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      Cost-Efficiency Analysis of a Multi-Pavilion Hospital in Cluj County


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          Background and aim

          Multi-hospital health systems have become the most popular administrative structure in healthcare, leading to both opportunities and challenges for hospital administrators. In government-funded healthcare systems, there is a balance between costs and the provision of health services.

          The aim of the present study is to assess the efficiency in terms of costs of a multi-pavilion hospital from Cluj County, Romania.


          The institution analyzed in this article is the Adults’ Clinical Hospital in Cluj-Napoca. A descriptive retrospective study collected data from January 2004 to December 2010. A set of indicators were compiled, divided into three main categories: personnel, statistics, and financial.


          Twenty-one financial indicators were investigated. Heterogeneity between different years was observed for the continuous hospitalization indicator and the wage budget indicator. The highest variability was observed between the budget and expenses indicators, while a smaller variability was observed at the average costs per patient. The costs per patient have increased at all pavilions in the studied time frame, the higher costs being at the Internal Medicine and Surgery pavilions: 10,203 RON in 2010 (1 euro ~ 4.4 RON)


          The pavilions included in the Adults’ Clinical Hospital Cluj-Napoca have different expenses patterns, as each pavilion is focused on different specialties. Each pavilion serves different target groups, requiring different procedures. This in turn results in different expense patterns across each pavilion.

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          Most cited references16

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          The effects of multi-hospital systems on hospital prices.

          US hospital prices are rising again after years of limited growth. We analyze trends in hospital prices during a period of significant price growth (1999-2003) to assess whether hospitals that are part of multi-hospital systems were able to increase their prices faster than non-system hospitals. We find hospitals that were members of multi-hospital systems were able to increase their prices substantially more than comparable non-systems hospitals (34% for large systems and 17% for small systems). Further, we find that the systems effect is not confined to hospitals that have other system member hospitals in their local markets. One possible explanation is that hospitals belonging to non-local multi-hospital systems have improved their bargaining position vis-à-vis health plans.
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            Crossing the quality chasm; a new health systemf for the twenty-first century

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              How The Expansion Of Hospital Systems Has Affected Consumers

              The past decade has seen profound changes in how the hospital industry has organized itself, including the rising importance of hospital systems. Theoretically, system consolidation can have positive effects from improved efficiency and quality or negative effects from greater market power. This study examines which hospitals consolidate and finds that hospitals were more likely to join systems if they were for-profit institutions, were located in urban areas, or had high managed care loads. Furthermore, the evidence suggests that system formation has primarily served to increase market power, not improve patient care quality or hospital efficiency, at least in the short run.

                Author and article information

                Clujul Med
                Clujul Med
                Clujul Medical
                Iuliu Hatieganu University of Medicine and Pharmacy
                15 January 2016
                : 89
                : 1
                : 110-116
                [1 ]Octavian Fodor Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
                [2 ]Epidemiology and Primary Health Care Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
                Author notes
                Address for correspondence: mihaimle@ 123456gmail.com

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

                Original Research
                Public Health

                public health,health care economics and organizations,hospitals,romania


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