Impact of the agent theory on private and public companies based on the analysis of Croatian health care system

Abstract

Republika Hrvatska godinama se suočava s izazovom održivosti vlastitog zdravstvenog sustava zbog neučinkovitosti ustanova javne zdravstvene zaštite. Prevladava mišljenje kako uzrok tome leži u samoj strukturi zdravstvenog sustava, koji pruža zdravstvenu zaštitu svim građanima. Ovaj rad nastoji istražiti mogu li javne zdravstvene ustanove biti učinkovitije unatoč samoj strukturi sustava. Osnovna pretpostavka rada je da su javne zdravstvene ustanove neučinkovite zbog utjecaja agencijske teorije. Da bismo ispitali tu pretpostavku, potrebno je usporediti javne i privatne zdravstvene ustanove. Cilj ovog rada je utvrditi postoji li veći utjecaj agencijske teorije u ustanovama javnog zdravstva u odnosu na različiti utjecaj privatnog i javnog vlasništva na metode upravljanja. Metodologija istraživanja odnosi se na financijsku analizu odabranih privatnih i javnih zdravstvenih ustanova. Ispitivanje stručne osposobljenosti ravnatelja u ustanovama pokazalo je da nema velikih razlika u udjelu stručnjaka iz područja ekonomije u privatnim i javnim institucijama. Analiza učinkovitosti temeljena na specifičnim ustanovama pokazala je da su javne zdravstvene ustanove neučinkovitije od privatnih s obzirom na upravljanje troškovima. Na temelju toga zaključak je da je utjecaj agencijske teorije dominantniji u javnim zdravstvenim ustanovama.For years, the Republic of Croatia has been faced with the challenge of sustainability of its health care system due to the inefficiency of public health care institutions. It is generally believed that such development is the cause of health care system structure itself, which provides health care to all citizens. This paper seeks to explore whether public health care institutions can be more effective despite the system structure itself. The basic premise of the paper is that public health care institutions are ineffective because of the agent theory impact. In order to examine that premise, it is necessary to compare public and private health care institutions. The aim of this paper is to find out whether there is a greater impact of the agent theory in public health institutions in regard to different influence of private and public ownership on the management methods. The research methodology refers to the financial analysis of selected private and public health institutions. The examination of the professional qualification of managing directors of these institutions showed that there are no major differences in the share of experts in the field of economics in private and public institutions. Efficiency analysis based on the specific institutions shows that public health institutions are more ineffective than the private ones when it comes to cost management. Based on this, the conclusion is that the agent theory impact is more prevalent in public health care institutions.