La empresa hospitalaria: un estudio empírico sobre la implantación de la contabilidad de gestión
The health system of a country is comprised of the set of institutions, agencies and resources both human and structural, and the range of health services and public and private institutions responsible for the production of health services, to improve and maintain the health population. Their results depend, of different forms of organization can adopt the health sector in each country according to their planning by health leaders and are the product of history and culture of the societies in which they develop. These systems are large hospitals organizations providing health, sensitive assistance as open organizations in a specific and general environment, the results depend on knowledge of their integrated systems management information as the clinical management of patients and the resource and the economic and financial. Knowledge of costing models, and their capacity to adapt to hospital environments, make their particularities, as the adopted model, its characteristics, its guidance for the calculation of costs, in their different ways: by cost centers for intermediate products, case-mix, or patients, is a necessity to the effect that these models provide analytical analysis of the quality and economic and social returns. These models are obtained by making decisions in hospital management. His constant adaptation to specific environments of the generation cost of dedicated systems with singular information needs adapted to hospital management. The presence of common elements in the various cost systems has allowed us to establish general criteria in the training of health cost by proposing two models we consider most suitable for such analysis. Thus the effect of knowing the reality, in Spain and in other European countries, we performed an empirical study differentiating between public and private hospitals, through a survey with more than fifty questions relying on the analysis of the literature, as well as empirical studies conducted in hospitals also materialize the above features, information systems available, information, level of computerization and its connection with the cost model to determine its preparation, present and future in obtaining a cost model for patients. The level of response achieved (24.7% in Spain and 13.2%% in Europe) and the results of the survey allows us to confirm that the application of the models developed for calculating costs based on the model of patient episodes Direct Costing evolved and activities (Activity Basic Cost), and implemented in two ways: without an advanced level of development in information systems or with an advanced level of development in information systems. allow optimal management of public hospitals.