Архів / Archive

УДК 657

Kavaldzhieva Kalina

Doctor

University of national and world economy

Sofia, Bulgaria

ANALYSIS OF EFFECTIVE MANAGEMENT SOLUTIONS THROUGH SOCIAL - ECONOMIC ANALYSIS AND THEIR INFLUENCE ON THE COST OF HEALTH SERVICES

Abstract

The social - economic analysis has resulted in detailed financial projections ( operating income and expenses applicable tariffs for water services) and the conclusions related to the implementation of the following indicators: 1) performance of financial profitability of the project - financial net present value of capital (FNPV/C), the financial internal rate of return (FRR/C), financial net present value of the investment (FNPV/K), financial internal rate of return on investment (FRR/K); 2) Affordability of tariffs for water and sewerage services; 3) Indicators of financial sustainability of the project (analysis of cumulative cash flow); 4) Identification of the sources of funding ( grants , municipal budget, loan or other credit institution).

Keywords: capital, investment, Internal rate of return; Net present value; аffordability, sustainable, profitability, performance, social efficiency, terminal value, risk.

In an analysis of public goods associated with decisions not only for current financing, but also for their more effective and quality implementation in subsequent years. Strongest priority financing of investment projects which contribute to the growth of public welfare over time. It is necessary to consider alternatives to the costs and benefits to choose which is the best option. Analysis "cost - benefit" is defined as a practical method for assessing the results of a project in the long term. In a narrow basis, the direct benefits and costs of the project, and a wide - its impact on large groups of people. Izmervaneyata efficiency will be achieved by displaying the economic rate of return and net present economic value.

Social affordability and sustainability issues.

Implementation of the project is an investment made for the purposes of hospital. The investment consists of the purchase of equipment on the territory of the hospital in accordance with European standards for hospitals. The aim is to obtain high quality medical services for diagnosis and treatment will be used modern technologies and their treatment will be refurbished, modern rooms. Target groups of the project are: the growing number of cancer patients, and the region we serve; All patients in the country who can not get modern radiotherapy of residence; sick socially disadvantaged; patients middle age.

Stakeholders in this project: Municipality of Plovdiv - direct beneficiaries of these and this Program for Komplex Oncology center Ltd.

Financial Sustainability.

On the basis of analysis - Financial and economic demonstrate financial sustainability, which means that there is no risk to the project is out of money; timing of receipts and payments is essential for the project. Financial - economic analysis in the investment is observed resistance, since the cumulative effect of the net cash flow is positive for each of the years of operation.

The long term effects of the results will be supported by strict adherence to the medical standard and European standards in the implementation of planned activities. The project is to meet the needs of access to quality health care, proper diagnosis and adequate treatment to over 25,000 patients a year with a prevalence of health Facilities prevention, diagnosis and treatment of cancer. Providing comfortable hospital environment and modern medical equipment will increase the quality and capacity of health services to patients COC EOOD- Plovdiv, incl.. Disadvantaged Roma - around 15-17% of the population of the area; people with disabilities and the elderly.

After completing the project, mainly the financing of the hospital will be provided by targeted subsidies from the state budget, contracts for medical assistance, revenues from NHIF number of patients served and number of clinical trails. With the envisaged CPP, introduction of new medical equipment will create conditions for providing high quality medical services and assistance to a larger number of patients and including patients with disabilities and provision of health services for new hospital clinical trails. The result will be increased revenue of the hospital, which will ensure its financial sustainability and competitiveness. The experience gained by the team of the hospital regarding the implementation of projects and the management of finances will contribute to institutional sustainability of the results. The lasting effect of the results will be backed by strict adherence to the medical standard and European standards in the implementation of the measures envisaged.

After completing the project, mainly the financing of hospitals will be provided by the contract to provide medical advice, receipts from the National Health Insurance Fund for the number of patients and number of clinical trails and state subsidies
The results of the project will remain municipal property as the project activities will be carried out in a hospital - municipal property;

After completion of the project, the sustainability of the results will be set by the warranty terms, recorded in contracts for implementation under the Law on Spatial Planning (not less than 5 years). Within the warranty periods, all identified deficiencies in the construction and repair activities and supplied equipment and devices will be removed at the expense of the contractor. Maintenance after expiry of the guarantee will be charged to the Onco center LTD.

Direct benefits of the project.

Developed by analyzing the direct benefits of the project are: Improvement and modernization of technical and architectural condition of the buildings; Service of a greater number of patients completed; Reducing hospital stays; Diagnostics, treatment, handling and procedures in accordance with the "Standards for Good Clinical Practice"; Increasing economic efficiency through savings of heating and electricity, reducing the need for medication to treat; Increasing comfort and satisfaction of patients and staff..

Indirect benefits of the project.

Indirect benefits of the project to improve the quality of medical care in the field of medicine in Bulgaria; Improving the image of the hospital; Reduce the time of absence from work; Increase the demand for services;

Economic effects of the project.

The effect of the project can be considered as:

1. Health - Performing surgical diagnosis, treatment, treatments and procedures in accordance with the "Standards for good clinical practice in the treatment of surgical diseases";
2. Organizing - implementing the goals and objectives set out in the Programme for Strategic Development of COC - Plovdiv, improve microclimate for workers and the requirements of supervisory authorities;
3. Social - benefit to society, which consists in improving the health of the nation, one of the priorities of the national health policy;
4. Political - achieving the objectives of the National Health Strategy.

Savings in health costs.

Following the provision of good material and technical base will improve medical services and will increase precision in diagnosis of patients. This will lead to a reduction of morbidity, reduce the stay of patients in hospitals and will extend the life of the people. According to the National Statistical Institute in 2013 about 8% of household spending on health care.

Economies of hospitalization expenses.

The implementation of projects in healthcare will be implemented and economy of hospitalization expenses. It is calculated based on the average length of stay of a person in a hospital due to gastrointestinal disease and the average of his daily upkeep.
Summarized the benefits of realization of the investment project are:

Benefits of the project

Taking into account the socio-economic benefits of the project is achieved increasing the criteria for evaluation of the project. In conclusion, the analysis of the calculated economic indicators leads to the conclusion that the project meets the criteria for applicability of EU funding:

• Economi c net present value is positiv and are 24 681 000 BGN.;
• The economic returns of the project is 20.94% and shows acceptance for the project financed by the EU.

Social tolerance (affordability).

The analysis based on multiple criteria simultaneously consider a number of goals and objectives in relation to the assessed intervention. It facilitates examination in the evaluation of investment goals set by politicians, if they in some cases could not be included in the financial and economic analysis, for example. social justice (affordability).

Justice project is particularly important objective. Following the implementation of the project besides the above - mentioned in the report will have benefits and affordability, which is calculated and analyzed on the basis of household income; Consumption and affordability.

From the analysis shows that the project is socially tolerable during the whole period

Conclusion. Practical use of financial - economic analysis leads to the conclusion that the planned capital expenditures and supported by national and European funds Oncology Center - purchase of medical equipment and prilezhashata infrastructure will operate in a fiscally sustainable manner, ie net cash flow for each year of service is positive. The analysis proved that the pricing, which does not include depreciation of the investment, which is obtained as a result of the approved grant, the project is financially sustainable and socially tolerable. Social tolerance is essential for society as a whole and the development of the industry.

References

1. Stoyanov.St. "Share capital" - habilitated work

2. Epstein, B and others. IAS / IFRS from 2004 to 2005. Comments and applications, R & B Consult, C, 2006.

3. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=DD:14:02:32006R1083: BG:PDF- Council Regulation (EO) № 1083/2006 of 11 July 2006 laying down general provisions on the European regional Development Fund, European Social Fund and the Cohesion Fund, repealing Regulation № 1260/1999; European Commission, Directorate General "Regional Development" 2008 - Guide to cost - benefit analysis of investment projects. Structural Funds, Cohesion Fund and the Pre-Accession Instrument.