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Title:VEČNIVOJSKI MODEL KADROVSKE REORGANIZACIJE JAVNIH ZDRAVSTVENIH ZAVODOV Z UVEDBO JAVNO-ZASEBNEGA PARTNERSTVA
Authors:Kušar, Boštjan (Author)
Bernik, Mojca (Mentor) More about this mentor... New window
Smrke, Dragica Maja (Co-mentor)
Files:.pdf DOK_Kusar_Bostjan_2019.pdf (5,85 MB)
 
Language:Slovenian
Work type:Doctoral dissertation (mb31)
Organization:FOV - Faculty of Organizational Sciences in Kranj
Abstract:Kadrovske reorganizacije javnih zdravstvenih zavodov niso nov pojem v slovenskem prostoru. Raziskave kažejo, da v Sloveniji do sedaj še ni bil izdelan predlog modela kadrovske reorganizacije javnih zdravstvenih zavodov s pomočjo uvedbe javno-zasebnega partnerstva in instituta svobodnega zdravnika specialista. Uvedba instituta svobodnega zdravnika specialista bi približala delovanje slovenskega zdravstvenega sistema Evropski skupnosti in svetu. Z njegovo uvedbo bi se znižali stroški dela, povečala bi se učinkovitost zaposlenih ter ustvarilo stimulativno delovno okolje za mlade zdravnike, kar bi posledično prispevalo k zajezitvi odhodov mladih zdravnikov v tujino. Uvedba svobodnega zdravnika specialista v slovenski zdravstveni sistem bi prinesla tudi nove možnosti sodelovanja med izvajalci zdravstvenih storitev in bolnišnicami, prav tako bi pozitivno vplivala na enakomerno dostopnost do zdravstvenih storitev, kar bi občutili uporabniki.V doktorski disertaciji je predstavljeno trenutno stanje zdravstvenega sistema v Republiki Sloveniji, ki se sooča z različnimi problemi; dolge čakalne dobe na vseh področjih dela, odhodi zdravnikov in zdravstvenih sodelavcev v tujino oziroma zasebništvo. Posledično prihaja do pomanjkanja kadra za redno delo, ki povzroča preobremenjenost zaposlenih. Na osnovi poglobljenega vpogleda v zdravstveni sistem v Republiki Sloveniji je bila izdelana raziskava, katere cilj je bil preveriti stališča nosilcev zdravstvene dejavnosti v Republiki Sloveniji – zdravnikov do uvedbe instituta svobodnega zdravnika v slovenski zdravstveni sistem ter na drugi strani pridobiti mnenje direktorjev javnih zdravstvenih zavodov o obravnavani temi. Raziskava je bila izvedena na celotni populaciji zdravnikov (N = 5.637) in vodstvenih delavcev (N = 92) v Sloveniji v letu 2014. Vrnjenih smo dobili 318 anketnih vprašalnikov s strani zdravnikov, kar predstavlja 5,6 % celotne populacije. S strani direktorjev je bilo vrnjenih 52 anketnih vprašalnikov, kar predstavlja 56,5 % celotne populacije. Zaradi urejenosti spremenljivk in postavljenih hipotez, so bili uporabljeni neprarametrični pristopi, ki so za razliko od standardnih parametričnih metod primernejši, kadar so spremenljivke urejenostne in predpostavke za uporabo parametričnih metod niso izpolnjene, kot v primeru naših hipotez. V poglobljeni statistični analizi smo za obdelavo podatkov uporabili še naslednje kazalce in metode: povprečno vrednost, standardni odklon, test Kaiser-Mayer-Olkin in Bartlettov test. S faktorsko analizo smo nadalje želeli reducirati spremenljivke, ki smo jih kasneje z multiplo regresijsko analizo primerjali in ugotavljali njihovo medsebojno odvisnost. Analiza demografskih podatkov kaže na enakomerno razporeditev pridobljenih odgovorov, glede na obravnavano populacijo. Drugi del raziskave se je nanašal na delovanje zdravstvenega sistema in možne izboljšave, torej vsebinski del. Rezultate obeh anket (za zdravnike in vodstvene delavce) smo najprej opisno primerjali in jih predstavili s frekvencami (%). Ugotovitve raziskave kažejo na nujnost sprememb slovenskega zdravstvenega sistema v organizacijskem smislu. V sistem vodenja javnih zdravstvenih zavodov je potrebno uvesti piramidno hierarhijo, ustrezno stimuliranje in motiviranje zaposlenih ter urejen sistem nagrajevanja zaposlenih. Direktorjem javnih zdravstvenih zavodov je potrebno dodeliti večjo avtonomijo, pooblastila in orodja za izboljšanje nastale situacije. Rezultat poglobljene analize je izdelan večnivojski model kadrovske reorganizacije javnih zdravstvenih zavodov z uvedbo javno-zasebnega partnerstva in instituta svobodnega zdravnika specialista. Model je oblikovan na osnovi trenutnega zdravstvenega sistema, kar v praksi pomeni, da bo z njegovo implementacijo dopolnil obstoječ zdravstveni sistem v Sloveniji, ne bi pa ga v celoti zamenjali. Pripravljen model predvideva novo obliko izvajanja zdravniškega poklica.
Keywords:kadrovska reorganizacija, kadrovski management, javno-zasebno partnerstvo, zdravstvo, model, institut svobodnega zdravnika specialista
Year of publishing:2019
Source:Kranj
URN:URN:SI:UM:DK:LESM1Q0Y
COBISS_ID:8108563 Link is opened in a new window
License:CC BY-NC-ND 4.0
This work is available under this license: Creative Commons Attribution Non-Commercial No Derivatives 4.0 International
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Downloads:12
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Secondary language

Language:English
Title:​​A multi-level model for the personnel reorganisation of public health institutions through implementation of a public-private partnership
Abstract:In Slovenia, reorganising the personnel of public health institutions is not a new concept. Research shows that Slovenia has not yet prepared a model for reorganising the personnel of public health institutions entailing the implementation of a public-private partnership and the institute of an independent physician specialist. The introduction of the institute of an independent physician specialist would bring the Slovenian health-care system in line with those in the European Community and around the world. Its introduction would reduce labour costs, boost employee performance and create a stimulating working environment for young doctors, thus helping to prevent young doctors from moving abroad. Moreover, introducing the institute of an independent physician specialist in the Slovenian health-care system would open up possibilities for co-operation between providers of health-care services and hospitals, while also positively affecting the issue of equal access to health-care services, which would also be felt by users. The doctoral dissertation presents the current situation in the health-care system in the Republic of Slovenia which has been facing different problems: long waiting lists in all areas of work as well as doctors and healthcare professionals moving abroad or taking up private practice. Consequently, there is a shortage of staff for regular work, resulting in employees’ overburdening. The study was conducted based on a review of the health-care system in the Republic of Slovenia and aimed to verify the views of those carrying out the health-care activity, i.e. doctors, on introduction of the institute of an independent physician specialist in the Slovenian health-care system and, on the other hand, to obtain public health institution directors’ opinions on the discussed issue. The study was carried out among the entire population of doctors (N=5,637) and managerial staff (N=92) in Slovenia in 2014. Of all questionnaires sent out to doctors, 318 were returned, accounting for 5.6% of the total population. The directors sent 52 questionnaires back, representing 56.5% of the total population. Due to the order of variables and formulated hypotheses, non-parametric approaches were applied that are more appropriate than the standard parametric methods when the variables are ordinal and the assumptions for using parametric methods are not substantiated, as was the case with our hypotheses. The data were processed in an in-depth statistical analysis using the following indicators and methods: mean value, standard deviation, Kaiser-Mayer-Olkin test and Bartlett's test. Factor analysis was conducted to further reduce the variables that were later compared, using multiple regression analysis, and their co-dependence was established. The analysis of demographic data shows an even distribution of obtained replies considering the studied population. The second part of the study delved into the functioning of the health-care system and possible improvements, i.e. the substantive part. The results of both surveys (for the doctors and the managerial staff) initially underwent a descriptive comparison and were presented in terms of frequencies (%). The study findings show that the Slovenian health-care system should necessarily change in terms of its organisation. The management system of public health institutions must be revamped so as to include a pyramid hierarchy, appropriate incentives and employee motivation as well as a well-structured employee remuneration system. Directors of public health institutions must be given more autonomy, broader authorisations and tools for improving the current situation. The result of the in-depth analysis is the multi-level model designed for reorganising the personnel of public health institutions by implementing a public-private partnership and the institute of an independent physician specialist.
Keywords:personnel reorganisation, personnel management, public-private partnership, health-care system, model, institute of independent physician specialist


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