Stakeholder theory approach to Hospital Supply Chain.
According to the context of Colombia, in which the EPS (HMO) are responsible for the healthcare of a group of affiliates and the Hospitals are contractors of the HMO for providing clinical services, reducing the healthcare cost has become important. The financial healthcare model in Colombia is a capitated model in which each EPS receives a payment for each affiliate and in exchange is committed to keep them healthy and provide healthcare services to the affiliate. Though this financial performance of the EPS is important (the instrumental aspect), it should not be confused and juxtaposed with the normative aspect of the medical practice, that is to give the best possible healthcare to patients. How to make tradeoffs between the normative and the instrumental aspect in healthcare is still a subject of study and it involves ethical principles and moral values.
Furthermore, in my research, it was exciting to find out that the Inventory of any medical institution is the reflect of the medical coherence or the normative-moral aspect. The quality of the inventory in terms of products is positive correlated with the clinical outcomes of the hospital. Furthermore, as a surgeon in the study stated, there is a hypothesis to test here and it is that the quality of the inventory is correlated positively with the coherence of the medical practice. Therefore, if the quality of the inventory is not the proper, it may be caused by three reasons: a. Clinicians haven’t done a proper job about investigating what is best for the patient; b. the administrative employees don’t listen to the physicians, whom should know what is the best for the patients and represent their interests and therefore focus mainly in costs (a short-term vision); c. the influence of the pharmaceutical or medical devices industry is strong in that hospital and is blurring the procurement decision.
Moreover, a surgeon that belongs to one of the hospitals involved in my research claimed that “it is important not to fall in the temptation of reducing costs at the expense of the patient’s health, in the case of surgery with the replacement of cheaper medical devices or pharmaceuticals and/or removing some of these items from the surgical tray without the sufficient clinical evidence”. It is important to remind to the readers that physicians owe to patients and their interests and that is different to any other industry where other industries or sectors in general owe to themselves, clearly pinpointing the normative or moral aspect of the clinical practice. Therefore, in the medical practice is frequent to find a tension between what is the best for the patient and what is best for the financial performance of the hospital or the EPS. It is up to medical institutions to prioritize the normative aspect (what is best for the patient) or the instrumental aspect (how to reduce more costs and to have financial success). I believe the formula depends on each hospital where I hope the normative aspect is protected whilst at the same time working with the physicians, clinical evidence and data, cost reduction may be possible.
Finally all this reflections took place during my new lecture of supply chain in the MBA 2019-2021 Intensivo at Inalde Business School. I would like to recognize the outstanding participations and as tradition the winners are: Diana Duran, Nicolás Gomez, Erika Murcia, Oscar Rincon, Martín Santocoloma, Rosmary Turbay and Miguel Zarate. Congratulations for those As...