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Abstract. Th is paper focuses on issues relating to gauging profi tability under circumstances in Czech healthcare organizations. At present, the trend in healthcare management is for more frequent utilization of advanced economic and cost accounting tools. Th ese qualitatively improve the decision-making process in healthcare establishments, as well as aiding provision of accurate data on the cost and revenue of the outputs of hospital organizations, such as the various diagnoses and types of patients. Herein the authors present analysis of the profi tability of such patient and diagnose-types (DRG) in selected hospital departments of Czech regional hospital. Revenue from insurance payments is compared with costs calculated via the Activity-Based Costing method so as to discern more accurately the proceeds of a given DRG and patient. Th e results of the study highlighted crucial diff erences between the income generated by individual cost objects (i.e. patients and DRGs). Utilizing such information could greatly benefi t decision-making and enhance cost eff ectiveness of the hospital services. However, any healthcare establishment worldwide is strictly curtailed in this by the ethical standards it must uphold when making decisions on potentially raising profi tability. Th e fi nal part of the study discusses the fi ndings of the profi tability analysis performed by the authors in the given context of general healthcare organizations management.

This article presents the results of the research undertaken at the Faculty of Management and Economics, Tomas Bata University in Zlin. The research focuses on the efficiency of the healthcare system. One of the goals was to compare the efficiency of private horizontally integrated hospitals and horizontally integrated hospitals owned by county, town or municipality. To evaluate the efficiency the Data Envelopment Analysis method was used, which is a benchmarking method applied to measure the efficiency of homogeneous organisational units. When undertaking such measuring it is crucial to assume that inputs are minimalised and outputs are maximised, i.e. outputs must bring a positive result while inputs must be as low as possible. Even though the research did not prove that either private horizontally integrated hospitals or horizontally integrated hospitals owned by the county, town or municipality to be more efficient than the others, the results are valuable as they point at specific options for increasing the efficiency of individual hospitals.

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Background: This paper investigated the impact of hospitals´ horizontal integration in the Czech Republic on the cost behavior. The aim of the research was to examined the hospitals costs in specific environment of region hospitals at NUTS 3 level (Nomenclature of Units for Territorial Statistics) – Administrative Regions. Methods: The survey was conducted in the period from April to August 2016 in the Czech Republic. The research was divided into two parts. The first part was based on data obtained from the Institute of Health Information and Statistics of the Czech Republic. We used Statgraphics Centurion XVII for the descriptive statistics and data visualization. Second part of the results was obtained through a survey research focused on managers of the horizontal integrated hospitals and their experiences with the cost behavior. Results: The results from statistical survey showed that up to 80 percent of the observed region hospitals at NUTS 3 level, the cost of treatment for a patient per day has decreased after integration into an association. Based on primary survey, 73% hospital managers confirm these results and see one of the advantages that it is possible to reduce costs through integration of hospitals. The largest savings, according to hospital managers, are due to central purchasing and investments, together and they have a better negotiation position with suppliers. Conclusion: We can confirm that horizontal integration of hospitals can lead to reduction of costs and higher efficiency, in the specific environment of region hospitals at NUTS 3 level.