and Finance, 1 (2), 78-83.

The 2018 Ageing Report: Economic and Budgetary Projections for the EU Member States (2016-2070), (2018), European Commision,

Turcotte-Tremblay, A.-M., Spagnolo, J., De Allegri, M., & Ridde, V. (2016). Does performance-based financing increase value for money in low- and middle- income countries? A systematic review, Health Economics Review, 6:30 (https://doi.org/10.1186/s13561-016-0103-9)

www1, (2018). The “Survey on the access to finance of enterprises” (SAFE) was published today. https://ec.europa.eu/growth/content/survey-access-finance-enterprises-safe-was-published-today_en

www2, (2018). Why are so many of our health services provided by charities? https://www.irishtimes.com/life-and-style/health-family/why-are-so-many-of-our-health-services-provided-by-charities-1.3300058

www3, (2019). Central Statistical Office, Local data Bank, https://bdl.stat.gov.pl/BDL/start

Velez-Gonzales, H., Pradhan, R., & Weech-Maldonado, R. (2011). The role of non-financial performance measures in predicting hospital financial performance: the case of for- profit system hospitals. Journal of Health Care Finance, 38 (2), 12-23.

Young, D.W., & Ballarin., E. (2006). Strategic Decision-Making in Healthcare Organizations: It Is Time to Get Serious. International Journal of Health Planning and Management 21, 173–91.

Younis, M.Z. (2012). A comparison study of urban and small rural hospitals financial and economic performance. Online Journal Rural Nursing Healthcare, 4, 38-48.

Zeller, T.L., Stanko, B.B., & Cleverey, W.O. (1996). A revised classification pattern of hospital financial ratios. Journal of Accounting and Public Policy, 2, 161-181.

Published
2021/05/18
Section
Original Scientific Paper