Reimbursement of costs in trial proceedings and enforcement proceedings Abstract The aim of the thesis is to describe comprehensively the issue of reimbursement of costs in trial proceedings and enforcement proceedings. Sometimes, it is considered to be only a marginal part of the civil procedure, however the reimbursement of costs is certainly very important for both parties to a case. Reimbursement of costs of proceedings is a very interesting topic that has been undergoing turbulent development in recent years. The thesis is divided into an introduction, three main parts and a conclusion. The introduction focuses mainly on the definition of the objectives of the thesis and subsequently the interest of the general public in the issue of reimbursement of cost is analyzed. The first part provides the general description of the institute of costs of proceedings and defines the essential terms related to this issue. Subsequently, the types of costs of proceedings and legal regulation connected with them are examined. The second part of the thesis focuses on reimbursement of costs in trial proceedings. The initial chapter explicates general rules contained in the Civil Procedure Code, which are based mainly on the principle of success in the case and the principle of fault. All exceptions to these principles...

Regulation of prices and reimbursement of medicinal products Abstract Medicinal products are essentially part of every human life. It is therefore desirable to ensure that they are offered on the market at a fair and affordable price, precisely through price and reimbursement regulation. The aim of this diploma thesis is to analyse how the regulation of prices and reimbursements applies to human medicinal products in the provision of outpatient health care, the price and reimbursement of which is decided by the State Institute for Drug Control in administrative proceedings. In order to achieve this goal, the thesis is divided into four parts. The first part defines the basic concepts needed understand the meaning and purpose of the system of price and reimbursement regulation, such as a medicinal product, price or reimbursement. Furthermore, this part is devoted to the types of administrative acts occurring in the field of price and reimbursement regulation and introduces the Ministry of Health and the State Institute for Drug Control as the most important administrative authorities operating in this field. The second part analyses the legislation effective until 31st December 2007. The forms of administrative activity then performed by the Ministry of Health and the Ministry of Finance are analysed in more...

Reference (bibliographic reference of this thesis) BOBULA, P. (2019) Influence of the interest groups on healthcare reimbursement decree in Czech Republic. Prague, 2019. Master's thesis (Mgr.). Charles University, Faculty of Social Sciences, Institute of Political Studies. Department of Political Science. Supervisor Mgr. Michal Paulus Abstract Reimbursement decree is an important part of the healthcare policy in Czech Republic. It determines how the resources will be allocated in the healthcare system the next year. According to the Czech legislature, Ministry of Health invites the representatives of insurance companies and healthcare providers to discuss and create a balanced form of reimbursement. When they are not able to agree, it's up to Ministry of Health to determine the reimbursement in corresponding segment. We assume that this kind of organization enables the involved representatives to push their interests in order to get more favorable financing for their profession. Different groups have different positions in the bargaining process so we can expect the existence of winners and losers according to the financial arrangements they were able to enforce. Using the content analysis of final protocols from reimbursement decree conciliations, spending of insurance companies in healthcare segments and...

The purpose of the thesis Reimbursement of costs in trial proceedings and enforcement proceedings is to provide a comprehensive view of the legal regulation on the topic of reimbursement of costs in trial and enforcement proceedings and subsequently to critically evaluate this regulation and to try to find a way to more appropriate solutions. The thesis consists of an introduction, two parts dealing separately with the reimbursement of costs in trial proceedings and the reimbursement of costs in the enforcement proceedings and a conclusion. The introduction specifies the topic of the thesis and its purpose. The first part of the thesis, which covers the reimbursement of costs in the trial proceedings, is divided into seven chapters. The first chapter generally defines the concept of costs. The second chapter then describes the specific types of costs that may be incurred in trial proceedings. The third chapter discusses the aspect of efficiency of costs, which is a very important factor in the decision to pay the costs. The subject of the fourth chapter is the specification of the obligation to pay the costs. The fifth chapter describes in detail the reimbursement of costs of the contentious trial proceedings, both in terms of legislation and in terms of general principles that are relevant to the...

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This dissertation seeks to investigate how hospital reimbursement policy affects the quality of care provided to patients when providers compete for healthcare labor that is limited in supply. Cost payment systems fully reimburse a provider’s the total cost of healthcare provided, fixed reimbursements are predetermined at a fixed amount and mixed reimbursements have a cost and fixed component. The first chapter investigates how government reimbursement schemes that induce quality competition among health providers affects the choice of quality of care provided to patients and how these choices depend on the labor supply constraints in the healthcare labor market. We build a theoretical model that explicitly incorporates the healthcare labor supply into a framework of a hospital cournot competition, to show how a hospitals' choice of quality of patient care will be directly influenced when there is a shortage of health personnel in a regulated reimbursement system. We find that multiple equilibria can arise in healthcare markets depending on the consumers’ sensitivity to quality and hospitals’ share of cost when investing in quality. Contrary to existing findings, we are able to show that the effects of reimbursement schemes can vary in different equilibria and in different labor market situations. For instance, in high patient quality sensitivity hospital markets under a high hospital quality equilibrium, we can show that a cost payment scheme decreases a provider’s quality of care while a fixed reimbursement scheme increases quality. More importantly we find that the labor market constraint increases or decreases the effect of the reimbursement system on quality of care. Consequently, the labor constraint changes the quality choice of the provider as compared to the quality level that would have been induced by a particular reimbursement’s policy incentive for quality. In the second chapter, we carry out some of the testable implications of the theoretical finding from the first chapter. This paper investigates how higher Medicare payments brought about by geographical reclassification affects a provider’s quality of care as captured by registered nurses (RN) and licensed practical nurses (LPN) staffing, as well as patient outcomes (mortality, urinary tract infections, pneumonia, peptic ulcer deep vein thrombosis) and length of stay when hospitals compete for nurses. In contrast with past literature, we specifically allow for asymmetry in the hospital’s choice of quality, by permitting coefficients to differ across reclassified hospitals in response to the higher Medicare payments. This asymmetry is based on the relativity of the labor cost faced by the hospital due to competition for nurses in the healthcare labor market. Using Healthcare Cost and Utilization Project (HCUP) and the Center for Medicare and Medicaid (CMS) data from the period 2001 to 2011, we find that hospitals who face relatively higher labor costs will post reclassification increase their RN to LPN staffing ratio as compared to hospitals in their post geographical reclassification areas. A higher RN staffing by these hospitals will result in an improvement of quality of care as the incidence of patient complications due to Pneumonia, Peptic Ulcer and Deep Vein Thrombosis reduces for hospitals that were reclassified after allowing for asymmetry in response to the higher Medicare payment due to differences in labor costs (Pneumonia and Peptic Ulcer complications improve as compared to pre re-class area hospitals and DVT in both pre/post re-class area hospitals). Length of stay also increases for hospitals that faced a higher labor cost while mortality and UTI complications remain unchanged post reclassification. Finally, in the third chapter, we examine how the for profit (FP) or not for profit (NFP) status of hospitals impact the choice of nurse staffing and patient outcomes when there is an increase in provider reimbursement due geographical reclassification. Most of the past studies focus on mortality and length of stay in FPs and NFPs, we extend these studies by investigating the impact of geographical reclassification on patient outcomes that have been established as outcomes sensitive to nursing care. From our regression results, with reference to the ratio of RN to LPN staffing, we find evidence that an increase in Medicare payments will have a greater impact in FPs than in NFPs as compared to their pre re-class geographical area control hospitals. We also find that in hospitals that face a relatively higher labor cost as compared to their controls; (1) There is no difference in the impact of reclassification between FPs and NFPs (2) There is a better response from FPs than NFPs to geographical reclassification when the outcome considered is DVT as evidenced by a decreases in cases of DVT (3) NFPs decrease length of stay whiles FPs increase length of stay as compared to their post re-class geographical area hospitals.

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Det finns ett uttalat behov av nya innovativa vårdmodeller inom hälso- och sjukvården. Svensk vård står inför signifikanta utmaningar och karaktäriseras av brist på sjukvårdsplatser, eskalerande kostnader och minskat patientförtroende. Hospital at Home (HaH) erbjuder möjligheter till förbättrad tillgänglighet, kostnadseffektivitet och patienttillit inom vården, men dess implementering begränsas av bristande förståelse för rådande finansiella förutsättningar, otillräckliga regelverk och inadekvata ersättningsmodeller. Denna studie syftar till att fördjupa förståelsen för de finansiella förutsättningar som påverkar implementeringen av innovativa vårdmodeller, såsom HaH, i komplexa decentraliserade sjukvårdssystem. Genom att utveckla ett teoretiskt ramverk som utforskar hur befintliga ersättningsstrukturer påverkar införandet av innovativa vårdformer, syftar denna studie till att bidra till förbättrat strategiskt beslutsfattande för en framgångsrik implementering och effektiv integrering av HaH i den svenska vården. Studien har tillämpat en utforskande abduktiv ansats, vilken realiserats genom en mixad metod som kombinerar enkäter och fallstudier. Datainsamlingen genomfördes via enkäter distribuerade till Sveriges 21 regioner samt genom semi-strukturerade intervjuer med representanter från tre svenska HaH-initiativ. Studien konstaterar att förberedelse och implementering av vårdinnovationer i decentraliserade system påverkas av flertalet både yttre och inre faktorer. Regelverk och direktiv, avtal samt extern budgetering och resursfördelning utgör grunden för hur vårdtjänster struktureras och finansieras. Dessa externa ramar är fundamentala i skapandet av en miljö som främjar vårdinnovation. Lokala variationer, vårdaktörer, verksamhetsformer och ersättningsmodeller spelar sedan en direkt roll i hur olika vårdmodeller utformas, finansieras och levereras i praktiken. Slutligen understryker studien behovet av en nationell definition av HaH och dess verksamhetsform, revidering av begränsande regelverk samt inkorporering av rörliga ersättningskomponenter till HaH-vårdutförare för att underlätta en storskalig implementering av HaH i Sverige. / There is a pressing need for innovative care delivery models within healthcare. Swedish healthcare faces formidable challenges including a shortage of hospital beds, escalating costs, and diminishing patient trust. Hospital at Home (HaH) presents an opportunity to enhance accessibility, cost-effectiveness, and patient trust within the healthcare system. However, its widespread adoption is impeded by a lack of understanding of current financial preconditions, insufficient regulations, and inadequate reimbursement models. This study seeks to enhance the understanding of financial preconditions influencing the implementation of innovative care models, such as HaH, within decentralized healthcare systems. Through the development of a theoretical framework that examines how current compensation structures impact the adoption of innovative care models, this study aims to inform strategic decision-making for the successful implementation and effective integration of HaH into Swedish healthcare. This thesis employs an exploratory abductive approach, utilizing a mixed-methods strategy that combines surveys and case studies. Data was collected through surveys distributed across all 21 Swedish regions, complemented by semi-structured interviews with representatives from three Swedish HaH initiatives. The study finds that the preparation and implementation of healthcare innovations in decentralized systems are significantly shaped by a range of external and internal factors. Regulatory frameworks, contractual agreements, and mechanisms for budgeting and resource distribution form the basis for how healthcare services are structured and financed. These external factors are fundamental in creating an environment that promotes healthcare innovation. Moreover, local variations, healthcare providers, operational forms, and reimbursement models directly influence how different care models are designed, financed, and delivered in practice. Finally, the study highlights the critical need for a national definition of HaH, the revision of restrictive regulations, and the integration of variable reimbursement components to facilitate widespread adoption of HaH across Sweden.

This descriptive survey study investigated the value of faculty practice among Commission of Collegiate Nurse Education (CCNE) Accredited Nursing Schools. The sample included all CCNE accredited schools that offered a Masters degree. Subjects from the 66 schools in the sample the dean and three Nurse Practitioner faculty who are teaching a clinical course. Response rate was 51% for the deans and 35% for the faculty. The opinions of deans were compared to the opinions of faculty on the views of faculty practice as research and the incorporation of faculty practice in the tenure and merit review system. The results showed faculty and deans differed on the value of faculty practice as research. However, only 6.5 % of statistically significance difference was contributable to whether the response was from a dean of a faculty. There was no significant difference to the inclusion of faculty practice in the tenure and merit review system. Boyer's expanded definition of research was used as a theoretical background. Deans viewed faculty practice more important as compared to the traditional faculty expectation of research than faculty did. The operational definition of faculty practice was that it required scholarly outcomes from the practice. Deans were more willing than faculty to acknowledge there were scholarly measurable outcomes to evaluate faculty practice than faculty were. The greatest difference in opinion of outcomes was the deans were more willing to accept clinically focused articles as an outcome than faculty were. Faculty were asked how the money from faculty practice was distributed. Faculty overwhelmingly reported that money generated from faculty practice most often goes to the individual faculty member. Suggested areas for future research involve investigation of the role of tenure committees in tenure decisions relating to research and faculty practice.

The purpose of my Master's thesis in law is to analyse the legal position which the private healthcare providers (i.e. operators of private healthcare facilities) occupy in the Czech healthcare system, particularly in the system of public health insurance. Since the private providers emerged in the Czech Republic only after the Velvet Revolution in 1989, the development of their position within the system is relatively short and unsettled. The legal regulation of the field is quite complicated, yet is the subject of strong political controversies, partly due to the generous but vaguely formulated constitutional right to free healthcare. Currently, the Parliament is in the middle of adoption of the healthcare reform of larger scale which would make changes that deserve to be examined. The thesis is composed of Introduction, three chapters and Conclusion. Each of the chapters aims on different aspect of the topic; however, they are interlinked by common legal institutes which play role in the whole thesis. First two subchapters of Chapter I are most general and introduce the possible ways of financing healthcare (public and private insurers, direct payment) and its specifics. The options of foreign citizens are also clarified. After the conclusion that the most important system in the Czech context...