Přístupy k zajištění kvality zdravotní péče: manažerské simulátory pro podporu rozhodování

Assuring the quality of healthcare is a very complex subject combining a variety of approaches (structural, process, result, etc.) on the macro-level of the health system as part of national health policy and even on micro-level in healthcare facilities. However, majority of models for monitoring the quality of health care is still based on a pragmatic approach to structural quality monitoring, with the primary aim to improve the health status of the population through affordable and quality healthcare in the long term. Michael Grossman's 1972 Grossman's concept on the health capital and the demand for health has been extremely influential in the field of healthcare economics. The model is based on human capital theory and is being introducing some novelty distinctive features, such as assumption that health can be seen as lasting over time periods - it depreciates and can therefore be analyzed as a capital good and of course that the demand for health care is a derived from the demand for health consists of two elements: consumption effect and investment effect. Unfortunately the high degree of uncertainty, complexity and environmental heterogeneity associated with health system unfortunately did not allow a smooth transfer of Grossmans model into the system dynamics frameworks. The use of management simulators in practice leads to higher rationality in decision making. Introduction of new methods, especially including methods based on system dynamics, helps in the way of shifting the empirical-intuitive decision to scientific decision-making. Heterogeneous multi-agent models of healthcare system allow realistic modeling of system environment and the interactions of entities operating on the healthcare market. These models can be also continuously "cultivated" using external data (demographic, economic, epidemiological, public-health, etc.) and consequently applied to solve alternative problems or scenarios. The thesis/dissertation presents its results as the synthesis of knowledge and approaches from individual areas of health economics, health care quality assurance and applied system dynamics as a framework -- or maybe a paradigm - for competent managerial decision making in health care management.