WorldWideScience

Sample records for economics hospital

  1. Foundation Trusts: economics in the 'postmodern hospital'.

    Science.gov (United States)

    Newbold, David

    2005-09-01

    Foundation Trust Hospitals are community-controlled health care providers which have increased autonomy about how they produce outcomes for the British National Health Service. Although there is a literature on hospital economics it is unclear how these innovative providers will behave, if they have to compete for scarce resources with other hospitals. This paper reviews some of the earlier theories, such as the neoclassical theory of the firm, and discusses their relevance along with 'newer' economic theories such as the transaction costs and evolutionary theory of the firm, plus organizational and human resources theory, to the performance of Foundation Trusts. Much contemporary health care provision is shaped along modernist lines, using scientific endeavour to maximize the impact on health outcomes and technical and social efficiency. However, there is an increasingly postmodern standpoint--critical of modernity--being taken by both patients and hospital staff, to deconstruct processes in the organizations that serve them. Foundation Trusts are postmodern hospitals insomuch as they (to attract scarce resources in a competitive environment), need to marshal the diverse theories of the firm together in order to provide a mass-customized, quality experience, transparently and at least cost--whilst maintaining a stable organizational culture for staff.

  2. Hospitalization rates among economic immigrants to Canada.

    Science.gov (United States)

    Ng, Edward; Sanmartin, Claudia; Manuel, Douglas G

    2017-07-19

    Economic immigrants generally, and economic class principal applicants (ECPAs) specifically, tend to have better health than other immigrants. However, health outcomes vary among subcategories within this group, especially by sex. This study examines hospitalization rates among ECPAs aged 25 to 74 who arrived in Canada between 1980 and 2006 as skilled workers, business immigrants, or live-in caregivers. The analysis used two linked databases to estimate age-standardized hospitalization rates (ASHRs) overall and for leading causes by sex. ASHRs of ECPA subcategories were compared with each other and with those of the Canadian-born population. Logistic regression was used to derive odds ratios for hospitalization among ECPAs, by sex. Male and female ECPAs aged 25 to 74 had significantly lower all-cause ASHRs than did the Canadian-born population in the same age range. This pattern prevailed for each ECPA subcategory and for each disease examined. Compared with skilled workers, business immigrants had lower odds of hospitalization; live-in caregivers who arrived after 1992 had higher odds. Adjustment for education, official language proficiency, and world region reduced the strength of or eliminated these associations. Compared with the Canadian-born population, ECPAs generally had low hospitalization rates. Differences were apparent among ECPA subcategories.

  3. Economic burden associated with hospital postadmission dehydration.

    Science.gov (United States)

    Pash, Elizabeth; Parikh, Niraj; Hashemi, Lobat

    2014-11-01

    Development of dehydration after hospital admission can be a measure of quality care, but evidence describing the incidence, economic burden, and outcomes of dehydration in hospitalized patients is lacking. The objective of this study was to compare costs and resource utilization of U.S. patients experiencing postadmission dehydration (PAD) with those who do not in a hospital setting. All adult inpatient discharges, excluding those with suspected dehydration present on admission (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes for dehydration: 276.0, 276.1, 276.5), were identified from the Premier database using ICD-9-CM codes. PAD and no-PAD (NPAD) groups were matched on propensity score adjusting for demographics (age, sex, race, medical, elective patients), patient severity (All Patient Refined Diagnosis-Related Groups severity scores), and hospital characteristics (geographic location, bed size, teaching and urban hospital). Costs, length of stay (LOS), and incidence of mortality and catheter-associated urinary tract infection (CAUTI) were compared between groups using the t test for continuous variables and the χ(2) test for categorical variables. In total, 86,398 (2.1%) of all the selected patients experienced PAD. Postmatching mean total costs were significantly higher for the PAD group compared with the NPAD group ($33,945 vs $22,380; P < .0001). Departmental costs were also significantly higher for the PAD group (all P < .0001). Compared with the NPAD group, the PAD group had a higher mean LOS (12.9 vs 8.2 days), a higher incidence of CAUTI (0.6% vs 0.5%), and higher in-hospital mortality (8.6% vs 7.8%) (all P < .05). The results for subgroup analysis also showed significantly higher total cost and longer LOS days for patients with PAD (all P < .05). The economic burden associated with hospital PAD in medical and surgical patients was substantial. © 2014 American Society for Parenteral and Enteral

  4. Economic aspects of radiation safety in hospitals

    International Nuclear Information System (INIS)

    Subrahmanian, G.; Venkataraman, G.

    1977-01-01

    Radiation protection procedures to be adhered to while using radiological equipment in hospitals both for the patients and the medical personnel are described in detail. The hazards resulting from careless handling of equipment and the need for adequately trained staff to handle the equipment is stressed. (A.K.)

  5. [Strategic planning: an important economic action for German hospitals].

    Science.gov (United States)

    Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G

    2011-11-01

    In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department. © Georg Thieme Verlag Stuttgart · New York.

  6. Abortions bring economic pressure to bear on hospitals.

    Science.gov (United States)

    Taravella, S

    1989-08-25

    The current abortion controversy has serious potential economic consequences for U.S. hospitals, from boycotts and other political actions, but also because of lack of reimbursement for procedures performed on indigent women. An example was given of a threatened boycott of a private hospital in Washington state by evangelical residents and their physicians. Another example of boycott of hospital blood donations was cited. 1078, or 28.7%, of 3752 U.S. hospitals that are equipped to perform abortions do so. 90% of abortions are done by 31% of U.S. hospitals. 90% of these are 1st trimester abortions, costing $200-300. Many employer-sponsored health insurance plans pay for abortions, but Medicaid programs pay for limited numbers of abortions: all abortions for poor women in 13 states, but only those need to save the woman's life in most states. The federal government paid $62,235 for 84 abortions in 13 states in 1988. California and New York have extensive abortion programs for the poor. Hospitals keep a low profile about abortion services, declining to advertise their activity.

  7. Economic burden of hospitalizations of Medicare beneficiaries with heart failure

    Directory of Open Access Journals (Sweden)

    Kilgore M

    2017-05-01

    Full Text Available Meredith Kilgore,1 Harshali K Patel,2 Adrian Kielhorn,2 Juan F Maya,2 Pradeep Sharma1 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 2Amgen, Inc., Thousand Oaks, CA, USA Objective: The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF.Methods: This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011. The primary end point was the average per-patient cost of hospitalization for individuals with HF. Secondary end points included the cumulative rate of hospitalization, the average length of hospital stay, and the cumulative 30-, 60-, and 90-day readmission rates.Results: Data from 63,678 patients with a mean age of 81.8 years were included in the analysis. All costs were inflated to $2,015 based on the medical care component of the Consumer Price Index. The mean per-patient cost of an HF-related hospitalization was $14,631. The mean per-patient cost of a cardiovascular (CV-related or all-cause hospitalization was $16,000 and $15,924, respectively. The cumulative rate of all-cause hospitalization was 218.8 admissions per 100 person-years, and the median length of stay for HF-related, CV-related, and all-cause hospitalizations was 5 days. Also, 22.3% of patients were readmitted within 30 days, 33.3% were readmitted within 60 days, and 40.2% were readmitted within 90 days.Conclusion: The costs associated with hospitalization for Medicare beneficiaries with HF are substantial and are compounded by a high rate of readmission. Keywords: heart failure, Medicare, health economics, hospitalization, costs

  8. Malnutrition in hospital: the clinical and economic implications.

    Science.gov (United States)

    Löser, Christian

    2010-12-01

    Undernutrition and malnutrition are common in hospitalized patients. Their combined prevalence on admission is estimated at 25% and is rising. Selective literature review with special consideration of current guidelines and meta-analyses. The nutritional state of every patient should be assessed on admission with simple, established parameters, and patients suffering from under- or malnutrition should be treated with a targeted nutritional intervention based on the established stepwise treatment algorithm. Under- and malnutrition are an independent risk and cost factor with a significant influence on mortality, morbidity, length of hospital stay, and quality of life. Their direct costs alone amount to some 9 billion Euros in Germany each year. Therapeutic trials and meta-analyses have clearly documented the therapeutic benefit and cost-effectiveness of oral nutritional supplements and tube feeds. Targeted nutritional intervention is an integral part of medical treatment and prevention. Undernutrition and malnutrition are common in hospitalized patients and are both medically and economically harmful. If they are detected early by targeted assessment and then treated appropriately according to the established stepwise treatment algorithm, better clinical outcomes and lower costs will result.

  9. The impact of economic crisis on the Greek hospitals' productivity.

    Science.gov (United States)

    Mitropoulos, Panagiotis; Mitropoulos, Ioannis; Karanikas, Haralampos; Polyzos, Nikolaos

    2018-01-01

    During the recent economic crisis, Greece implemented a comprehensive reform in the health care system. The 2010 health reform occurred under the constraints imposed by the memorandum of understanding that the Greek Government signed with its EU/International Monetary Fund creditors to control its deficit. The objective of the study is to examine the impact of the reform on the efficiency and productivity of public hospitals in Greece. We use the Malmquist productivity index to comparatively examine the potential changes before and after the reform years. We compare productivity, efficiency, and technological changes using panel data of 111 public acute hospitals operating in Greece throughout the recession period of 2009 to 2012. Bootstrapping methods are applied to allow for uncertainty owing to sampling error and for statistical inference for the Malmquist productivity index and its decompositions. The analysis indicates that the productivity has been increased following the policy changes. It appears that the expected benefits from the reform in general have been achieved, at least in the short-term. This result is examined in the light of management and operations activities, which are related with the reform process. Therefore, at a second stage, the Malmquist index is regressed on variables that may potentially be statistically associated with productivity growth. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Economic evaluation of occupational safety preventive measures in a hospital.

    Science.gov (United States)

    Ramos, Delfina G; Arezes, Pedro M; Afonso, Paulo

    2015-01-01

    When an organization performs an integrated analysis of risks through its Occupational Health and Safety Management System, several steps are suggested to address the implications of the identified risks. Namely, the organization should make a detailed analysis of the monetary impact for the organization of each of the preventive measures considered. However, it is also important to perform an analysis of the impact of each measure on society (externalities). The aim of this paper is to present a case study related to the application of the proposed economic evaluation methodology. An analysis of the work accidents in a hospital has been made. Three of the major types of accidents have been selected: needle stings, falls and excessive strain. Following the risk assessment, some preventive measures have been designed. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organization's perspective) and in economic terms (including the benefits for the worker and for the Society). While the financial ratio is only advantageous in some cases, when the externalities are taken into account, the B/C ratio increases significantly. It is important to consider external benefits to make decisions concerning the implementation of preventive measures in Occupational Health and Safety projects.

  11. [Medico-economic assessment of the Pontoise Hospital stroke unit].

    Science.gov (United States)

    Yekhlef, F; Decup, D; Niclot, P; Servan, J; Descombes, S; Richecoeur, J; Ollivier, A

    2010-11-01

    Annually, approximately 120,000 people in France have a stroke. Various controlled studies have pointed out the benefits of treatment in a stroke unit (SU). The objective of this study was to evaluate, from a medical point of view, the economic impact of the Pontoise Hospital SU. Based on the national cost study (NCS [étude nationale des coûts: ENC]) we analyzed data of five diagnosis related groups (DRG) which have a principle diagnosis in relation with stroke. This work was limited to strokes and transient ischemic events in adults and excluded sub-arachnoid hemorrhage. Medical and economic parameters were collected over the period from January to October 2006 and compared with those of the same period in 2005, that is to say before the opening of the SU. Three hundred and twenty-three hospital stays occurred between January 1st and October 31st, 2006 and 216 during the same time period before the opening of the SU, an increase of approximately 50% of all stroke-related admissions in our hospital. The number of stays carried out in the neurology unit increased by 29%. There was no significant difference between the two periods regarding age (median 69 versus 70 years) and sex- ratio. Average length of stay (ALS) was the same (9 days). There were no significant differences concerning the death rate (5.6% versus 6.2%) and that of discharge to home (44.6% versus 44.4%). The cost by stay in 2006 was 3534 euros [median; min 664-max 57,542] versus 3541 euros in 2005 [681-35,149] (p=0.57). Analysis by DRG highlighted an increase in the cost for serious strokes, cerebral infarctions and hemorrhages. For transitory ischemic events, the cost and the ALS decreased. After the opening of the SU, there was an increase in the activity without an increase in the total cost. This could be related in part to the limited means allocated to the stroke unit at its opening (in particular medical staff). The NCS can be used to evaluate the activity of a stroke unit. This work could

  12. Economic rationalism and the cost efficiency of hospital chaplaincy: an Australian study.

    Science.gov (United States)

    Newell, C; Carey, L B

    2000-01-01

    Health care reform is also occurring in Australia and effects hospital chaplaincy programs. "Economic rationalism" is the philosophic foundation of this effort and its contrast with the values inherit in hospital chaplaincy are highlighted. Selected research results from the Australian system are described and the authors offer a perspective on the cost efficiency of hospital chaplaincy.

  13. Economic impact of surgery cancellation in a general hospital, Iran

    African Journals Online (AJOL)

    unhcc

    cause of inefficient use of operating room (OR) time and a drain on finite .... of total hospitalizations. In this hospital (270 beds ... Preoperative instructions not followed or patient not instructed. Change in .... concrete possibilities of reducing the level of surgical cancellations by .... room case-mix problem under uncertainty and.

  14. Avoiding mandatory hospital nurse staffing ratios: an economic commentary.

    Science.gov (United States)

    Buerhaus, Peter I

    2009-01-01

    The imposition of mandatory hospital nurse staffing ratios is among the more visible public policy initiatives affecting the nursing profession. Although the practice is intended to address problems in hospital nurse staffing and quality of patient care, this commentary argues that staffing ratios will lead to negative consequences for nurses involving the equity, efficiency, and costs of producing nursing care in hospitals. Rather than spend time and effort attempting to regulate nurse staffing, this commentary offers alternatives strategies that are directed at fixing the problems that motivate the advocates of staffing ratios.

  15. [Intelligence, socio-economic status and hospital admissions of young adults].

    Science.gov (United States)

    Bosma, H; Traag, T; Berger-van Sijl, M; van Eijk, J; Otten, F

    2007-05-12

    To determine whether socio-economic differences in hospital admissions of adolescents and young adults are related to differences in intelligence. . Retrospective cohort study. The data were derived from a group of 10,231 young adults and adolescents who were followed for a total of 47,212 person years with regard to their hospital admissions. Intelligence was measured in the first year of secondary school by 2 non-verbal intelligence tests for fluid intelligence. Data from hospital admissions were matched to a large-scale educational and occupational cohort. Data were analysed with Cox proportional hazards analysis. Intelligence was not found to be related to hospital admissions. However, a low occupational and educational level of the young adults or their parents, was strongly related to heightened risk for hospital admissions. In particular, the low socio-economic status of a respondent was associated with heightened risk for hospital admissions due to accidents (relative risk: 3.49; 95% confidence interval: 1.91-6.39). The small extent to which the socio-economic differences in hospital admissions seem to be based upon fluid intelligence, at least in adolescents and young adults, as well as the heightened risks of hospital admissions in lower socio-economic status groups and the associated high costs for health care legitimise further study of the determinants of these differences.

  16. Quantifying the economic impact of communication inefficiencies in U.S. hospitals.

    Science.gov (United States)

    Agarwal, Ritu; Sands, Daniel Z; Schneider, Jorge Díaz

    2010-01-01

    Care delivery is a complex enterprise that involves multiple interactions among multiple stakeholders. Effective communication between these dispersed parties is critical to ensuring quality and safety and improves operational efficiencies. Time and motion studies in hospital settings provide strong evidence that care providers-doctors and nurses-spend a significant proportion of their time obtaining or providing information (i.e., communicating). Yet, surprisingly, no studies attempt to quantify the economic waste associated with communication inefficiencies in hospital settings at a national level. Our research focuses on developing models for quantifying the economic burden on hospitals of poor communications. We developed a conceptual model of the effects of poor communications in hospitals that isolates four outcomes: (1) efficiency of resource utilization, (2) effectiveness of core operations, (3) quality of work life, and (4) service quality, identifying specific metrics for each outcome. We developed estimates of costs associated with wasted physician time, wasted nurse time, and increase in length of stay caused by communication inefficiencies across all U.S. hospitals, using primary data collected from interviews in seven hospitals and secondary data from a literature review, the Bureau of Labor Statistics (BLS), and the Agency for Healthcare Research and Quality (AHRQ). We find that U.S. hospitals waste over $12 billion annually as a result of communication inefficiency among care providers. Increase in length of stay accounts for 53 percent of the annual economic burden. A 500-bed hospital loses over $4 million annually as a result of communication inefficiencies. We note that our estimates are conservative as they do not include all dimensions of economic waste arising from poor communications. The economic burden of communication inefficiency in U.S. hospitals is substantial. Information technologies and process redesign may help alleviate some of

  17. Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness

    Science.gov (United States)

    2014-01-01

    Background Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Methods Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using validated questionnaires. Descriptive analyses and linear regression were used to test the model and relative importance analyses were performed. Results The selected attributes predict hospital attractiveness significantly (79.3%). The relative importance analysis revealed that hospital attractiveness is most strongly predicted by professional attributes (35.3%) and relational attributes (29.7%). In particular, professional development opportunities (18.8%), hospital prestige (16.5%), organizational support (17.2%) and leader support (9.3%) were found to be most important. Besides these non-economic aspects, the employed physicians indicated pay and financial benefits (7.4%) as a significant predictor of hospital attractiveness. Work-life balance and job security were not significantly related to hospital attractiveness. Conclusions This study shows that initiatives aimed at strengthening physicians’ positive perceptions of professional and relational aspects of practicing medicine in hospitals, while assuring satisfactory financial conditions, may offer useful avenues for increasing the level of perceived hospital attractiveness. Overall, hospitals are advised to use a differentiated approach to increase their attractiveness to physicians. PMID:24884491

  18. Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness.

    Science.gov (United States)

    Trybou, Jeroen; Gemmel, Paul; Van Vaerenbergh, Yves; Annemans, Lieven

    2014-05-21

    Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using validated questionnaires. Descriptive analyses and linear regression were used to test the model and relative importance analyses were performed. The selected attributes predict hospital attractiveness significantly (79.3%). The relative importance analysis revealed that hospital attractiveness is most strongly predicted by professional attributes (35.3%) and relational attributes (29.7%). In particular, professional development opportunities (18.8%), hospital prestige (16.5%), organizational support (17.2%) and leader support (9.3%) were found to be most important. Besides these non-economic aspects, the employed physicians indicated pay and financial benefits (7.4%) as a significant predictor of hospital attractiveness. Work-life balance and job security were not significantly related to hospital attractiveness. This study shows that initiatives aimed at strengthening physicians' positive perceptions of professional and relational aspects of practicing medicine in hospitals, while assuring satisfactory financial conditions, may offer useful avenues for increasing the level of perceived hospital attractiveness. Overall, hospitals are advised to use a differentiated approach to increase their attractiveness to physicians.

  19. The effects of ownership and system affiliation on the economic performance of hospitals.

    Science.gov (United States)

    Renn, S C; Schramm, C J; Watt, J M; Derzon, R A

    1985-01-01

    We investigated differences among five types of hospitals, defined by ownership (investor-owned or not-for-profit), system affiliation (system-affiliated or freestanding), and government sponsorship on 24 measures of economic performance. Using multivariate analysis of 1980 Medicare cost report and other data from a national sample of 561 hospitals, we found that investor-owned chain hospitals charged significantly more, and were more profitable, than all other types of hospitals except freestanding for-profits; there were no differences in productive efficiency that could be attributed to ownership or affiliation; the investor-owned hospitals had higher debt-to-asset ratios, less-capital-intensive plants, and greater capital costs as a percentage of operating costs than the not-for-profits; and there were no consistent case-mix differences among the hospitals.

  20. Renovating Charity Hospital or building a new hospital in post-Katrina New Orleans: economic rationale versus political will.

    Science.gov (United States)

    Leleu, Hervé; Moises, James; Valdmanis, Vivian Grace

    2013-02-01

    Since September 2005, Charity Hospital of New Orleans has been closed due to Hurricane Katrina. A debate following the closing arose about whether this public hospital should be renovated or a new medical center affiliated with the Louisiana State University should be built. Using academic literature, government statistics, and popular press reports, we describe the economic implications that support the view that Charity Hospital should have been renovated. We also address why this policy was not pursued by demonstrating the influence politics and individual stakeholders (specifically, Louisiana State University) had on the eventual policy pursued. In this commentary we also note the political identity movement away from public-sector provision of services to private-sector interests.

  1. Linking Hospital and Tax data to support research on the economic impacts of hospitalization

    Directory of Open Access Journals (Sweden)

    Claudia Sanmartin

    2017-04-01

    This project has created a unique linked database that will support research on the economic consequences of ‘health shocks’ for individuals and their families, and the implications for income, labour and health policies. This database represents a new and unique resource that will fill an important national data gap, and enable a wide range of relevant research.

  2. Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010.

    Science.gov (United States)

    Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, A S M; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

    2014-07-01

    Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010. In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons

  3. Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

    Science.gov (United States)

    Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, ASM; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

    2014-01-01

    Objective Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. Design From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. Results We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93–8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96–121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76–147) in direct costs and US$59 million (95% CI: 37–91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4–2.6) in direct costs and US$0.4 million (95% CI: 0.1–0.8) in indirect costs in 2010. Conclusions In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. PMID:24750586

  4. Hospitalizations and economic analysis in psychotic patients with paliperidone palmitate long-acting injection.

    Science.gov (United States)

    Mesones-Peral, Jesús E; Gurillo-Muñoz, Pedro; Sánchez-Sicilia, Mari Paz; Miller, Adam; Griñant-Fernández, Alejandra

    Prevent hospitalizations in psychotic disorders is an important aim, so long-acting antipsychotic is a good option that can control better the correct adherence. Moreover, in the current economic context pharmacoeconomic studies are necessary. We estimate the effect in prevention of paliperidone palmitate long-acting injection (PP-LAI) and calculate the economic cost in the 12 months preceding the start of treatment with PP-LAI and 12 months later. Mirror image study of 71 outpatients diagnosed with psychotic disorders and treated with PP-LAI. In a first analysis, we measured along one year: number of hospitalizations/year, number of hospitalization in days, number of emergency assists/year and if there is antipsychotics associated to long-acting treatment. After this phase, we applied Fees Act of Valencia for economic analysis and estimate of the cost per hospitalization (€ 5,640.41) and hospital emergency (€ 187.61). After one year of treatment with PP-LAI (mean dose=130.65mg/month), we obtained greater numbers in assistance variables: total hospitalizations decrease, 78.8% (P=.009); shortening in hospitalization days, 89.4% (P=.009); abridgement of number of emergency assists, 79.1% (P=.002); decrease of rate of antipsychotics associated to long-acting treatment, 21% (P<.0001); increase in monotherapy, 53.8% (P<.0001). Therefore, after 12 months of treatment with PP-LAI we obtained a reduction in inpatient spending (savings of € 175,766.54) and increased spending on antipsychotics 32% (equivalent to € 151,126.92). PP-LAI can be an effective therapy for the treatment of patients with severe psychotic disorders: improves symptomatic stability and can prevent hospitalizations with cost-effective symptom control. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Hospital-physician collaboration: landscape of economic integration and impact on clinical integration.

    Science.gov (United States)

    Burns, Lawton Robert; Muller, Ralph W

    2008-09-01

    Hospital-physician relationships (HPRs) are an important area of academic research, given their impact on hospitals' financial success. HPRs also are at the center of several federal policy proposals such as gain sharing, bundled payments, and pay-for-performance (P4P). This article analyzes the HPRs that focus on the economic integration of hospitals and physicians and the goals that HPRs are designed to achieve. It then reviews the literature on the impact of HPRs on cost, quality, and clinical integration. The goals of the two parties in HPRs overlap only partly, and their primary aim is not reducing cost or improving quality. The evidence base for the impact of many models of economic integration is either weak or nonexistent, with only a few models of economic integration having robust effects. The relationship between economic and clinical integration also is weak and inconsistent. There are several possible reasons for this weak linkage and many barriers to further integration between hospitals and physicians. Successful HPRs may require better financial conditions for physicians, internal changes to clinical operations, application of behavioral skills to the management of HPRs, changes in how providers are paid, and systemic changes encompassing several types of integration simultaneously.

  6. The potential economic value of screening hospital admissions for Clostridium difficile.

    Science.gov (United States)

    Bartsch, S M; Curry, S R; Harrison, L H; Lee, B Y

    2012-11-01

    Asymptomatic Clostridium difficile carriage has a prevalence reported as high as 51-85 %; with up to 84 % of incident hospital-acquired infections linked to carriers. Accurately identifying carriers may limit the spread of Clostridium difficile. Since new technology adoption depends heavily on its economic value, we developed an analytic simulation model to determine the cost-effectiveness screening hospital admissions for Clostridium difficile from the hospital and third party payer perspectives. Isolation precautions were applied to patients testing positive, preventing transmission. Sensitivity analyses varied Clostridium difficile colonization rate, infection probability among secondary cases, contact isolation compliance, and screening cost. Screening was cost-effective (i.e., incremental cost-effectiveness ratio [ICER] ≤ $50,000/QALY) for every scenario tested; all ICER values were ≤ $256/QALY. Screening was economically dominant (i.e., saved costs and provided health benefits) with a ≥10.3 % colonization rate and ≥5.88 % infection probability when contact isolation compliance was ≥25 % (hospital perspective). Under some conditions screening led to cost savings per case averted (range, $53-272). Clostridium difficile screening, coupled with isolation precautions, may be a cost-effective intervention to hospitals and third party payers, based on prevalence. Limiting Clostridium difficile transmission can reduce the number of infections, thereby reducing its economic burden to the healthcare system.

  7. Economic impact of electronic prescribing in the hospital setting: A systematic review.

    Science.gov (United States)

    Ahmed, Zamzam; Barber, Nick; Jani, Yogini; Garfield, Sara; Franklin, Bryony Dean

    2016-04-01

    To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting. We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality. The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported. There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers' decisions. Copyright © 2016. Published by Elsevier Ireland Ltd.

  8. Economic burden of Clostridium difficile in five hospitals of the Florence health care system in Italy

    Directory of Open Access Journals (Sweden)

    Poli A

    2015-11-01

    Full Text Available Anna Poli,1 Sergio Di Matteo,2 Giacomo M Bruno,2 Enrica Fornai,1 Maria Chiara Valentino,2 Giorgio L Colombo2,31Vigilanza e Controllo Infezioni Correlate all'Assistenza, Ospedale Piero Palagi, Azienda Sanitaria di Firenze, Firenze, Italy; 2SAVE Studi – Health Economics and Outcomes Research, Milan, Italy; 3Department of Drug Sciences, University of Pavia, Pavia, ItalyIntroduction: Despite the awareness about the increasing rates of Clostridium difficile infection (CDI and the economic burden arising from its management (prolonged hospitalization, laboratory tests, visits, surgical treatment, environmental sanitation, few studies are available in Italy on the economic costs directly attributable to the CDI. The Florence health care system has designed a study with the aim of describing the costs attributable to the CDI and defines the incremental economic burden associated with the management of this complication.Methods: We conducted a retrospective study in five hospitals of the Florence health care system. The enrolled population included all patients who were hospitalized during the year 2013 with a diagnosis of CDI. Of the 187 total cases reported in 2013, 69 patients were enrolled, for whom the main cause of hospitalization was directly attributable to CDI.Results: We enrolled 69 patients (19 males and 50 females, with a mean age of 82.16 years (minimum 46 to maximum 98. The total number of hospitalization days observed was 886 (12.8 per patient on average. The data from this study show that the mean total incremental cost for a patient with CDI was €3,270.52 per year. The hospital stay length is the most significant cost parameter, having the largest influence on the overall costs, with an impact of 87% on the total cost. The results confirm the costs for the management of CDI in five hospitals of the Florence health care system are in line with data from the international literature.Conclusion: The economic impact of CDI is most

  9. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

    Science.gov (United States)

    Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

    2017-07-01

    To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

  10. Treatment, monitoring, and economic outcomes of venous thromboembolism among hospitalized patients in China.

    Science.gov (United States)

    Wu, Eric Q; Xie, Jipan; Wu, Chun; Du, Ella Xiaoyan; Li, Nanxin; Tan, Ruoding; Liu, Yuanli

    2014-03-01

    The prevalence of venous thromboembolism (VTE) has been increasing in China. However, the treatment pattern and economic burden of these patients have not been well-understood. The objective of this study was to examine the patient characteristics, treatment pattern, anticoagulant monitoring, and economic burden of VTE among hospitalized patients in China. Hospitalizations with a diagnosis of VTE [including deep vein thrombosis (DVT) or pulmonary embolism (PE)] between 1 January 2010 and 30 June 2013 were included. Descriptive analysis was conducted for patients' characteristics, anticoagulant treatment, international normalized ratio (INR) monitoring, and hospitalization cost [in 2013 Chinese yuan (Y) and US dollars (US$)]. Multivariate regressions were performed to assess factors associated with oral anticoagulant use and total costs of inpatient care. A total of 1,047 VTE-related hospitalizations were selected. The sample had a mean age of 62.4 years, with 45.9 % female. About 46.3 % of hospitalizations used heparin only, 35.0 % used warfarin, 0.8 % used rivaroxaban, and 18.0 % did not use anticoagulants. Among hospitalizations where warfarin was used, 90.8 % received at least one INR test and only 30 % had the last INR within the target therapeutic range (2-3) before discharge. The mean (standard deviation) total cost per hospitalization was Y29,114 (43,772) [US$4,757 (7,152)]. PE, VTE as primary diagnosis, female, insurance coverage, anticoagulant treatment, co-morbidities, admission condition, and surgical procedure were significantly associated with inpatient costs. Conventional anticoagulants were most commonly used in the study sample. Under-monitoring and suboptimal care may be an issue for patients treated with warfarin. The average total inpatient cost of VTE-related hospitalizations is high.

  11. Analysis of economic burden for patients with cystic echinococcosis in five hospitals in northwest China.

    Science.gov (United States)

    Wang, Le; Wen, Hao; Feng, Xiaohui; Jiang, Xiaoming; Duan, Xinyu

    2012-12-01

    The direct and indirect economic burden of human cystic echinococcosis (CE) was investigated in the five specialist hydatid hospitals in Xinjiang, PR China, to provide information for health policy in the future. A total of 2018 CE patients (age range 2-88 years) attending the hospitals were studied between 2004 and 2008. The per-person direct medical cost was US$1493.12 (95% CI 1438.43-1547.80) and the per-person direct non-medical cost was US$19.67. The indirect economic cost was US$1435.96 per person, and the disability-adjusted life-years (DALY) lost was approximately 1.03 DALY/person. This study is the first to combine the human capital method with DALYs to analyse the indirect CE economic burden in northwest China. Factors such as age, occupation and hospital level should be considered when developing polices to reduce the economic burden of CE. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  12. Executive and financial manager’s awareness of economic issues in private and public hospitals in Shiraz

    Directory of Open Access Journals (Sweden)

    Tayebe Hoseinpur

    2014-07-01

    Full Text Available Introduction: Managers, as the members of decision making team in hospitals, are required to understand economic issues In order to increase their knowledge, make better decisions making, and bring about economic growth in hospitals. Thus by measuring the managers’ level of economic knowledge and understanding their weaknesses at this field, we can take an important step in line with this transcendental target. Method: This was an analytical– descriptive study conducted in 2013. In this study, the views of 30 hospital executives and financial managers about various aspects of hospital economy including payment methods, techniques of economic evaluation, hospital income, and cost and subtractions were studied using questionnaires and interviews. SPSS 18 was used to analyze the collected data. P<0.05 was considered statistically significant. Results: None of the studied managers had a good level of knowledge and most managers (80.7% had an undesirable level of knowledge, and few of them had a moderate level of knowledge. The administrators’ average knowledge of the ways to reduce the cost and increase the income of private hospitals was more than that of hospital administrators; as to the economic evaluation techniques and methods of payment, hospital administrators had more knowledge than managers of private hospitals. Conclusion: The managers’ low level of economic knowledge can be enhanced by more selective appointment of individuals for these sensitive positions and also increased by their participation in workshops and training courses.

  13. The comparative economic performance of investor-owned chain and not-for-profit hospitals.

    Science.gov (United States)

    Watt, J M; Derzon, R A; Renn, S C; Schramm, C J; Hahn, J S; Pillari, G D

    1986-01-09

    We examined the differences in the economic performance of 80 matched pairs of investor-owned chain and not-for-profit hospitals in eight states during 1978 and 1980, and considered how their operating strategies might affect their relative success in a more price-conscious market. We found that total charges (adjusted for case mix) and net revenues per case were both significantly higher in the investor-owned chain hospitals, mainly because of higher charges for ancillary services; there were no significant differences between the two groups of hospitals in regard to patient-care costs per case (adjusted for case mix), but the investor-owned hospitals had significantly higher administrative overhead costs; investor-owned hospitals were more profitable; investor-owned hospitals had fewer employees per occupied bed but paid more per employee; investor-owned hospitals had funded more of their capital through debt and had significantly higher capital costs in proportion to their operating costs; and the two groups did not differ in patient mix, as measured by their Medicare case-mix indexes or the proportions of their patients covered by Medicare or Medicaid. We conclude that investor-owned chain hospitals generated higher profits through more aggressive pricing practices rather than operating efficiencies - a result not unexpected in view of past cost-based reimbursement policies. Recent changes in these policies are creating new pressures for cost control and moderation in charges, to which both types of hospitals must adapt. Neither type has a clear-cut advantage in the ability to make the necessary changes.

  14. Investment in radiotherapy infrastructure positively affected the economic status of an oncology hospital.

    Science.gov (United States)

    Smigielska, Mirella; Milecki, Piotr

    2012-01-01

    Radiotherapy is among the most efficient treatment methods of cancer. However, a radiotherapy base needs a substantial financial investment, especially before the beginning of its operation, and in some cases, in developing countries such a huge investment may cause some financial disturbances for a hospital concerned. To assess the influence of investments modernizing the radiotherapy base in the period between 2000 and 2007 on the financial condition of the oncology hospital in the region with population of about 3 million. Financial reports and medical statistics for the period between 2000 and 2007 from the studied oncology hospital and a recognized staffing model, as well as data on epidemiological situation of the region have been used to calculate the economic effects of financial investment in the radiotherapy base. The growth of RT therapeutic potential has been driven by two cost-effective investment programmes. The total amount invested in both programmes was PLN 127,191,000. The number of radiotherapy patients treated in the hospital increased from 2301 in 2000 to 4799 in 2007 with a the same number of five therapeutic machines, although all five of them were replaced over that period. Investments modernizing the radiotherapy base lead to a significant increase in depreciation and operating costs, which adversely affects financial results of the hospital. Long term trends showed that investments had positive influence on hospital performance shown both in increased income and larger number of patients treated.

  15. Demographic and socio-economic patterns of hospitalization for infectious diseases in Israel.

    Science.gov (United States)

    Ellencweig, A Y; Slater, P E

    1986-06-01

    Hospitalization rates in Israel for five common enteric communicable diseases were computed according to age, sex, religion, origin and place of residence. Higher rates were found for non-Jews of both sexes and males of all origins. Higher rates were also found for settlements inhabited by new immigrants of low socio-economic classes. These findings suggest that more emphasis should be placed upon sanitary improvements and education for better health, rather than on merely improving the health delivery system.

  16. Economic analysis of cloud-based desktop virtualization implementation at a hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Kim, Seok; Kim, Taeki; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb; Hwang, Hee

    2012-10-30

    Cloud-based desktop virtualization infrastructure (VDI) is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with any device. However, the economic validity of investing in the adoption of the system at a hospital has not been established. This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time). Return on investment (ROI), net present value (NPV), and internal rate of return (IRR) indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH) showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users), the greater the number of adopted VMs was the more investable the system was. This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS) operation and utilization in a tertiary hospital setting.

  17. Economic analysis of cloud-based desktop virtualization implementation at a hospital

    Directory of Open Access Journals (Sweden)

    Yoo Sooyoung

    2012-10-01

    Full Text Available Abstract Background Cloud-based desktop virtualization infrastructure (VDI is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with anydevice. However, the economic validity of investing in the adoption of the system at a hospital has not been established. Methods This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time. Return on investment (ROI, net present value (NPV, and internal rate of return (IRR indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. Results The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users, the greater the number of adopted VMs was the more investable the system was. Conclusions This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS operation and utilization in a tertiary hospital setting.

  18. Socio-economic impact of improper hospital waste management on waste disposal employees

    International Nuclear Information System (INIS)

    Khan, M.R.; Raza, Z. L.

    2011-01-01

    Background: Improper disposal of hospital waste results in spread of disease to the community and its handlers. Objectives: To study the socio-economic impact of inappropriate disposal of hospital waste on the health of the waste disposal staff. Materials and Methods: Interviews were conducted from 50 hospital waste collectors of Lahore and using a pre-structured questionnaire, the information was filled. The data were statistically analyzed for frequencies, and cross tabulation. Results: The improper disposal of hospital waste lead to disease in 45 hospital waste collectors. Eighteen waste collectors were infected with respiratory diseases,14 with skin infection, 7 with tuberculosis and 6 with hepatitis. Only 8 workers were provided with special clothes by the hospital management. The chances of getting infection was high in those who were not provided with special clothes like, gowns, gloves and shoes as compared to those who were provided with these.The total cost of recovery for these diseases also varied with an amount of Rs. 68,340 for the treatment of hepatitis, Rs. 3,150 for tuberculosis, Rs. 1,500 for respiratory diseases and Rs. 1,000 for skin infection. Only 12 workers were given a small remuneration ranging from Rs.100-400 per month as compensation from the hospital administration. Conclusions: Use of protective clothing by the hospital waste disposal collectors can significantly reduce their exposure to the diseases. Policy message: Provision of clothing and gloves to the waste disposal collectors, would help significantly in reducing diseases like tuberculosis, hepatitis, respiratory diseases and skin infection. (author)

  19. Greek economic crisis and impaired perinatal parameters: experience from a public maternity hospital.

    Science.gov (United States)

    Sdona, E; Papamichail, D; Ragkou, E; Briana, D D; Malamitsi-Puchner, A; Panagiotopoulos, T

    2017-07-04

    Since 2008, Greece suffers a severe economic crisis. Adverse health outcomes have been reported, but studies on perinatal health are sparse. We aimed to examine the impact of economic crisis on perinatal parameters during early and established crisis periods. Birth records of 14 923 neonates, born in a public maternity hospital from 2005-2014, were reviewed for maternal (age, delivery mode) and neonatal (gender, birthweight, gestational age) variables. Univariable analysis tested the association of study variables with time-periods 2005-2007, 2009-2011 and 2012-2014. Multivariable logistic regression analysis identified factors independently associated with low birthweight (LBW) (period, independently of maternal age. In conclusion, impaired perinatal parameters, manifested by increasing maternal age, LBW, prematurity and CS rate, were observed during the years of economic decline, with possible adverse consequences for later health.

  20. An economic evaluation of Clostridium difficile infection management in an Italian hospital environment.

    Science.gov (United States)

    Magalini, S; Pepe, G; Panunzi, S; Spada, P L; De Gaetano, A; Gui, D

    2012-12-01

    Clostridium difficile infection (CDI) accounts for the majority of nosocomial cases of diarrhea, and with recent upsurge of multidrug-resistant strains, morbidity and mortality have increased. Data on clinical impact of CDI come mostly from Anglo-Saxon countries, while in Italy only two studies address the issue and no economic data exist on costs of CDI in the in hospital setting. A retrospective cross-sectional study with pharmacoeconomic analysis was performed on the CDI series of the Policlinico Gemelli of Rome, a major 1400 bed Hospital. The clinical charts of 133 patients in a 26 month period were reviewed. All costs of the involved resources were calculated and statistical analysis was carried out with means and standard deviations, and categorical variables as number and percentages. The results show the significant sanitary costs of CDI in an Italian hospital setting. The cost analysis of the various elements (exams, imaging studies, therapies, etc.) shows that none independently influences the high cost burden of CDI, but that it is the simple length of hospital stay that represents the most important factor. Prevention of CDI is the most cost-effective approach. The major break-through in cost reduction of CDI would be a therapeutical intervention or procedure that shortens hospital length of stay.

  1. Economic burden of managing Type 2 diabetes mellitus: Analysis from a Teaching Hospital in Malaysia.

    Science.gov (United States)

    Ismail, Aniza; Suddin, Leny Suzana; Sulong, Saperi; Ahmed, Zafar; Kamaruddin, Nor Azmi; Sukor, Norlela

    2017-01-01

    Type 2 diabetes mellitus (T2DM) is a chronic disease that consumes a large amount of health-care resources. It is essential to estimate the cost of managing T2DM to the society, especially in developing countries. Economic studies of T2DM as a primary diagnosis would assist efficient health-care resource allocation for disease management. This study aims to measure the economic burden of T2DM as the primary diagnosis for hospitalization from provider's perspective. A retrospective prevalence-based costing study was conducted in a teaching hospital. Financial administrative data and inpatient medical records of patients with primary diagnosis (International Classification Disease-10 coding) E11 in the year 2013 were included in costing analysis. Average cost per episode of care and average cost per outpatient visit were calculated using gross direct costing allocation approach. Total admissions for T2DM as primary diagnosis in 2013 were 217 with total outpatient visits of 3214. Average cost per episode of care was RM 901.51 (US$ 286.20) and the average cost per outpatient visit was RM 641.02 (US$ 203.50) from provider's perspective. The annual economic burden of T2DM for hospitalized patients was RM 195,627.67 (US$ 62,104) and RM 2,061,520.32 (US$ 654,450) for those being treated in the outpatient setting. Economic burden to provide T2DM care was higher in the outpatient setting due to the higher utilization of the health-care service in this setting. Thus, more focus toward improving T2DM outpatient service could mitigate further increase in health-care cost from this chronic disease.

  2. Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study.

    Science.gov (United States)

    López-Ortega, Mariana; García-Peña, Carmen; Granados-García, Víctor; García-González, José Juan; Pérez-Zepeda, Mario Ulises

    2013-02-08

    The burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs. A comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures. A total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to

  3. [Medico-economic analysis of a neurosurgery department at a university hospital].

    Science.gov (United States)

    Lemaire, J-J; Delom, C; Coste, A; Khalil, T; Jourdy, J-C; Pontier, B; Gabrillargues, J; Sinardet, D; Chabanne, A; Achim, V; Sakka, L; Coste, J; Chazal, J; Salagnac, A; Coll, G; Irthum, B

    2015-02-01

    Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. The average annual, analytic income statement was +1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Economics of Palliative Care for Hospitalized Adults With Serious Illness: A Meta-analysis.

    Science.gov (United States)

    May, Peter; Normand, Charles; Cassel, J Brian; Del Fabbro, Egidio; Fine, Robert L; Menz, Reagan; Morrison, Corey A; Penrod, Joan D; Robinson, Chessie; Morrison, R Sean

    2018-06-01

    Economics of care for adults with serious illness is a policy priority worldwide. Palliative care may lower costs for hospitalized adults, but the evidence has important limitations. To estimate the association of palliative care consultation (PCC) with direct hospital costs for adults with serious illness. Systematic searches of the Embase, PsycINFO, CENTRAL, PubMed, CINAHL, and EconLit databases were performed for English-language journal articles using keywords in the domains of palliative care (eg, palliative, terminal) and economics (eg, cost, utilization), with limiters for hospital and consultation. For Embase, PsycINFO, and CENTRAL, we searched without a time limitation. For PubMed, CINAHL, and EconLit, we searched for articles published after August 1, 2013. Data analysis was performed from April 8, 2017, to September 16, 2017. Economic evaluations of interdisciplinary PCC for hospitalized adults with at least 1 of 7 illnesses (cancer; heart, liver, or kidney failure; chronic obstructive pulmonary disease; AIDS/HIV; or selected neurodegenerative conditions) in the hospital inpatient setting vs usual care only, controlling for a minimum list of confounders. Eight eligible studies were identified, all cohort studies, of which 6 provided sufficient information for inclusion. The study estimated the association of PCC within 3 days of admission with direct hospital costs for each sample and for subsamples defined by primary diagnoses and number of comorbidities at admission, controlling for confounding with an instrumental variable when available and otherwise propensity score weighting. Treatment effect estimates were pooled in the meta-analysis. Total direct hospital costs. This study included 6 samples with a total 133 118 patients (range, 1020-82 273), of whom 93.2% were discharged alive (range, 89.0%-98.4%), 40.8% had a primary diagnosis of cancer (range, 15.7%-100.0%), and 3.6% received a PCC (range, 2.2%-22.3%). Mean Elixhauser index scores ranged

  5. Positioning matrix of economic efficiency and complexity: a case study in a university hospital.

    Science.gov (United States)

    Ippolito, Adelaide; Viggiani, Vincenzo

    2014-01-01

    At the end of 2010, the Federico II University Hospital in Naples, Italy, initiated a series of discussions aimed at designing and applying a positioning matrix to its departments. This analysis was developed to create a tool able to extract meaningful information both to increase knowledge about individual departments and to inform the choices of general management during strategic planning. The name given to this tool was the positioning matrix of economic efficiency and complexity. In the matrix, the x-axis measures the ratio between revenues and costs, whereas the y-axis measures the index of complexity, thus showing "profitability" while bearing in mind the complexity of activities. By using the positioning matrix, it was possible to conduct a critical analysis of the characteristics of the Federico II University Hospital and to extract useful information for general management to use during strategic planning at the end of 2010 when defining medium-term objectives. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Vertical Integration of Hospitals and Physicians: Economic Theory and Empirical Evidence on Spending and Quality.

    Science.gov (United States)

    Post, Brady; Buchmueller, Tom; Ryan, Andrew M

    2017-08-01

    Hospital-physician vertical integration is on the rise. While increased efficiencies may be possible, emerging research raises concerns about anticompetitive behavior, spending increases, and uncertain effects on quality. In this review, we bring together several of the key theories of vertical integration that exist in the neoclassical and institutional economics literatures and apply these theories to the hospital-physician relationship. We also conduct a literature review of the effects of vertical integration on prices, spending, and quality in the growing body of evidence ( n = 15) to evaluate which of these frameworks have the strongest empirical support. We find some support for vertical foreclosure as a framework for explaining the observed results. We suggest a conceptual model and identify directions for future research. Based on our analysis, we conclude that vertical integration poses a threat to the affordability of health services and merits special attention from policymakers and antitrust authorities.

  7. A techno-economic assessment of grid connected photovoltaic system for hospital building in Malaysia

    Science.gov (United States)

    Mat Isa, Normazlina; Tan, Chee Wei; Yatim, AHM

    2017-07-01

    Conventionally, electricity in hospital building are supplied by the utility grid which uses mix fuel including coal and gas. Due to enhancement in renewable technology, many building shall moving forward to install their own PV panel along with the grid to employ the advantages of the renewable energy. This paper present an analysis of grid connected photovoltaic (GCPV) system for hospital building in Malaysia. A discussion is emphasized on the economic analysis based on Levelized Cost of Energy (LCOE) and total Net Present Post (TNPC) in regards with the annual interest rate. The analysis is performed using Hybrid Optimization Model for Electric Renewables (HOMER) software which give optimization and sensitivity analysis result. An optimization result followed by the sensitivity analysis also being discuss in this article thus the impact of the grid connected PV system has be evaluated. In addition, the benefit from Net Metering (NeM) mechanism also discussed.

  8. Hospital waste sterilization: a technical and economic comparison between radiation and microwave treatments

    International Nuclear Information System (INIS)

    Tata, A.; Beone, F.

    1995-01-01

    Hospital waste (HW) disposal is becoming a problem of increasing importance in almost all industrially advanced countries. In Italy the yearly hospital waste production is about 250,000 tons and only 60,000 are treated by incineration at present time. As by a recent Italian law a meaningful percentage of HW (50 to 60%), corresponding to food residuals, plastic, paper, various organic materials, etc., could be landfilled as municipal refuses if preliminarily submitted to a suitable sterilization treatment. Under this perspective, sterilization/sanitation techniques represent now a technically and commercially viable alternative to HW thermal destruction that, besides more and more socially and politically less accepted. Electron Beam (EB) and Microwave (MW) treatments are two of the most interesting and emerging HW sterilization techniques, and, based on engineering real data, a technical and economic comparison is carried out, focusing vantages and limits of each process. (author)

  9. Economic costs of hospitalized diarrheal disease in Bangladesh: a societal perspective.

    Science.gov (United States)

    Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Huda, Tanvir M; Salim Uzzaman, M; Haider, Sabbir; Rahman, Hafizur; Islam, Ziaul; Khan, Jahangir A M; Van Der Meer, Robert; Morton, Alec

    2018-01-01

    Diarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality worldwide. Although the burden of the diarrheal diseases is much lower in developed countries, it is a significant public health problem in low and middle-income countries like Bangladesh. Though diarrhea is preventable and managed with low-cost interventions, it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those patients. The aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal illness. This study was conducted in six randomly selected district hospitals from six divisions (larger administrative units) in Bangladesh. The study was performed from the societal perspective which means all types of costs were identified, measured and valued no matter who incurred them. Cost analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal diseases. The study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires, observation checklists, analysis of hospital database, telephone interviews and compilation of service statistics. The average total societal cost of illness per episode was BDT 5274.02 (US $ 67.18) whereas the average inpatient and outpatient costs were BDT 8675.09 (US $ 110.51) and BDT 1853.96 (US $ 23.62) respectively. The cost burden was significantly highest for poorest households, 21.45% of household income, compared to 4.21% of the richest quintile. Diarrheal diseases continue to be an overwhelming problem in Bangladesh. The economic impact of any public health interventions (either preventive or promotive) that can reduce the prevalence

  10. Hospital costs for treatment of acute heart failure: economic analysis of the REVIVE II study.

    Science.gov (United States)

    de Lissovoy, Greg; Fraeman, Kathy; Teerlink, John R; Mullahy, John; Salon, Jeff; Sterz, Raimund; Durtschi, Amy; Padley, Robert J

    2010-04-01

    Acute heart failure (AHF) is the leading cause of hospital admission among older Americans. The Randomized EValuation of Intravenous Levosimendan Efficacy (REVIVE II) trial compared patients randomly assigned to a single infusion of levosimendan (levo) or placebo (SOC), each in addition to local standard treatments for AHF. We report an economic analysis of REVIVE II from the hospital perspective. REVIVE II enrolled patients (N = 600) hospitalized for treatment of acute decompensated heart failure (ADHF) who remained dyspneic at rest despite treatment with intravenous diuretics. Case report forms documented index hospital treatment (drug administration, procedures, days of treatment by care unit), as well as subsequent hospital and emergency department admissions during follow-up ending 90 days from date of randomization. These data were used to impute cost of admission based on an econometric cost function derived from >100,000 ADHF hospital billing records selected per REVIVE II inclusion criteria. Index admission mean length of stay (LOS) was shorter for the levo group compared with standard of care (SOC) (7.03 vs 8.96 days, P = 0.008) although intensive care unit (ICU)/cardiac care unit (CCU) days were similar (levo 2.88, SOC 3.22, P = 0.63). Excluding cost for levo, predicted mean (median) cost for the index admission was levo US $13,590 (9,458), SOC $19,021 (10,692) with a difference of $5,431 (1,234) favoring levo (P = 0.04). During follow-up through end of study day 90, no significant differences were observed in numbers of hospital admissions (P = 0.67), inpatient days (P = 0.81) or emergency department visits (P = 0.41). Cost-effectiveness was performed with a REVIVE-II sub-set conforming to current labeling, which excluded patients with low baseline blood pressure. Assuming an average price for levo in countries where currently approved, there was better than 50% likelihood that levo was both cost-saving and improved survival. Likelihood that levo would

  11. Economic analysis of an epilepsy outreach model of care in a university hospital setting.

    Science.gov (United States)

    Maloney, Eimer; McGinty, Ronan N; Costello, Daniel J

    2017-07-01

    The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals. In 2014, the epilepsy service at Cork University Hospital established an Epilepsy Outreach Service providing regular, ambulatory outpatient follow up at residential care facilities in Cork city and county in an effort to improve access to care, reduce the burden and expense of patient and carer travel to hospital outpatient appointments, and to provide a dedicated specialist phone service for epilepsy related queries in order to reduce emergency room visits when possible. We present the findings of an economic analysis of the outreach service model of care compared to the traditional hospital outpatient service and demonstrate significant cost savings and improved access to care with this model. Ideally these cost savings should be used to develop novel ways to enhance epilepsy care for persons with disability. We propose that this model of care can be more suitable for persons with disability living in residential care who are at risk of losing access to specialist epilepsy care. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Are hospital staff aware of the economic benefits of employing people with disabilities?

    Directory of Open Access Journals (Sweden)

    Małgorzata M. Machaj

    2015-10-01

    Full Text Available Introduction : One of the regulations governing employment on the open labour market is the Act for vocational and social rehabilitation and employment of people with disabilities, which defines disability in the context that it impacts upon a person’s ability to work. Aim of the research : To evaluate the level of hospital staff awareness of the financial impacts of employing people with disabilities at the Central Clinical Hospital of the Ministry of the Interior in Warsaw. Material and methods: The sample and control groups consisted of people working at the hospital, comprising 247 individuals, including 194 women and 53 men, aged between 25 and 60 years. The sample group consisted of people with disabilities. The control group consisted of colleagues with disabilities, of both sexes, and of the same age range. There was also a separate sample group comprising 60 people from middle management and senior management. The sample and control groups were provided with a questionnaire about issues relating to the economic aspects of employing people with disabilities. The results were compared with data from the questionnaire for management and from hospital statistics. The methodology of mathematical statistics was used. Results : Discrepancies were found between sample and control groups, and hospital statistics pertaining to people with disabilities as employees in terms of the burden placed on the business, such as sick leave, breaks from work in the general sense, additional leave, accessing specialist tests during working hours, and earnings, in particular reimbursement of the cost of workplace equipment and funding for salaries. Conclusions: There is a significant degree of divergence between managers’ and employees’ notions of privileges for disabled workers and their actual scale. There is misunderstanding and lack of knowledge of the applicable provisions of the Act for the Vocational and Social Rehabilitation and Employment of

  13. Estimating the Direct Medical Economic Burden of Health Care-Associated Infections in Public Tertiary Hospitals in Hubei Province, China.

    Science.gov (United States)

    Li, Hao; Liu, Xinliang; Cui, Dan; Wang, Quan; Mao, Zongfu; Fang, Liang; Zhang, Furong; Yang, Ping; Wu, Huiling; Ren, Nili; He, Jianyun; Sun, Jing

    2017-07-01

    This study estimated the attributable direct medical economic burden of health care-associated infections (HAIs) in China. Data were extracted from hospitals' information systems. Inpatient cases with HAIs and non-HAIs were grouped by the propensity score matching (PSM) method. Attributable hospitalization expenditures and length of hospital stay were measured to estimate the direct medical economic burden of HAIs. STATA 12.0 was used to conduct descriptive analysis, bivariate χ 2 test, paired Z test, PSM ( r = 0.25σ, nearest neighbor 1:1 matching), and logistic regress analysis. The statistically significant level was set at .05. The HAIs group had statistically significant higher expenditures and longer hospitalization stay than the non-HAIs group during 2013 to 2015 ( P economic burden of HAIs calls for more effective HAI surveillance and better control with appropriate incentives.

  14. The Economic Burden of Autonomic Dysreflexia during Hospitalization for Individuals with Spinal Cord Injury.

    Science.gov (United States)

    Squair, Jordan W; White, Barry A B; Bravo, Grace I; Martin Ginis, Kathleen A; Krassioukov, Andrei V

    2016-08-01

    We sought to determine the economic burden of autonomic dysreflexia (AD) from the perspective of the Canadian healthcare system in a case series of individuals with spinal cord injury (SCI) presenting to emergency care. In doing so, we sought to illustrate the potential return on investments in the translation of evidence-informed practices and developments in the prevention, diagnosis, and management of AD. Activity-based costing methodology was employed to estimate the direct healthcare or hospitalization costs of AD following presentation to the emergency department. Differences in trends were noted between patients who were promptly diagnosed, managed, and discharged, and patients whose experience followed a less direct or ideal path to discharge. We recorded 29 emergency room visits for conditions ultimately diagnosed as AD. Overall, median length of stay was 3 days (interquartile range [IQR] = 1.25-5.75), but extended up to 103 consecutive days. Cost analysis revealed median healthcare costs of $5029 (IQR = $2397-9522) for hospital admissions for AD, with the highest estimated hospital cost for a single admission > $190,000. Emergency room admissions resulting from AD can result in dramatic healthcare costs. Delayed diagnosis and inefficient management of AD may lead to further complications, adding to the strain on already limited healthcare resources. Prompt recognition of AD; broader translation of evidence-informed practices; and novel diagnosis, self-management, and/or therapeutic/pharmaceutical applications may prove to mitigate the burden of AD and improve patient well-being.

  15. The Economic Standpoint of Referral System at Using Tertiary Hospital Services in Iran

    Directory of Open Access Journals (Sweden)

    Samad Rouhani

    2017-03-01

    Full Text Available Background and purpose: Although, economically, referral systems make utilization of health facilities at different levels sound, in many countries caretakers often bypass primary care facilities that are regularly costlier for caretakers and health care systems. The main objective of the current study was to assess the utilization of hospital services with more emphasis on economic point of view.  Materials and methods: The present study was a facility-based cross-sectional study. A researcher developed questionnaire was used to collect the data. The samples were randomly selected and interviewed on their consent. SPSS Software was also used to analyze the collected data through Chi-2, correlation, and t-test. Results: Just 29.4 percent of the attendees to the hospital were carrying out a referral slip from their family medicine. Five variables including type of care, type of attending, appointment arrangement, satisfaction with family medicine, and vising family medicine were statistically analyzed and found significantly related to carrying referral slip. Conclusion: Because of dysfunction of referral system, Iran’s health care system was found to be far from achieving economic advantages of a referral based DHS. It is actually an inappropriate use of limited health resources in a country like Iran that seriously suffers from shortage of financial and health system resources. This is likely due to deficiencies in the components of its referral system, therefore, a full revision of current reforms and appropriate remedies for deficiencies in the components of referral system was found to be in top priority in Iran.

  16. The consequences of hospital autonomization in Colombia: a transaction cost economics analysis.

    Science.gov (United States)

    Castano, Ramon; Mills, Anne

    2013-03-01

    Granting autonomy to public hospitals in developing countries has been common over recent decades, and implies a shift from hierarchical to contract-based relationships with health authorities. Theory on transactions costs in contractual relationships suggests they stem from relationship-specific investments and contract incompleteness. Transaction cost economics argues that the parties involved in exchanges seek to reduce transaction costs. The objective of this research was to analyse the relationships observed between purchasers and the 22 public hospitals of the city of Bogota, Colombia, in order to understand the role of relationship-specific investments and contract incompleteness as sources of transaction costs, through a largely qualitative study. We found that contract-based relationships showed relevant transaction costs associated mainly with contract incompleteness, not with relationship-specific investments. Regarding relationships between insurers and local hospitals for primary care services, compulsory contracting regulations locked-in the parties to the contracts. For high-complexity services (e.g. inpatient care), no restrictions applied and relationships suggested transaction-cost minimizing behaviour. Contract incompleteness was found to be a source of transaction costs on its own. We conclude that transaction costs seemed to play a key role in contract-based relationships, and contract incompleteness by itself appeared to be a source of transaction costs. The same findings are likely in other contexts because of difficulties in defining, observing and verifying the contracted products and the underlying information asymmetries. The role of compulsory contracting might be context-specific, although it is likely to emerge in other settings due to the safety-net role of public hospitals.

  17. The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey.

    Science.gov (United States)

    Yang, Juan; Jit, Mark; Leung, Kathy S; Zheng, Ya-Ming; Feng, Lu-Zhao; Wang, Li-Ping; Lau, Eric H Y; Wu, Joseph T; Yu, Hong-Jie

    2015-10-06

    The seasonal influenza vaccine coverage rate in China is only 1.9 %. There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level, even though this kind of information is important for informing national-level immunization policy decision-making. A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective. Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013. Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients. The study enrolled 529 outpatients (median age: eight years; interquartile range [IQR]: five to 20 years) and 254 inpatients (median age: four years; IQR: two to seven years). Among the outpatients, 22.1 % (117/529) had underlying diseases and among the inpatients, 52.8 % (134/254) had underlying diseases. The average total costs related to influenza-associated outpatient visits and inpatient visits were US$ 155 (standard deviation, SD US$ 122) and US$ 1,511 (SD US$ 1,465), respectively. Direct medical costs accounted for 45 and 69 % of the total costs related to influenza-associated outpatient and inpatient visits, respectively. For influenza outpatients, the mean cost per episode in children aged below five years (US$ 196) was higher than that in other age groups (US$ 129-153). For influenza inpatients, the mean cost per episode in adults aged over 60 years (US$ 2,735) was much higher than that in those aged below 60 years (US$ 1,417-1,621). Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions (outpatients: US$ 186 vs. US$ 146; inpatients: US$ 1

  18. Medical store management: an integrated economic analysis of a tertiary care hospital in central India.

    Science.gov (United States)

    Mahatme, Ms; Dakhale, Gn; Hiware, Sk; Shinde, At; Salve, Am

    2012-04-01

    Economic analysis plays a pivotal role in the management of medical store. The main objectives of this study were to consider always better control-vital, essential and desirable (ABC-VED) analysis with economic order quantity (EOQ), comparison of indexed cost and the actual cost, and to assess the expenditure for the forthcoming years. Based on cost and criticality, a matrix of nine groups by combining ABC and VED analysis was formulated. Drug categories were narrowed down for prioritization to direct supervisory monitoring. The subgroups AE and AV of the categories category I and II should be ordered based on EOQ. The difference between the actual annual drug expenditure (ADE) and the derived indexed cost using the cost inflation index (CII) was calculated. Linear regression was used to assess the expenditure for the forth coming years. The total ADE for the financial year of 2010-2011 was Rs. 1,91,44,253 which was only 7.68% of annual hospital expenditure. Using the inflation index, the indexed cost of acquisition of ADE for year 2010-2011 was Rs. 1,95,10,387. The difference between the two was estimated to be 2.11%. Thus, the CII justifies the demand of increased budget for next year and prompts us for cautious use of drugs. By taking into consideration the ADE of last 10 years, we have forecasted the budget for forthcoming years which will help significantly for making policies according to the available budget.

  19. [Economic impact of consultation-liaison psychiatry in a French University Hospital Centre].

    Science.gov (United States)

    Yrondi, A; Petiot, D; Arbus, C; Schmitt, L

    2016-02-01

    In times of fiscal restraint for health structures, apart from the clinical input, it seems important to discuss the economic impact of liaison psychiatry. There are only a few studies on the economic added value provided by a liaison psychiatry team. In addition to this, only a few psychiatric pathologies are coded as they should be, hence we make the assumption of an additional development provided by a specialised team. Over a short period of 4months, in three departments of the Toulouse University Hospital Centre, the added value to the general pricing system of liaison psychiatry was studied. The population was represented by all the consecutive requests for consultations from patients over 18years old, men and women, hospitalised at that time. These three departments frequently request consultations with the psychiatry liaison team. They set a diagnostic, and if this is associated with a higher Homogeneous Group of Patients (HGP), it provides added value. Fifty-two patients benefited from a psychiatric consultation over 4months. The results highlight a development of € 8630.43 for the traumatology department, € 3325.03 for the internal medicine department, and € 513.61 for the haematology department over the study period. The overall development over this period was € 12,469.07. To our knowledge, this approach is one of the first in France to highlight an economic impact of the intervention of liaison psychiatry in the claiming departments. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  20. Outsourcing and benchmarking in a rural public hospital: does economic theory provide the complete answer?

    Science.gov (United States)

    Young, S H

    2003-01-01

    The ideology and pronouncements of the Australian Government in introducing 'competitive neutrality' to the public sector has improved efficiency and resource usage. In the health sector, the Human Services Department directed that non-clinical and clinical areas be market tested through benchmarking services against the private sector, with the possibility of outsourcing. These services included car parking, computing, laundry, engineering, cleaning, catering, medical imaging (radiology), pathology, pharmacy, allied health and general practice. Managers, when they choose between outsourcing, and internal servicing and production, would thus ideally base their decision on economic principles. Williamson's transaction cost theory studies the governance mechanisms that can be used to achieve economic efficiency and proposes that the optimal organisation structure is that which minimises transaction costs or the costs of exchange. Williamson proposes that four variables will affect such costs, namely: (i) frequency of exchange; (ii) asset specificity; (iii) environmental uncertainty; and (iv) threat of opportunism. This paper provides evidence from a rural public hospital and examines whether Williamson's transaction cost theory is applicable. Case study research operates within the interpretivism paradigm and is used in this research to uncover why the outsourcing decision was made. Such research aims to study real-life experiences by examining the way people think and act and, in contrast to positivism, allows the interviewer to participate to better understand the details and features of the experiences. In the present research, individual interviews were conducted with managers of the hospital and owners and staff of the vendor organisations using semi- and unstructured questions to ascertain the extent of, and processes used in, outsourcing specific functional areas, and areas that were not outsourced. Pathology, radiology, dental technician services and lawn

  1. Economic Evaluation of Laboratory Testing Strategies for Hospital-Associated Clostridium difficile Infection

    Science.gov (United States)

    Robilotti, Elizabeth; Peterson, Lance R.; Banaei, Niaz; Dowdy, David W.

    2014-01-01

    Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and 93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI. PMID:24478478

  2. Economic evaluation of laboratory testing strategies for hospital-associated Clostridium difficile infection.

    Science.gov (United States)

    Schroeder, Lee F; Robilotti, Elizabeth; Peterson, Lance R; Banaei, Niaz; Dowdy, David W

    2014-02-01

    Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and 93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI.

  3. Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness

    OpenAIRE

    Trybou, Jeroen; Gemmel, Paul; Van Vaerenbergh, Yves; Annemans, Lieven

    2014-01-01

    Background: Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Methods: Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using valida...

  4. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  5. Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil

    Directory of Open Access Journals (Sweden)

    Michelle Quarti Machado Rosa

    2018-02-01

    Full Text Available Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS and National database of Hospitalizations (SIH. We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease, respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization, totaling (international dollar Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%, followed by microvascular complications (25.4% and DM per se (18.1%. Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies.

  6. Economic evaluation of an extended nutritional intervention in older Australian hospitalized patients: a randomized controlled trial.

    Science.gov (United States)

    Sharma, Yogesh; Thompson, Campbell; Miller, Michelle; Shahi, Rashmi; Hakendorf, Paul; Horwood, Chris; Kaambwa, Billingsley

    2018-02-05

    Prevalence of malnutrition in older hospitalized patients is 30%. Malnutrition is associated with poor clinical outcomes in terms of high morbidity and mortality and is costly for hospitals. Extended nutrition interventions improve clinical outcomes but limited studies have investigated whether these interventions are cost-effective. In this randomized controlled trial, 148 malnourished general medical patients ≥60 years were recruited and randomized to receive either an extended nutritional intervention or usual care. Nutrition intervention was individualized and started with 24 h of admission and was continued for 3 months post-discharge with a monthly telephone call whereas control patients received usual care. Nutrition status was confirmed by Patient generated subjective global assessment (PG-SGA) and health-related quality of life (HRQoL) was measured using EuroQoL 5D (EQ-5D-5 L) questionnaire at admission and at 3-months follow-up. A cost-effectiveness analysis was conducted for the primary outcome (incremental costs per unit improvement in PG-SGA) while a cost-utility analysis (CUA) was undertaken for the secondary outcome (incremental costs per quality adjusted life year (QALY) gained). Nutrition status and HRQoL improved in intervention patients. Mean per included patient Australian Medicare costs were lower in intervention group compared to control arm (by $907) but these differences were not statistically significant (95% CI: -$2956 to $4854). The main drivers of higher costs in the control group were higher inpatient ($13,882 versus $13,134) and drug ($838 versus $601) costs. After adjusting outcomes for baseline differences and repeated measures, the intervention was more effective than the control with patients in this arm reporting QALYs gained that were higher by 0.0050 QALYs gained per patient (95% CI: -0.0079 to 0.0199). The probability of the intervention being cost-effective at willingness to pay values as low as $1000 per unit

  7. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy

    OpenAIRE

    Barbadoro, Pamela; Di Tondo, Elena; Menditto, Vincenzo Giannicola; Pennacchietti, Lucia; Regnicoli, Februa; Di Stanislao, Francesco; D?Errico, Marcello Mario; Prospero, Emilia

    2015-01-01

    Objective The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED) for non-urgent visits. Methods The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use. Results Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32?6.47) of re-admissions have be...

  8. Economic evaluation of centre haemodialysis and continuous ambulatory peritoneal dialysis in Ministry of Health hospitals, Malaysia.

    Science.gov (United States)

    Hooi, Lai Seong; Lim, Teck Onn; Goh, Adrian; Wong, Hin Seng; Tan, Chwee Choon; Ahmad, Ghazali; Morad, Zaki

    2005-02-01

    This is a multi-centre study to determine cost efficiency and cost effectiveness of the Ministry of Health centre haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) programme. Forty-four haemodialysis and 11 CAPD centres were enrolled in this study in 2001. Sixty patients, 30 from each modality, were evaluated. Micro-costing was used to determine costs. The number of haemodialyses conducted ranged from 402 to 23,000 procedures per year, while for CAPD, output ranged from 70 to 2300 patient months/year. Cost ranged from RM79.61 to RM475.79 per haemodialysis treatment, with a mean cost of RM169 per HD (USD 1 = RM 3.80). The cost of CAPD treatment ranged from RM1400 to RM3200 per patient month, with a mean of RM2186. Both modalities incurred similar outpatient costs. The cost of erythropoeitin per year is RM4500 and RM2500 for haemodialysis and CAPD, respectively. The number of life years saved is 10.96 years for haemodialysis and 5.21 years for CAPD. Cost per life year saved is RM33 642 for haemodialysis and RM31 635 for CAPD. The cost for land, building, equipment, overheads, and staff were higher for haemodialysis, while consumables and hospitalization cost more for CAPD. Sensitivity analysis was performed for two discount rates (3 and 5%), varying erythropoietin doses and maximum and minimum overheads. Relative cost effectiveness of haemodialysis and CAPD was unchanged in all sensitivity scenarios, except for overhead costs, which influenced the cost effectiveness of HD. It is economically viable to promote the use of both CAPD and haemodialysis because the cost effectiveness of both are nearly equal.

  9. Impact of structural and economic factors on hospitalization costs, inpatient mortality, and treatment type of traumatic hip fractures in Switzerland.

    Science.gov (United States)

    Mehra, Tarun; Moos, Rudolf M; Seifert, Burkhardt; Bopp, Matthias; Senn, Oliver; Simmen, Hans-Peter; Neuhaus, Valentin; Ciritsis, Bernhard

    2017-12-01

    The assessment of structural and potentially economic factors determining cost, treatment type, and inpatient mortality of traumatic hip fractures are important health policy issues. We showed that insurance status and treatment in university hospitals were significantly associated with treatment type (i.e., primary hip replacement), cost, and lower inpatient mortality respectively. The purpose of this study was to determine the influence of the structural level of hospital care and patient insurance type on treatment, hospitalization cost, and inpatient mortality in cases with traumatic hip fractures in Switzerland. The Swiss national medical statistic 2011-2012 was screened for adults with hip fracture as primary diagnosis. Gender, age, insurance type, year of discharge, hospital infrastructure level, length-of-stay, case weight, reason for discharge, and all coded diagnoses and procedures were extracted. Descriptive statistics and multivariate logistic regression with treatment by primary hip replacement as well as inpatient mortality as dependent variables were performed. We obtained 24,678 inpatient case records from the medical statistic. Hospitalization costs were calculated from a second dataset, the Swiss national cost statistic (7528 cases with hip fractures, discharged in 2012). Average inpatient costs per case were the highest for discharges from university hospitals (US$21,471, SD US$17,015) and the lowest in basic coverage hospitals (US$18,291, SD US$12,635). Controlling for other variables, higher costs for hip fracture treatment at university hospitals were significant in multivariate regression (p < 0.001). University hospitals had a lower inpatient mortality rate than full and basic care providers (2.8% vs. both 4.0%); results confirmed in our multivariate logistic regression analysis (odds ratio (OR) 1.434, 95% CI 1.127-1.824 and OR 1.459, 95% confidence interval (CI) 1.139-1.870 for full and basic coverage hospitals vs. university hospitals

  10. The Factors Influencing Economic Efficiency of the Hospital Bed Care in Terms of the Regional Allowance Organizations

    Directory of Open Access Journals (Sweden)

    Vaňková Ivana

    2014-09-01

    Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

  11. Skin cancer has a large impact on our public hospitals but prevention programs continue to demonstrate strong economic credentials.

    Science.gov (United States)

    Shih, Sophy T F; Carter, Rob; Heward, Sue; Sinclair, Craig

    2017-08-01

    While skin cancer is still the most common cancer in Australia, important information gaps remain. This paper addresses two gaps: i) the cost impact on public hospitals; and ii) an up-to-date assessment of economic credentials for prevention. A prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using State service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Combining inpatient and outpatient costs, total annual costs for Victoria were $48 million to $56 million. The SunSmart program is estimated to have prevented more than 43,000 skin cancers between 1988 and 2010, a net cost saving of $92 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). At about $50 million per year for hospitals in Victoria alone, the cost burden of a largely preventable disease is substantial. Skin cancer prevention remains highly cost-effective, yet underfunded. Implications for public health: Increased funding for skin cancer prevention must be kept high on the public health agenda. Hospitals would also benefit from being able to redirect resources to non-preventable conditions. © 2017 The Authors.

  12. [Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

    Science.gov (United States)

    Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

    2016-06-01

    To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

  13. Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients: a prospective cohort study.

    Science.gov (United States)

    Shah, D N; Aitken, S L; Barragan, L F; Bozorgui, S; Goddu, S; Navarro, M E; Xie, Y; DuPont, H L; Garey, K W

    2016-07-01

    Few studies have investigated the additional healthcare costs of recurrent C. difficile infection (CDI). To quantify inpatient treatment costs for CDI and length of stay among hospitalized patients with primary CDI only, compared with CDI patients who experienced recurrent CDI. This was a prospective, observational cohort study of hospitalized adult patients with primary CDI followed for three months to assess for recurrent CDI episodes. Total and CDI-attributable hospital length of stay (LOS) and hospitalization costs were compared among patients who did or did not experience at least one recurrent CDI episode. In all, 540 hospitalized patients aged 62±17 years (42% males) with primary CDI were enrolled, of whom 95 patients (18%) experienced 101 recurrent CDI episodes. CDI-attributable median (interquartile range) LOS and costs (in US$) increased from 7 (4-13) days and $13,168 (7,525-24,456) for patients with primary CDI only versus 15 (8-25) days and $28,218 (15,050-47,030) for patients with recurrent CDI (Pcosts increased from 11 (6-22) days and $20,693 (11,287-41,386) for patients with primary CDI only versus 24 (11-48) days and $45,148 (20,693-82,772) for patients with recurrent CDI (Pcost of pharmacological treatment while hospitalized was $60 (23-200) for patients with primary CDI only (N=445) and $140 (30-260) for patients with recurrent CDI (P=0.0013). This study demonstrated that patients with CDI experience a significant healthcare economic burden attributed to CDI. Economic costs and healthcare burden increased significantly for patients with recurrent CDI. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  14. Socio-economic deprivation associated with acute rheumatic fever. A hospital-based case-control study in Bangladesh.

    Science.gov (United States)

    Zaman, M M; Yoshiike, N; Chowdhury, A H; Jalil, M Q; Mahmud, R S; Faruque, G M; Rouf, M A; Haque, K M; Tanaka, H

    1997-07-01

    There are few studies on the relationship between socio-economic factors and rheumatic fever (RF) in the populations where the burden of both socio-economic deprivation and RF is still very high. The aim of this study is to assess the association between some socio-economic factors and RF by examining data available from a RF hospital in Bangladesh. We have reviewed the medical records of patients presenting with manifestations suggestive of RF during a 1-year period. From the patients who showed group A beta-haemolytic streptococcal upper respiratory infection (ABHS infection), 44 RF cases defined by the Jones criteria and 86 control subjects, who did not satisfy the criteria, were identified for analysis. The median age was 12 years and 60% were female. RF was significantly associated with low income (odds ratio [OR] 2.37; P = 0.04); poor living conditions: substandard (kacha) house (OR 2.93, P = 0.02); and poor nutritional status: low height for age (OR 2.68, P = 0.02). Multiple logistic regression analysis revealed an increased OR for kacha house (OR 3.18, P = 0.02) but the same estimate for low height for age (OR 2.68; P = 0.04). Our analysis shows that, among the patients presenting to the RF hospital with proven ABHS infection, acute RF is associated with socio-economic deprivation.

  15. A news media analysis of the economic and reputational penalties of the hospital readmissions reduction program.

    Science.gov (United States)

    Winborn, Melissa S; Alencherril, Joyce; Pagán, José A

    2014-01-01

    Section 3025 of the Affordable Care Act (ACA) of 2010 established the Hospital Readmissions Reduction Program (HRRP), an initiative designed to penalize hospitals with excess 30-day readmissions. This study investigates whether readmission penalties under HRRP impose significant reputational effects on hospitals. Data extracted from 2012 to 2013 news stories suggest that the higher the actual penalty, the higher the perceived cost of the penalty, the more likely it is that hospitals will state they have no control over the low-income patients they serve or that they will describe themselves as safety net providers. The downside of being singled out as a low-quality hospital deserving a relatively high penalty seems to be larger than the upside of being singled out as a high-quality hospital facing a relatively low penalty. Although the financial burden of the penalties seems to be low, hospitals may be reacting to the fact that information about excess readmissions and readmission penalties is being released widely and is scrutinized by the news media and the general public. © The Author(s) 2014.

  16. Economics.

    Science.gov (United States)

    Palley, Paul D; Parcero, Miriam E

    2016-10-01

    A review of literature in the calendar year 2015 dedicated to environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and water management, climate change and disaster risk management, economic growth, water supply policies, water consumption, water price regulation, and water price valuation.

  17. Addressing the risk of bacterial contamination in platelets: a hospital economic perspective.

    Science.gov (United States)

    Li, Justin W; Brecher, Mark E; Jacobson, Jessica L; Harm, Sarah K; Chen, Dorothy; El-Gamil, Audrey; Dobson, Al; Mintz, Paul D

    2017-10-01

    Bacterially contaminated platelets (PLTs) remain a serious risk. The Food and Drug Administration has issued draft guidance recommending hospitals implement secondary testing or transfuse PLTs that have been treated with pathogen reduction technology (PRT). The cost implications of these approaches are not well understood. We modeled incurred costs when hospitals acquire, process, and transfuse PLTs that are PRT treated with INTERCEPT (Cerus Corp.) or secondary tested with the PLT PGD Test (Verax Biomedical). Hospitals will spend $221.27 (30.0%) more per PRT-treated apheresis PLT unit administered compared to a Zika-tested apheresis PLT unit that is irradiated and PGD tested in hospital. This difference is reflected in PRT PLT units having: 1) a higher hospital purchase price ($100.00 additional charge compared to an untreated PLT); 2) lower therapeutic effectiveness than untreated PLTs among hematologic-oncologic patients, which contributes to additional transfusions ($96.05); or 3) fewer PLT storage days, which contributes to higher outdating cost from expired PLTs ($67.87). Only a small portion of the incremental costs for PRT-treated PLTs are offset by costs that may be avoided, including primary bacterial culture, secondary bacterial testing ($26.65), hospital irradiation ($8.50), Zika testing ($4.47), and other costs ($3.03). The significantly higher cost of PRT-treated PLTs over PGD-tested PLTs should interest stakeholders. For hospitals that outdate PLTs, savings associated with expiration extension to 7 days by adding PGD testing will likely be substantially greater than the cost of implementing PGD-testing. Our findings might usefully inform a hospital's decision to select a particular blood safety approach. © 2017 The Authors Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  18. Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications

    OpenAIRE

    Reed, Deoine; Kemmerly, Sandra A.

    2009-01-01

    The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program ha...

  19. Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-12-01

    The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. We classified the reasons for readmissions as either procedure- or medical-related. Cost-to-charge ratios supplied with the Nationwide Readmissions Database were used to compute the individual per-patient cost of 90-day readmissions as a continuous variable in separate general linear models for THA and TKA. Payer, patient, clinical, and hospital factors were treated as covariates. We estimated the national burden of readmissions by payer and by the reason for readmission. The national rates of 30- and 90-day readmissions after THA were 4% (95% confidence interval [CI], 4.2%-4.5%) and 8% (95% CI, 7.5%-8.1%), respectively. The national rates of 30- and 90-day readmissions after primary TKA were 4% (95% CI, 3.8%-4.0%) and 7% (95% CI, 6.8%-7.2%), respectively. The five most important variables responsible for the cost of 90-day THA readmissions (in rank order, based

  20. Paying for hospital-based care of Kala-azar in Nepal: assessing catastrophic, impoverishment and economic consequences.

    Science.gov (United States)

    Adhikari, Shiva R; Maskay, Nephil M; Sharma, Bishnu P

    2009-03-01

    Households obtaining health care services in developing countries incur substantial costs, despite services generally being provided free of charge by public health institutions. This constitutes an economic burden on low-income households, and contributes to deepening their level of poverty. In addition to the economic burden of obtaining health care, the method of financing these payments has implications for the distribution of household assets. This effect on resource-poor households is amplified since they have decreased access to health insurance. Recent literature, however, ignores the importance of the method of financing health care payments. This paper looks at the case of Nepal and highlights the impact on households of paying for hospital-based care of Kala-azar (KA) by analysing the catastrophic, impoverishment and economic consequences of their coping strategies. The paper utilizes micro-data on a random selection of 50% of the KA-affected households of Siraha and Saptari districts of Nepal. The empirical results suggest that direct costs of hospital-based treatment of KA are catastrophic since they consume 17% of annual household income. This expenditure causes more than 20% of KA-affected households to fall below the poverty line, with the remaining households being pushed into the category of marginal poor; the poverty gap ratio is more than 90%. Further, KA incidence can have prolonged and severe economic consequences for the household economy due to the mechanisms of informal sector financing to which households resort. A heavy burden of loan repayments can lead households on a downward spiral that eventually becomes a poverty trap. In other words, the method of financing health care payments is an important ingredient in understanding the economic burden of disease.

  1. Economism

    Directory of Open Access Journals (Sweden)

    P. Simons

    2010-07-01

    Full Text Available Modern society is characterised not only by a fascination with scientific technology as a means of solving all problems, especially those that stand in the way of material progress (technicism, but also by an obsessive interest in everything that has to do with money (economism or mammonism. The article discusses the relationship between technicism and economism, on the basis of their relationship to utilitarian thinking: the quest for the greatest happiness for the greatest number of people. Recent major studies of neo-liberalism (seen as an intensification of utilitarianism by Laval and Dardot are used as reference to the development of utilitarianism. It is suggested that the western view of the world, as expressed in economism and technicism, with a utilitarian ethics, features three absolutisations: those of theoretical thinking, technology and economics. In a second part, the article draws on the framework of reformational philosophy to suggest an approach that, in principle, is not marred by such absolutisations.

  2. The economic cost of hospital malnutrition in Europe; a narrative review.

    Science.gov (United States)

    Khalatbari-Soltani, Saman; Marques-Vidal, Pedro

    2015-06-01

    Malnutrition among hospitalized patients increases length of stay (LOS) and carries extra hospitalization costs. To review the impact of malnutrition on hospital LOS and costs in Europe. PubMed and Google Scholar search. All articles from January 2004 until November 2014 were identified. Reference lists of relevant articles were also manually searched. Ten studies on LOS and nine studies on costs were reviewed. The methods used to assess malnutrition and to calculate costs differed considerably between studies. Malnutrition led to an increased LOS ranging from 2.4 to 7.2 days. Among hospitalized patients, malnutrition led to an additional individual cost ranging between 1640 € and 5829 €. At the national level, the costs of malnutrition ranged between 32.8 million € and 1.2 billion €. Expressed as percentage of national health expenditures, the values ranged between 2.1% and 10%. In Europe, malnutrition leads to an increase in LOS and in hospital costs, both at the individual and the national level. Standardization of methods and results reported is needed to adequately compare results between countries. Copyright © 2015 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  3. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  4. [Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

    Science.gov (United States)

    Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

    2009-02-01

    Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

  5. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population

    Directory of Open Access Journals (Sweden)

    Chen SY

    2013-05-01

    Full Text Available Shih-Yin Chen,1 Concetta Crivera,2 Michael Stokes,1 Luke Boulanger,1 Jeffrey Schein2 1United BioSource Corporation, Lexington, MA, USA; 2Janssen Scientific Affairs, LLC, Raritan, NJ, USA Objective: To evaluate the clinical and economic burden of acute coronary syndrome (ACS, a common cardiovascular illness, in the Medicare population. Methods: Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Results: Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD-related diagnoses. The incidence of death since admission was 309 cases per 1000 person–years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609. Conclusion: In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to

  6. The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti.

    Science.gov (United States)

    Zuraik, Christopher; Sampalis, John; Brierre, Alexa

    2018-06-01

    The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.

  7. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre: a cost comparison study.

    Science.gov (United States)

    Eichler, Klaus; Hess, Sascha; Chmiel, Corinne; Bögli, Karin; Sidler, Patrick; Senn, Oliver; Rosemann, Thomas; Brügger, Urs

    2014-10-01

    Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. From the health-economic point of view, our new service model shows 'dominance' over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Reforming reimbursement of public hospitals in Greece during the economic crisis: Implementation of a DRG system.

    Science.gov (United States)

    Polyzos, Nikolaos; Karanikas, Haralampos; Thireos, Eleftherios; Kastanioti, Catherine; Kontodimopoulos, Nick

    2013-01-01

    Until recently, in-patient NHS hospital care in Greece was reimbursed via an anachronistic and under-priced retrospective per diem system, which has been held primarily responsible for continuous budget deficits. The purpose of this paper is to present the efforts of the Ministry of Health (MoH) to implement a new DRG-based payment system. As in many countries, the decision was to adopt a patient classification from abroad and to refine it for use in Greece with national data. Pricing was achieved with a combination of activity-based costing with data from selected Greek hospitals, and "imported" cost weights. Data collection, IT support and monitoring are provided via ESY.net, a web-based facility developed and implemented by the MoH. After an initial pilot testing of the classification in 20 hospitals, complete DRG reimbursement data was reported by 113 hospitals (85% of total) for the fourth quarter of 2011. The recorded monthly increase in patient discharges billed with the new system and in revenue implies increasing adaptability by the hospitals. However, the unfavorable inlier vs. outlier distribution of discharges and revenue observed in some health regions signifies the need for corrective actions. The importance of this reimbursement reform is discussed in light of the current crisis faced by the Greek economy. There is yet much to be done and many projects are currently in progress to support this effort; however the first cost containment results are encouraging. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Economic impact of an integrated RIS/PACS system in a university hospital

    International Nuclear Information System (INIS)

    Kroeger, M.; Wetekam, V.; Nissen-Meyer, S.; Reiser, M.

    1999-01-01

    Problem: The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. Results: The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. Conclusion: It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic. (orig.) [de

  10. Socio-economics: a propensity of self-medication among OPD patients of a teaching hospital

    OpenAIRE

    Subha Sankar Chattopadhyay; Angana Datta; Aritra Ghosh; Suvadip Biswas; Krishnendu Mandal; Supreeti Biswas

    2016-01-01

    Background: Use of over the counter (OTC) drug is very much common in India. Not only medical professionals or educated urban population but also it is common in rural area and low educated person. This study was done to assess the extent of knowledge and practices of OTC drugs among OPD patients of a tertiary care hospital. Methods: A questionnaire based study was conducted among 1680 Medicine OPD (outpatient department) patients. Results: Among the participants, 62% patients taking ...

  11. [Assessing the economic impact of adverse events in Spanish hospitals by using administrative data].

    Science.gov (United States)

    Allué, Natalia; Chiarello, Pietro; Bernal Delgado, Enrique; Castells, Xavier; Giraldo, Priscila; Martínez, Natalia; Sarsanedas, Eugenia; Cots, Francesc

    2014-01-01

    To evaluate the incidence and costs of adverse events registered in an administrative dataset in Spanish hospitals from 2008 to 2010. A retrospective study was carried out that estimated the incremental cost per episode, depending on the presence of adverse events. Costs were obtained from the database of the Spanish Network of Hospital Costs. This database contains data from 12 hospitals that have costs per patient records based on activities and clinical records. Adverse events were identified through the Patient Safety Indicators (validated in the Spanish Health System) created by the Agency for Healthcare Research and Quality together with indicators of the EuroDRG European project. This study included 245,320 episodes with a total cost of 1,308,791,871€. Approximately 17,000 patients (6.8%) experienced an adverse event, representing 16.2% of the total cost. Adverse events, adjusted by diagnosis-related groups, added a mean incremental cost of between €5,260 and €11,905. Six of the 10 adverse events with the highest incremental cost were related to surgical interventions. The total incremental cost of adverse events was € 88,268,906, amounting to an additional 6.7% of total health expenditure. Assessment of the impact of adverse events revealed that these episodes represent significant costs that could be reduced by improving the quality and safety of the Spanish Health System. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  12. Ozonation of hospital raw wastewaters for cytostatic compounds removal. Kinetic modelling and economic assessment of the process

    Energy Technology Data Exchange (ETDEWEB)

    Ferre-Aracil, J. [Universitat Politècnica de València – EPSA, Department of Chemical and Nuclear Engineering. Institute for Industrial, Radiophysical and Environmental Safety (ISIRYM), Pl. Ferrandiz i Carbonell, 03801 Alcoi, Alicante (Spain); Valcárcel, Y. [Environmental Health and Ecotoxicology Research Group, Universidad Rey Juan Carlos, Avd. Atenas s/n, Móstoles, 28922 Alcorcón (Spain); Negreira, N.; López de Alda, M. [Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18-26, 08034 Barcelona (Spain); Barceló, D. [Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18-26, 08034 Barcelona (Spain); Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, Emili Grahit 101, 17003 Girona (Spain); Cardona, S.C. [Universitat Politècnica de València – EPSA, Department of Chemical and Nuclear Engineering. Institute for Industrial, Radiophysical and Environmental Safety (ISIRYM), Pl. Ferrandiz i Carbonell, 03801 Alcoi, Alicante (Spain); Navarro-Laboulais, J., E-mail: jnavarla@iqn.upv.es [Universitat Politècnica de València – EPSA, Department of Chemical and Nuclear Engineering. Institute for Industrial, Radiophysical and Environmental Safety (ISIRYM), Pl. Ferrandiz i Carbonell, 03801 Alcoi, Alicante (Spain)

    2016-06-15

    The kinetics of the ozone consumption for the pretreatment of hospital wastewater has been analysed in order to determine the reaction rate coefficients between the ozone and the readily oxidisabled organic matter and cytostatic compounds. The wastewater from a medium size hospital was treated with ozone and peroxone methodologies, varying the ozone concentration, the reaction time and the hydrogen peroxide doses. The analysis shows that there are four cytostatic compounds, i.e. irinotecan, ifosfamide, cyclophosphamide and capecitabine, detected in the wastewaters and they are completely removed with reasonably short times after the ozone treatment. Considering the reactor geometry, the gas hydrodynamics, the mass transfer of ozone from gas to liquid and the reaction of all oxidisable compounds of the wastewater it is possible to determine the chemical ozone demand, COzD, of the sample as 256 mg O{sub 3} L{sup −1} and the kinetic rate coefficient with the dissolved organic matter as 8.4 M{sup −1} s{sup −1}. The kinetic rate coefficient between the ozone and the cyclophosphamide is in the order of 34.7 M{sup −1} s{sup −1} and higher for the other cytostatics. The direct economic cost of the treatment was evaluated considering this reaction kinetics and it is below 0.3 €/m{sup 3} under given circumstances. - Highlights: • 17 cytostatic compounds were analysed and 4 detected by SPE-LC/MS-MS. • The ozonation is 100% effective on the removal of the detected cytostatics. • The kinetics of cytostatic ozonation reaction is modeled by competitive kinetics. • The economic cost of the treatment of hospital wastewater was assessed.

  13. Ozonation of hospital raw wastewaters for cytostatic compounds removal. Kinetic modelling and economic assessment of the process

    International Nuclear Information System (INIS)

    Ferre-Aracil, J.; Valcárcel, Y.; Negreira, N.; López de Alda, M.; Barceló, D.; Cardona, S.C.; Navarro-Laboulais, J.

    2016-01-01

    The kinetics of the ozone consumption for the pretreatment of hospital wastewater has been analysed in order to determine the reaction rate coefficients between the ozone and the readily oxidisabled organic matter and cytostatic compounds. The wastewater from a medium size hospital was treated with ozone and peroxone methodologies, varying the ozone concentration, the reaction time and the hydrogen peroxide doses. The analysis shows that there are four cytostatic compounds, i.e. irinotecan, ifosfamide, cyclophosphamide and capecitabine, detected in the wastewaters and they are completely removed with reasonably short times after the ozone treatment. Considering the reactor geometry, the gas hydrodynamics, the mass transfer of ozone from gas to liquid and the reaction of all oxidisable compounds of the wastewater it is possible to determine the chemical ozone demand, COzD, of the sample as 256 mg O 3 L −1 and the kinetic rate coefficient with the dissolved organic matter as 8.4 M −1 s −1 . The kinetic rate coefficient between the ozone and the cyclophosphamide is in the order of 34.7 M −1 s −1 and higher for the other cytostatics. The direct economic cost of the treatment was evaluated considering this reaction kinetics and it is below 0.3 €/m 3 under given circumstances. - Highlights: • 17 cytostatic compounds were analysed and 4 detected by SPE-LC/MS-MS. • The ozonation is 100% effective on the removal of the detected cytostatics. • The kinetics of cytostatic ozonation reaction is modeled by competitive kinetics. • The economic cost of the treatment of hospital wastewater was assessed.

  14. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeffrey

    2013-01-01

    To evaluate the clinical and economic burden of acute coronary syndrome (ACS), a common cardiovascular illness, in the Medicare population. Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male) representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD)-related diagnoses. The incidence of death since admission was 309 cases per 1000 person-years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609). In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to improve long-term outcomes.

  15. Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry.

    Science.gov (United States)

    Scollo, M; Lal, A; Hyland, A; Glantz, S

    2003-03-01

    To compare the quality and funding source of studies concluding a negative economic impact of smoke-free policies in the hospitality industry to studies concluding no such negative impact. Researchers sought all studies produced before 31 August 2002. Articles published in scientific journals were located with Medline, Science Citation Index, Social Sciences Citation Index, Current Contents, PsychInfo, Econlit, and Healthstar. Unpublished studies were located from tobacco company websites and through internet searches. 97 studies that made statements about economic impact were included. 93% of the studies located met the selection criteria as determined by consensus between multiple reviewers. Findings and characteristics of studies (apart from funding source) were classified independently by two researchers. A third assessor blind to both the objective of the present study and to funding source also classified each study. In studies concluding a negative impact, the odds of using a subjective outcome measure was 4.0 times (95% confidence interval (CI) 1.4 to 9.6; p = 0.007) and the odds of not being peer reviewed was 20 times (95% CI 2.6 to 166.7; p = 0.004) that of studies concluding no such negative impact. All of the studies concluding a negative impact were supported by the tobacco industry. 94% of the tobacco industry supported studies concluded a negative economic impact compared to none of the non-industry supported studies. All of the best designed studies report no impact or a positive impact of smoke-free restaurant and bar laws on sales or employment. Policymakers can act to protect workers and patrons from the toxins in secondhand smoke confident in rejecting industry claims that there will be an adverse economic impact.

  16. [Economic impact of etanercept and adalimumab biosimilars on hospitals scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products].

    Science.gov (United States)

    Berreur, B; Guerin, F; Christophe, B; Limido, G; Paubel, P

    2018-01-01

    To evaluate the economic impact of future prescriptions of etanercept and adalimumab biosimilars at the territorial scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products. Determination of the number and status of patients (naive or in continuation of treatment) from the National Database "Datamart de Consommation Inter-Régimes" of health insurance, concerned by a dispensation in a pharmacy of etanercept or adalimumab in 2015. Calculation of potential savings in case of biosimilar requirements according to 3 hypotheses: 63% (rate observed in a previous study) of initiations are treated with biosimiliaries and the others by princeps (H 1 ); all initiations under biosimilars and continuation therapy with the princeps (H 2 ) or all patients are treated with biosimilars (H 3 ). The annual savings are estimated at 237,000 € with the H 1 hypothesis. In the case of H 2 , the expected savings would be 376,200 € per year. In the case of H 3 , savings for the community could reach almost 1,282,800 € per year. The arrival of biosimilars allows significant savings for medicines market. According to the French recommendations in 2016, the expected savings are between the H 1 and H 2 hypothesis. The rate of penetration of biosimilars depends on many factors such as the involvement of health professionals, patient adherence, or health authority recommendations. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  17. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy.

    Directory of Open Access Journals (Sweden)

    Pamela Barbadoro

    Full Text Available The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED for non-urgent visits.The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use.Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32-6.47 of re-admissions have been registered; the distribution shows a high frequency of events in the age 65-84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37-52.57. The regression model has shown the significant role played by age, type of structure (geriatric acute care, and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38-15.27 of the total number of respondents to the questionnaire (N = 504. The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3-7.8 p = 0.008, while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30-0.90.In the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization.

  18. Economic aspects of hospital treated pneumococcal pneumonia and the results of Pneumo 23 vaccine use in Serbia

    Directory of Open Access Journals (Sweden)

    Adžić Tatjana

    2008-01-01

    Full Text Available INTRODUCTION In Serbia, there is a significant number of persons suffering of pneumococcal pneumonia. Persons aged 65 years or older, immunocompromised patients, patients with co-morbidities, such as chronic obstructive lung disease and congestive heart failure, are at the highest risk for developing pneumococcal pneumonia. Most of the patients are treated empirically, although it is often overlooked that Streptococcus pneumoniae can be resistant to the used antibiotics. The treatment costs of such inpatients and outpatients are very high. In Serbia, immunization of persons at risk to develop the diseases caused by Streptococcus pneumoniae is carried out using pneumococcus polysaccharide vaccine according to clinical indications. The exact number of immunized persons and the total number of registered patients are still unknown, but it is certain of being unjustifiably low. OBJECTIVE The goal of the study was to investigate, during a one-year period, the number and basic characteristics of persons hospitably treated for pneumonia, the type of cause of the infection, applied antibiotic medications, duration and costs of hospital treatment at the Institute for Lung Diseases and Tuberculosis of the Clinical Centre of Serbia in Belgrade. METHOD We retrospectively analyzed the medical records of patients with pneumonia treated at the Institute for Lung Diseases and Tuberculosis of the Clinical Centre of Serbia in Belgrade during 2006. RESULTS During the observed one-year period, 290 patients underwent hospital treatment, of whom the cause of the infection was confirmed in 116 (40%. The average duration of hospitalization was 12 days, with treatment cost of 32,031.74 RSD (402.42 EUR per patient. The treatment cost per patient including general and intensive care was 18,290.01 RSD (229.78 EUR. The distribution cost of Pneumo 23 vaccine in Serbia, without purchase tax, was 746.90 RSD (9.38 EUR. CONCLUSION Pneumococcal pneumonia is a significant medical

  19. Clinical and economic outcomes of Acinetobacter vis a vis non-Acinetobacter infections in an Indian teaching hospital

    Directory of Open Access Journals (Sweden)

    Priyendu Asim

    2016-01-01

    Full Text Available Context: Acinetobacter infections are a major nosocomial infection causing epidemics of infection in the Intensive Care Units (ICU. Aims: This study estimates the clinical and economic outcomes of Acinetobacter infections and compares them with those of non-Acinetobacter bacterial infections. Settings and Design: Prospective cross-sectional observational study carried out for 6 months in the medicine ICU of a tertiary care hospital. Materials and Methods: Patients were divided in two groups, one group with Acinetobacter infections and the other with non-Acinetobacter infections. The data was collected for infection, length of stay (LOS, mortality and cost along with patient demographics from the hospital records for analysis. Statistical Analysis Used: The data was analyzed using Statistical Package for the Social Sciences Version 15.0. The LOS and cost of treatment (COT for the two groups were compared using the nonparametric Mann–Whitney U-test. Results: A total of 220 patients were studied out of which 91 had Acinetobacter infections. The median LOS was 20 days in Group-A and 12 days in Group-B (P < 0.0001. The median COT was INR 125,862 in Group-A and INR 68,228 in the Group-B (P < 0.0001. Mortality in Group-A and Group-B was 32.97 and 32.56 (P = 0.949 respectively. Conclusion: The burden of Acinetobacter infections in ICUs is increasing with the increase in LOS and COT for the patients. The infection control team has to play a major role in reducing the rate of nosocomial infections.

  20. Annual economic burden of hepatitis B virus-related diseases among hospitalized patients in twelve cities in China.

    Science.gov (United States)

    Zhang, S; Ma, Q; Liang, S; Xiao, H; Zhuang, G; Zou, Y; Tan, H; Liu, J; Zhang, Y; Zhang, L; Feng, X; Xue, L; Hu, D; Cui, F; Liang, X

    2016-03-01

    A nationwide survey of hepatitis B virus (HBV)-associated economic burden has not previously been performed in China. The purpose of this study was to examine the direct, indirect, and intangible costs of HBV-related diseases within the span of one year. A random sample was taken from specialty and general hospitals across 12 cities in six provinces of China. Intangible costs were estimated based on willingness to pay or open-ended answers provided by patients. The results showed that 27 hospitals were enrolled, with a sample population of 4726 patients (77.7% response rate). The average annual costs were $4454.0 (direct), $924.3 (indirect), and $6611.10 (intangible), corresponding to 37.3%, 7.7%, and 55.1% of the total costs, respectively. The direct medical fees were substantially greater than the non-medical fees. Annual indirect costs were divided into outpatient ($112.9) and inpatient ($811.40) loss of income. The intangible costs of chronic HBV were notably higher than either the direct or indirect costs, consistent with the social stigma in China. The comparison amongst individual cities for the average ratio of direct to indirect costs revealed that the sizes of ratios were negatively correlated with the socioeconomic status of the regions. This study suggested that as a whole in China, the HBV-related diseases caused a heavy financial burden which was positively associated with disease severity. Although the intangible costs coincided with a high prevalence of discrimination against CHB patients in Chinese society, our study may serve as future reference for detailed exploration. © 2015 John Wiley & Sons Ltd.

  1. Energy planning of a hospital using Mathematical Programming and Monte Carlo simulation for dealing with uncertainty in the economic parameters

    International Nuclear Information System (INIS)

    Mavrotas, George; Florios, Kostas; Vlachou, Dimitra

    2010-01-01

    For more than 40 years, Mathematical Programming is the traditional tool for energy planning at the national or regional level aiming at cost minimization subject to specific technological, political and demand satisfaction constraints. The liberalization of the energy market along with the ongoing technical progress increased the level of competition and forced energy consumers, even at the unit level, to make their choices among a large number of alternative or complementary energy technologies, fuels and/or suppliers. In the present work we develop a modelling framework for energy planning in units of the tertiary sector giving special emphasis to model reduction and to the uncertainty of the economic parameters. In the given case study, the energy rehabilitation of a hospital in Athens is examined and the installation of a cogeneration, absorption and compression unit is examined for the supply of the electricity, heating and cooling load. The basic innovation of the given energy model lies in the uncertainty modelling through the combined use of Mathematical Programming (namely, Mixed Integer Linear Programming, MILP) and Monte Carlo simulation that permits the risk management for the most volatile parameters of the objective function such as the fuel costs and the interest rate. The results come in the form of probability distributions that provide fruitful information to the decision maker. The effect of model reduction through appropriate data compression of the load data is also addressed.

  2. Medical and health economic evaluation of prevention- and control measures related to MRSA infections or -colonisations at hospitals.

    Science.gov (United States)

    Korczak, Dieter; Schöffmann, Christine

    2010-03-16

    Methicillin-resistant Staphylococcus aureus (MRSA) are dangerous agents of nosocomial infections. In 2007 the prevalence of MRSA is 20.3% in Germany (Oxacilline-resistance according to EUCAST-criteria [EUCAST = European Committee on Antimicrobial Susceptibility Testing]). Which measurements are effective in the prevention and control of MRSA-infections in the hospital?How effective are contact precautions, screening, decolonisation, education and surveillance?Which recommendations can be given to health care politics on the basis of cost-effectiveness studies?Have there been any adverse effects on patients and clinical staff?What kind of liability problems exist? Based on a systematic review of the literature studies are included which have been published in German or English language since 2004. 1,508 articles have been found. After having surveyed the full text, 33 medical, eight economic and four ethical/juridical studies are included for the Health Technology Assessment (HTA) report. The key result of the HTA report is that different measurements are effective in the prevention and control of MRSA-infections in hospitals, though the majority of the studies has a low quality. Effective are the conduction of differentiated screening measurements if they take into account the specific endemic situation, the use of antibiotic-control programs and the introduction and control of hygienic measurements. The break even point of preventive and control measurements cannot be defined because the study results differ too much. In the future it has to be more considered that MRSA-infections and contact precautions lead to a psycho-social strain for patients. It is hardly possible to describe causal efficacies because in the majority of the studies confounders are not sufficiently considered. In many cases bundles of measurements have been established but not analyzed individually. The internal and external validity of the studies is too weak to evaluate single interventions

  3. Medical and health economic evaluation of prevention- and control measures related to MRSA infections or -colonisations at hospitals

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2010-03-01

    Full Text Available Introduction: Methicillin-resistant Staphylococcus aureus (MRSA are dangerous agents of nosocomial infections. In 2007 the prevalence of MRSA is 20.3% in Germany (Oxacilline-resistance according to EUCAST-criteria [EUCAST = European Committee on Antimicrobial Susceptibility Testing]. Objectives: * Which measurements are effective in the prevention and control of MRSA-infections in the hospital? * How effective are contact precautions, screening, decolonisation, education and surveillance? * Which recommendations can be given to health care politics on the basis of cost-effectiveness studies? * Have there been any adverse effects on patients and clinical staff? * What kind of liability problems exist?MethodsBased on a systematic review of the literature studies are included which have been published in German or English language since 2004. Results: 1,508 articles have been found. After having surveyed the full text, 33 medical, eight economic and four ethical/juridical studies are included for the Health Technology Assessment (HTA report. The key result of the HTA report is that different measurements are effective in the prevention and control of MRSA-infections in hospitals, though the majority of the studies has a low quality. Effective are the conduction of differentiated screening measurements if they take into account the specific endemic situation, the use of antibiotic-control programs and the introduction and control of hygienic measurements. The break even point of preventive and control measurements cannot be defined because the study results differ too much. In the future it has to be more considered that MRSA-infections and contact precautions lead to a psycho-social strain for patients. Discussion: It is hardly possible to describe causal efficacies because in the majority of the studies confounders are not sufficiently considered. In many cases bundles of measurements have been established but not analyzed individually. The

  4. In-Hospital Economic Burden of Metastatic Renal Cell Carcinoma in France in the Era of Targeted Therapies: Analysis of the French National Hospital Database from 2008 to 2013.

    Directory of Open Access Journals (Sweden)

    Rana Maroun

    Full Text Available The aim of this study was to assess the economic burden of hospitalisations for metastatic renal cell carcinoma (mRCC, to describe the patterns of prescribing expensive drugs and to explore the impact of geographic and socio-demographic factors on the use of these drugs.We performed a retrospective analysis from the French national hospitals database. Hospital stays for mRCC between 2008 and 2013 were identified by combining the 10th revision of the International Classification of Diseases (ICD-10 codes for renal cell carcinoma (C64 and codes for metastases (C77 to C79. Incident cases were identified out of all hospital stays and followed till December 2013. Descriptive analyses were performed with a focus on hospital stays and patient characteristics. Costs were assessed from the perspective of the French National Health Insurance and were obtained from official diagnosis-related group tariffs for public and private hospitals.A total of 15,752 adult patients were hospitalised for mRCC, corresponding to 102,613 hospital stays. Of those patients, 68% were men and the median age at first hospitalisation was 69 years [Min-Max: 18-102]. Over the study period, the hospital mortality rate reached 37%. The annual cost of managing mRCC at hospital varied between 28M€ in 2008 and 42M€ in 2012 and was mainly driven by inpatient costs. The mean annual per capita cost of hospital management of mRCC varied across the study period from 8,993€ (SD: €8,906 in 2008 to 10,216€ (SD: €10,527 in 2012. Analysis of the determinants of prescribing expensive drugs at hospital did not show social or territorial differences in the use of these drugs.This study is the first to investigate the in-hospital economic burden of mRCC in France. Results showed that in-hospital costs of managing mRCC are mainly driven by expensive drugs and inpatient costs.

  5. Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review.

    Science.gov (United States)

    Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph

    2017-09-01

    Multichamber bags (MCBs) may offer potential clinical, ergonomic, and economic advantages compared with (hospital) pharmacy compounded bags (COBs) and multibottle systems (MBSs). A systematic literature review was performed to identify and assess the available evidence regarding advantages of MCBs compared with COBs and MBSs. Medline, Embase, the Cochrane Databases, and EconLit were searched for articles reporting clinical, ergonomic, and economic outcomes for MCBs compared with COBs or MBSs. The search was limited to studies conducted in hospitalized patients >2 years of age that were published in English between January 1990 and November 2014. The Population Intervention Comparison Outcomes Study Design (PICOS) framework was used for the analysis. From 1307 unique citations, 74 potentially relevant publications were identified; review of references identified 2 additional publications. Among the 76 publications, 18 published studies met the inclusion criteria. Most were retrospective in design. Ten studies reported clinical outcomes, including 1 prospective randomized trial and multiple retrospective analyses that reported a lower risk of bloodstream infection for MCBs compared with other delivery systems. Sixteen studies reported ergonomic and/or economic outcomes; most reported a potential cost benefit for MCBs, with consistent reports of reduced time and labor compared with other systems. The largest cost benefit was observed in studies evaluating total hospitalization costs. The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

  6. [Secondhand smoke in hospitality venues. Exposure, body burden, economic and health aspects in conjunction with smoking bans].

    Science.gov (United States)

    Fromme, H; Kuhn, J; Bolte, G

    2009-04-01

    Secondhand smoke was classified by national and international organisations as a known cause of cancer in humans and has many adverse health effects, especially cardiovascular diseases and lung tumours. Global studies have clearly shown that hospitality venues have the highest levels of indoor air pollution containing different substances that are clearly carcinogenic--such as tobacco-related chemicals--compared with other, smoke-free indoor spaces. Data from the human biomonitoring of non-smoking employees in the food service industry confirm this high exposure level. Non-smokers exposed to secondhand smoke in these environments are at increased risk for adverse health effects. The consistent protection of non-smokers in public places such as restaurants and bars through a smoking ban results in a significant reduction of the pollutants in the air (mostly > 90%) and clearly reduces the internal body burden for users and employees. Furthermore, health complaints by non-smoking employees are reduced and the higher risk for lung tumours of employees in the food service industry compared with the general population can be effectively reduced as well. According to current standards of knowledge, other measures such as spatial separation of smoking areas or the use of mechanical venting systems do not achieve a comparably high and effective pollutant reduction under field conditions. Studies concerning the economic effects of prohibiting smoking in public places conducted in various countries have shown that beverage-focused gastronomic enterprises experience a short-term down trend but that food-focused gastronomic enterprises do not experience any negative or even positive effects. The positive effects of a ban on smoking in public places on the general population are a decline in cigarette consumption and the reduction of secondhand smoke exposure by non-smokers. Smoking bans in hospitality venues are not necessarily linked with a shift of the tobacco consumption to

  7. [Use of a Delphi survey to assess the hospital economic impact of innovative products: The example of idarucizumab a dabigatran-specific reversal agent].

    Science.gov (United States)

    Jamet, N; Thivilliers, A P; Paubel, P; Chevalier, D; Bourguignon, S; Bézie, Y

    2017-11-01

    The economic impact of therapeutic innovations on the hospital patient management cannot be easily estimated. The objective of this study is to illustrate the use of a Delphi survey as a support tool to identify the changes following the use of idarucizumab in dabigatran-treated patients with uncontrolled/life-threatening bleeding or who required emergency surgery/urgent procedures. The Delphi questionnaires have been administrated to 8 emergency physicians or anesthetists from 6 different hospital centers. Following the answers, an economic valorization has been carried out on every parameter on which a consensus was reached (at least 4 answers showing an identical trend). A mean management cost for each etiology with and without the use of idarucizumab has thus been identified. For gastro-intestinal and other life-threatening bleedings (excepted intracranial bleedings), the total management cost of the hospital stay was respectively 6058 € (-35%) and 6219 € (-34%) following the use of the reversal agent. The hospital management cost for intracranial bleeding is slightly increasing to 9790 € (+3%). The cost of a stay for emergency surgery decreases to 6962€ (-2%). This study shows a positive economic impact following the use of the dabigatran-specific reversal agent for patients with uncontrolled/life-threatening bleeding excepted in the case of intracranial bleeding. Moreover, it points out that a Delphi survey is an easy way to predict the hospital economic impact of a therapeutic innovation when no other evaluation is possible. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  8. An analysis of hospital capital planning and financing in three European countries: Using the principal-agent approach to identify the potential for economic problems.

    Science.gov (United States)

    Thompson, Ceri R; McKee, Martin

    2011-02-01

    To explore differences in national approaches to hospital capital planning and financing in three European countries and to understand the roles and positions of the actors involved. Case studies of major new hospital developments were undertaken in each of the study countries (France, Sweden and England), based on a review of documents related to each development and the national framework within which they took place, as well as interviews with key informants. The principal-agent model was used, focusing on identification of differing utilities and information asymmetries. There are substantial differences between countries, for example in relation to the role of the hospital in its own redevelopment, the organisational distance between actors, the institutional level at which decision rights for major investments are exercised, and how principals control the agents. These differences have implications for the processes involved and the nature of economic and health care problems that can arise. There is evidence of, and opportunity for economic problems in all systems but these seems to be greater in France and England where the hospital leads the process, where there is limited involvement by the regional bodies, and informational differences appear greater. We conclude that hospital planning processes should be informed by an explicit understanding of the powerful groups involved and their divergent preferences and utilities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. The clinical and economic impact of exacerbations of chronic obstructive pulmonary disease: a cohort of hospitalized patients.

    Directory of Open Access Journals (Sweden)

    Francesco Blasi

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is a common disease with significant health and economic consequences. This study assesses the burden of COPD in the general population, and the influence of exacerbations (E-COPD on disease progression and costs.This is a secondary data analysis of healthcare administrative databases of the region of Lombardy, in northern Italy. The study included ≥ 40 year-old patients hospitalized for a severe E-COPD (index event during 2006. Patients were classified in relation to the number and type of E-COPD experienced in a three-year pre-index period. Subjects were followed up until December 31st, 2009, collecting data on healthcare resource use and vital status.15857 patients were enrolled -9911 males, mean age: 76 years (SD 10. Over a mean follow-up time of 2.4 years (1.36, 81% of patients had at least one E-COPD with an annual rate of 3.2 exacerbations per person-year and an all-cause mortality of 47%. A history of exacerbation influenced the occurrence of new E-COPD and mortality after discharge for an E-COPD. On average, the healthcare system spent 6725€ per year per person (95%CI 6590-6863. Occurrence and type of exacerbations drove the direct healthcare cost. Less than one quarter of patients presented claims for pulmonary function tests.COPD imposes a substantial burden on healthcare systems, mainly attributable to the type and occurrence of E-COPD, or in other words, to the exacerbator phenotypes. A more tailored approach to the management of COPD patients is required.

  10. [HERA-QUEST: HTA evaluation of generic pharmaceutical products to improve quality, economic efficiency, patient safety and transparency in drug product changes in hospitals].

    Science.gov (United States)

    Gyalrong-Steur, Miriam; Kellermann, Anita; Bernard, Rudolf; Berndt, Georg; Bindemann, Meike; Nusser-Rothermundt, Elfriede; Amann, Steffen; Brakebusch, Myga; Brüggmann, Jörg; Tydecks, Eva; Müller, Markus; Dörje, Frank; Kochs, Eberhard; Riedel, Rainer

    2017-04-01

    In view of the rising cost pressure and an increasing number of drug shortages, switches between generic drug preparations have become a daily routine in hospitals. To ensure consistently high treatment quality and best possible patient safety, the equivalence of the new and the previous drug preparation must be ensured before any change in the purchase of pharmaceutical products takes place. So far, no easily usable, transparent and standardized instrument for this kind of comparison between generic drug products has been available. A group of pharmaceutical experts has developed the drug HTA (health technology assessment) model "HERA" (HTA Evaluation of geneRic phArmaceutical products) through a multi-step process. The instrument is designed to perform both a qualitative and economic comparison of equivalent drug preparations ("aut idem" substitution) before switching products. The economic evaluation does not only consider unit prices and consumption quantity, but also the processing costs associated with a product change process. The qualitative comparison is based on the evaluation of 34 quality criteria belonging to six evaluation fields (e.g., approval status, practical handling, packaging design). The objective evaluation of the quality criteria is complemented by an assessment of special features of the individual hospital for complex drug switches, including the feedback of the physicians utilizing the drug preparation. Thus potentially problematic switches of pharmaceutical products can be avoided at the best possible rate, contributing to the improvement of patient safety. The novel drug HTA model HERA is a tool used in clinical practice that can add to an increase in quality, therapeutic safety and transparency of drug use while simultaneously contributing to the economic optimization of drug procurement in hospitals. Combining these two is essential for hospitals facing the tension between rising cost pressure and at the same time increasing demands

  11. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fellows Jeffrey L

    2012-08-01

    Full Text Available Abstract Background Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of ‘forced abstinence’ for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231. Methods/Design The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW and at Oregon Health & Science University (OHSU hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR follow-up calls, compared to usual care inpatient counseling (UC. In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed

  12. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Fellows, Jeffrey L; Mularski, Richard; Waiwaiole, Lisa; Funkhouser, Kim; Mitchell, Julie; Arnold, Kathleen; Luke, Sabrina

    2012-08-01

    Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of 'forced abstinence' for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231). The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW) and at Oregon Health & Science University (OHSU) hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR) follow-up calls, compared to usual care inpatient counseling (UC). In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed seven-day abstinence at six months, self-reported seven

  13. The technical-economic potential of thermal energy saving in hospitals; El potencial tecnico-economico de ahorro de energia termica en hospitales

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, A. [Universidad Nacional Autonoma de Mexico (Mexico); Islas, J [Universidad Nacional Autonoma de Mexico, Mexico, D.F. (Mexico); Arriola, A. [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)

    2001-07-01

    The hospitals are important consumers of energy. At the General Hospital of Zone (HGZ) N of the IMSS in Aguscalientes (HGZ N . IMSS Ags.), the diesel oil is the main fuel that is used to satisfy the requirements of thermal energy of the hospital. According to the data collected by this author, this fuel represented in 2001, 75% of its total energy consumption and the 67.9% of its total costs in energy that ascended to $396.131 (December 2001 Dollars) Since this last amount represents an important percentage of the total expenses of the hospital (29.367 million dollars) it is important to determine the technical-economic possibilities of thermal energy saving of the hospital. The HGZ N 1 IMSS Ags. is located in a ampler conglomerate where the IMSS units are located, such as, the regional laundry, the sport unit, the center of social security, the familiar medicine unit N 1 and the hospital. Nevertheless departing from the installation of the electrical systems and the provision of steam and hot water to the hospital, the electrical and thermal fluids of all this facilities are distributed. Due to this situation, in this work we will refer to the global consumption of the IMSS of Aguascalientes development where the hospital is the main consumer of thermal energy. In the present work we will calculate the technical-economic potential of thermal energy saving in the development of the IMSS through the thermodynamic technique of folding point or pinch technique. [Spanish] Los hospitales son importantes consumidores de energia. En el Hospital General de Zona N del IMSS en Aguscalientes (HGZ N - IMSS Ags.), el diesel es el principal combustible que se usa para satisfacer los requerimientos de energia termica del hospital. Segun los datos obtenidos por el autor anterior, este combustible represento en 2001 el 75% de su consumo total energetico y el 67.9% de sus costos totales en energeticos que ascendieron a $396,131 (dolares de diciembre de 2001). Dado que esta ultima

  14. Encouraging Healthful Dietary Behavior in a Hospital Cafeteria: A Field Study Using Theories from Social Psychology and Behavioral Economics

    OpenAIRE

    Mazza, Mary Carol

    2013-01-01

    Public policy efforts to curb obesity often adhere to a rational actor model of human behavior, asserting that consumer behavior will change provided proper economic incentives, nutritional information, and health education. However, rigorous academic research related to such questions remains limited in scope and appears inconclusive as to the success of such economic and cognitive interventions. In contrast, research in social psychology and behavioral economics suggests that decision mak...

  15. Underestimated uncertainties. Hospital-at-home for COPD exacerbations and methodological issues in the economic evaluation of healthcare

    NARCIS (Netherlands)

    L.M.A. Goossens (Lucas)

    2013-01-01

    textabstractEconomic evaluation has been defined as `the comparative analysis of alternative courses of action in terms of both their costs and consequences’. In an economic evaluation in healthcare, two or more interventions are compared in terms of costs and health outcomes. This results in

  16. Nowhere to run, or hide. Current economic downturn may exacerbate hospitals' weakness with buildings, technology costs, reimbursements.

    Science.gov (United States)

    Becker, Cinda

    2008-04-21

    As the economy moves through what many believe is a recession, healthcare won't be immune, experts say. "I don't know much in the economy that is recession-proof, and I don't think healthcare is either," says W. David Bradford, left, a Medical University of South Carolina economics professor. Because of the current economic conditions, some systems are rethinking where they put their money.

  17. Economic burden and its associated factors of hospitalized patients infected with A (H7N9) virus: a retrospective study in Eastern China, 2013-2014.

    Science.gov (United States)

    Huo, Xiang; Chen, Li-Ling; Hong, Lei; Xiang, Lun-Hui; Tang, Fen-Yang; Chen, Shan-Hui; Gao, Qiang; Chen, Cong; Dai, Qi-Gang; Sun, Chuan-Wu; Xu, Ke; Dai, Wen-Jun; Qi, Xian; Li, Chang-Cheng; Yu, Hui-Yan; Zhou, Yin; Huang, Hao-Di; Pan, Xing-Yang; Xu, Chang-Sha; Zhou, Ming-Hao; Bao, Chang-Jun

    2016-09-01

    H7N9 continues to cause human infections and remains a pandemic concern. Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation, including infectious disease prevention and control investment. However, there are limited data on such impacts. Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed. Patients' direct medical costs of hospitalization were derived from their hospital bills. A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics. The mean direct cost of hospitalization for H7N9 was estimated to be ¥ 71 060 (95 % CI, 48 180-104 820), i.e., US$ 10 996 (95 % CI, 7 455-16 220), and was ¥12 060 (US$ 1 861), ¥136 120 (US$ 21 001) and ¥218 610 (US$ 33 728) for those who had mild or severe symptoms or who died, respectively. The principal components of the total fees differed among patients with different disease severity, although medication fees were always the largest contributors. Disease severity, proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient's direct medical cost of hospitalization. The direct medical costs of hospitalized patients with H7N9 are significant, and far surpass the annual per capita income of Jiangsu Province, China. The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation. Not applicable. This is a survey study with no health care intervention implemented on human participants.

  18. Economic impact of enoxaparin versus unfractionated heparin for venous thromboembolism prophylaxis in patients with acute ischemic stroke: a hospital perspective of the PREVAIL trial.

    Science.gov (United States)

    Pineo, Graham; Lin, Jay; Stern, Lee; Subrahmanian, Tarun; Annemans, Lieven

    2012-03-01

    The PREVAIL (Prevention of VTE [venous thromboembolism] after acute ischemic stroke with LMWH [low-molecular-weight heparin] and UFH [unfractionated heparin]) study demonstrated a 43% VTE risk reduction with enoxaparin versus UFH in patients with acute ischemic stroke (AIS). A 1% rate of symptomatic intracranial and major extracranial hemorrhage was observed in both groups. To determine the economic impact, from a hospital perspective, of enoxaparin versus UFH for VTE prophylaxis after AIS. A decision-analytic model was constructed and hospital-based costs analyzed using clinical information from PREVAIL. Total hospital costs were calculated based on mean costs in the Premier™ database and from wholesalers acquisition data. Costs were also compared in patients with severe stroke (National Institutes of Health Stroke Scale [NIHSS] score ≥14) and less severe stroke (NIHSS score <14). The average cost per patient due to VTE or bleeding events was lower with enoxaparin versus UFH ($422 vs $662, respectively; net savings $240). The average anticoagulant cost, including drug-administration cost per patient, was lower with UFH versus enoxaparin ($259 vs $360, respectively; net savings $101). However, when both clinical events and drug-acquisition costs were considered, the total hospital cost was lower with enoxaparin versus UFH ($782 vs $922, respectively; savings $140). Hospital cost-savings were greatest ($287) in patients with NIHSS scores ≥14. The higher drug cost of enoxaparin was offset by the reduction in clinical events as compared to the use of UFH for VTE prophylaxis after an AIS, particularly in patients with severe stroke. Copyright © 2011 Society of Hospital Medicine.

  19. [Morbidity and mortality associated to influenza A (H1N1) 2009 admissions in two hospitals of the Metropolitan area and analysis of its economic impact].

    Science.gov (United States)

    Armstrong, Macarena; Fica, Alberto; Dabanch, Jeannette; Olivares, Felipe; Fasce, Rodrigo; Triantafilo, Vjera

    2012-12-01

    Influenza A (H1N1) 2009 infection was an important cause of morbidity and mortality in Chile. To characterize the clinical pattern of hospitalized patients, identify risk factors associated with ICU admission or death, and evaluate its economic impact. Twenty five adult patients admitted to 2 hospitals in the Metropolitan Area from May 2009 to December 2010 with PCR confirmed H1N1 infection were analyzed. Total hospital charges were obtained and, using data of registered cases, expenses for the whole country during the first epidemic wave were estimated. Aill cases presented a risk factor: age over 60 years old (n = 13, 52%), co-morbid conditions (n = 24, 96%) or pregnancy (n = 1, 4%). Pneumonia was present in 64% (n = 16) and 16% (n = 4) had hypotension. Only 6 patients (24%) had a CURB-65 score ≥ 2 and 36% (n = 9) requiring ICU admission. Case fatality rate was 16% (n = 4). By multivariate analysis, diabetes mellitus type 2 was independently associated with ICU admission or death (OR 8.12; IC95 1.11-59.2, p Chile during the first wave. The CURB-65 score was inappropriate to recognize patients at risk of hospitalization or ICU admission.

  20. Assessing the economic value of avoiding hospital admissions by shifting the management of gram+ acute bacterial skin and skin-structure infections to an outpatient care setting.

    Science.gov (United States)

    Ektare, V; Khachatryan, A; Xue, M; Dunne, M; Johnson, K; Stephens, J

    2015-01-01

    To estimate, from a US payer perspective, the cost offsets of treating gram positive acute bacterial skin and skin-structure infections (ABSSSI) with varied hospital length of stay (LOS) followed by outpatient care, as well as the cost implications of avoiding hospital admission. Economic drivers of care were estimated using a literature-based economic model incorporating inpatient and outpatient components. The model incorporated equal efficacy, adverse events (AE), resource use, and costs from literature. Costs of once- and twice-daily outpatient infusions to achieve a 14-day treatment were analyzed. Sensitivity analyses were performed. Costs were adjusted to 2015 US$. Total non-drug medical cost for treatment of ABSSSI entirely in the outpatient setting to avoid hospital admission was the lowest among all scenarios and ranged from $4039-$4924. Total non-drug cost for ABSSSI treated in the inpatient setting ranged from $9813 (3 days LOS) to $18,014 (7 days LOS). Inpatient vs outpatient cost breakdown was: 3 days inpatient ($6657)/11 days outpatient ($3156-$3877); 7 days inpatient ($15,017)/7 days outpatient ($2495-$2997). Sensitivity analyses revealed a key outpatient cost driver to be peripherally inserted central catheter (PICC) costs (average per patient cost of $873 for placement and $205 for complications). Drug and indirect costs were excluded and resource use was not differentiated by ABSSSI type. It was assumed that successful ABSSSI treatment takes up to 14 days per the product labels, and that once-daily and twice-daily antibiotics have equal efficacy. Shifting ABSSSI care to outpatient settings may result in medical cost savings greater than 53%. Typical outpatient scenarios represent 14-37% of total medical cost, with PICC accounting for 28-43% of the outpatient burden. The value of new ABSSSI therapies will be driven by eliminating the need for PICC line, reducing length of stay and the ability to completely avoid a hospital stay.

  1. Inpatient Profile of Patients with Major Depression in Portuguese National Health System Hospitals, in 2008 and 2013: Variation in a Time of Economic Crisis.

    Science.gov (United States)

    Rodrigues, Daniel Francisco Santos; Nunes, Carla

    2018-02-01

    The economic crisis has placed Portugal in a situation of budgetary constraints with repercussions on mental health, since 2009. This study analyses the association between economic crisis and the inpatient profile of major depression in the working-age population in Portuguese National Health System hospitals. This was an observational, descriptive and cross-sectional study. An individual analysis of hospitalisation and an ecological analysis at district level, were performed before 2008 and during the crisis (2013). Data on the hospitalisation episodes, working-age population and psychiatric inpatient beds were analysed. An increase in hospitalisation rates for major depression were observed, and across country, high spatial variations were perceived: districts with lower rates of urbanisation and population density had higher hospitalisation rates for major depression. Hospitalisation rates were positively influenced by the available inpatient beds. The results for 2013 were more critical (higher hospitalisation rates, less beds). Further research is needed to understand all patterns, considering other individual and contextual information.

  2. Economic costs and health-related quality of life outcomes of hospitalised patients with high HIV prevalence: A prospective hospital cohort study in Malawi.

    Science.gov (United States)

    Maheswaran, Hendramoorthy; Petrou, Stavros; Cohen, Danielle; MacPherson, Peter; Kumwenda, Felistas; Lalloo, David G; Corbett, Elizabeth L; Clarke, Aileen

    2018-01-01

    Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence. Sequential medical admissions to Queen Elizabeth Central Hospital, Malawi, between June-December 2014 were followed until discharge, with standardised classification of medical diagnosis and estimation of healthcare resources used. Primary costing studies estimated total health provider cost by medical diagnosis. Participants were interviewed to establish direct non-medical and indirect costs. Costs were adjusted to 2014 US$ and INT$. HRQoL was measured using the EuroQol EQ-5D. Multivariable analyses estimated predictors of economic outcomes. Of 892 eligible participants, 80.4% (647/892) were recruited and medical notes found. In total, 447/647 (69.1%) participants were HIV-positive, 339/447 (75.8%) were on ART prior to admission, and 134/647 (20.7%) died in hospital. Mean duration of admission for HIV-positive participants not on ART and HIV-positive participants on ART was 15.0 days (95%CI: 12.0-18.0) and 12.2 days (95%CI: 10.8-13.7) respectively, compared to 10.8 days (95%CI: 8.8-12.8) for HIV-negative participants. Mean total provider cost per hospital admission was US$74.78 (bootstrap 95%CI: US$25.41-US$124.15) higher for HIV-positive than HIV-negative participants. Amongst HIV-positive participants, the mean total provider cost was US$106.87 (bootstrap 95%CI: US$25.09-US$106.87) lower for those on ART than for those not on ART. The mean total direct non-medical and indirect cost per hospital admission was US$87.84. EQ-5D utility scores were lower

  3. Five Years After the Hawai‘i Smoke-free Law: Tourism and Hospitality Economic Indicators Appear Unharmed

    Science.gov (United States)

    Rivard, Cheryl; Lipsher, Julian; Hyland, Andrew

    2013-01-01

    Opponents of Hawai‘i's smoke-free law argued that such a law would lead to a decrease in tourism. The purpose of this study is to determine if there is evidence of an adverse impact of Hawai‘i's smoke-free law on tourism utilizing data obtained from Hawai‘i's Department of Business, Economic Development & Tourism website for tourists from the United States. Descriptive statistics were reported before and after the law and linear regression was used to assess the relationship between the implementation of the law and changes in indicators of tourism while adjusting for underlying economic factors. The most pronounced fluctuations observed with all tourism indicators occurred around the time the US entered the recession (December 2007), with steady increases following the end of the US recession. While controlling for economic and seasonal trends, the presence of the smoke-free law was associated with an increase in arrivals (β= 42847.9; 95% CI: 16303.3, 69392.5), accommodation employees (β= 969.0; 95% CI: 351.1, 1586.8) and food services & beverage places employees (β=3390.8; 95% CI: 2326.9, 4454.7). Fluctuations in tourism indicators are likely to be associated with greater economic forces, such as decreasing GDP and consumer confidence in the United States and greater global economic trends, rather than the smoke-free law. PMID:24167770

  4. Five years after the Hawai'i smoke-free law: tourism and hospitality economic indicators appear unharmed.

    Science.gov (United States)

    Dobson Amato, Katharine A; Rivard, Cheryl; Lipsher, Julian; Hyland, Andrew

    2013-10-01

    Opponents of Hawai'i's smoke-free law argued that such a law would lead to a decrease in tourism. The purpose of this study is to determine if there is evidence of an adverse impact of Hawai'i's smoke-free law on tourism utilizing data obtained from Hawai'i's Department of Business, Economic Development & Tourism website for tourists from the United States. Descriptive statistics were reported before and after the law and linear regression was used to assess the relationship between the implementation of the law and changes in indicators of tourism while adjusting for underlying economic factors. The most pronounced fluctuations observed with all tourism indicators occurred around the time the US entered the recession (December 2007), with steady increases following the end of the US recession. While controlling for economic and seasonal trends, the presence of the smoke-free law was associated with an increase in arrivals (β= 42847.9; 95% CI: 16303.3, 69392.5), accommodation employees (β= 969.0; 95% CI: 351.1, 1586.8) and food services & beverage places employees (β=3390.8; 95% CI: 2326.9, 4454.7). Fluctuations in tourism indicators are likely to be associated with greater economic forces, such as decreasing GDP and consumer confidence in the United States and greater global economic trends, rather than the smoke-free law.

  5. A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region.

    Science.gov (United States)

    Roberts, Derek J; Das, Debanjana; Mercado, Michelle; Vis, Christine; Kortbeek, John B; Kirkpatrick, Andrew W; Ball, Chad G

    2014-05-01

    Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression. An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged. Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Health Economic Evaluation of Home and Hospital-Based Care in T2D Patients on Insulin Therapy.

    Science.gov (United States)

    Janati, Ali; Sarabchian, Mohamad Ali; Mohaghegh, Bahram; Aghmohamadzadeh, Naser; Seyedin, Hesam; Gholizadeh, Masumeh; Hasanpoor, Edris

    2017-11-01

    Type 2 Diabetes is a main concern of public health in contemporary world with remarkable mortality, delayed complications and health costs. Governments are obliged to improve the quality of health care and consider appropriate strategies to reduce the costs. An alternative strategy for hospital services is care at home. Therefore, this study was aimed to evaluate the cost-effectiveness of home-based and hospital-based diabetes care. A quasi-experimental, pre-test and post-test design was conducted in Northwest Iran. Sixty subjects who were eligible insulin-treatment type 2 diabetes mellitus were randomly assigned into two equal groups to receive home-based or conventional hospital-based care. Data on glycosylated hemoglobin (HbA1c), hypoglycemia episodes, time needed to achieve glycemic control level, diabetes treatment satisfaction, diabetes knowledge and costs during three months were collected. The cost of home-based care in insulin therapy diabetes was 61% less compared with the hospital-based methods. The former strategy was cost-effective in terms of reduction in HbA1C and the time needed to achieve glycemic control. The patients in home care group were more satisfied and knowledgeable. The care at home approach for type 2 diabetic patients can be introduced and supported as a cost-effective care method in the country.

  7. Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-11-01

    The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs. The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA. The year-to-year risk of 90-day readmission was reduced by 2% and 4% (P total joint arthroplasty volume. The top 5 factors associated with the cost of 90-day TKA readmissions were (in rank order) the length of stay, hospital's teaching status, discharge disposition, patient's gender, and age. Although readmission rates declined slightly, the results of this study do not support the hypothesis that readmission costs have decreased since the introduction of health care reform legislation. Instead, we found that clinical and hospital factors were among the most important cost drivers. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. A window-DEA based efficiency evaluation of the public hospital sector in Greece during the 5-year economic crisis.

    Science.gov (United States)

    Flokou, Angeliki; Aletras, Vassilis; Niakas, Dimitris

    2017-01-01

    The main objective of this study was to apply the non-parametric method of Data Envelopment Analysis (DEA) to measure the efficiency of Greek NHS hospitals between 2009-2013. Hospitals were divided into four separate groups with common characteristics which allowed comparisons to be carried out in the context of increased homogeneity. The window-DEA method was chosen since it leads to increased discrimination on the results especially when applied to small samples and it enables year-by-year comparisons of the results. Three inputs -hospital beds, physicians and other health professionals- and three outputs-hospitalized cases, surgeries and outpatient visits- were chosen as production variables in an input-oriented 2-year window DEA model for the assessment of technical and scale efficiency as well as for the identification of returns to scale. The Malmquist productivity index together with its components (i.e. pure technical efficiency change, scale efficiency change and technological scale) were also calculated in order to analyze the sources of productivity change between the first and last year of the study period. In the context of window analysis, the study identified the individual efficiency trends together with "all-windows" best and worst performers and revealed that a high level of technical and scale efficiency was maintained over the entire 5-year period. Similarly, the relevant findings of Malmquist productivity index analysis showed that both scale and pure technical efficiency were improved in 2013 whilst technological change was found to be in favor of the two groups with the largest hospitals.

  9. Economic impact of interventional study on rational use of antiseptics and disinfectants in Super Speciality Hospital of Nagpur.

    Science.gov (United States)

    Agarwal, Vandana; Gharpure, Kunda; Thawani, Vijay; Makhija, Sushil; Thakur, Anita; Powar, Rajaram

    2008-03-01

    To measure the impact of interventions on rational use of antiseptics and disinfectants (A and D) for cost containment in Super Speciality Hospital (SSH) of Government Medical College, Nagpur (GMCN), India. This study was conducted from October 2003 to March 2007 in SSH of GMCN. In the pre-interventional phase (Phase-I), purchase, stocking and distribution of A and D was studied to find problem areas. Based on this formative data an intervention was planned (Phase-II) during which rationing of the A and D was done. Rational quantities needed for different A and D procedures were calculated based on recommendations of National Aids Control Organization (NACO) with modifications to suit our hospital setup. Detailed information, education, communication and training about rational use of A and D were provided to the hospital staff. In the post-interventional phase (Phase-III), the use of A and D was rationalized at the distribution level and the efficacy of in-use A and D was tested at user sites. Data about medicine expenditure, patient record and A and D usage in various departments was obtained from hospital records. Savings on A and D as against total annual medicine expenditure was calculated taking the cost of A and D in the post-intervention period. The expenditure on A and D as a result of intervention decreased by 20.7%. Out of the total medicine expenditure, the expenditure on A and D which accounted for 6.2% before intervention, decreased to 1.95% after the intervention. The information, education and communication (IEC) interventions attempted by us resulted in significant decrease in the use and expenditure of A and D.

  10. The Economic Burden of Hospital-Acquired Clostridium difficile Infection: A Population-Based Matched Cohort Study.

    Science.gov (United States)

    Nanwa, Natasha; Kwong, Jeffrey C; Krahn, Murray; Daneman, Nick; Lu, Hong; Austin, Peter C; Govindarajan, Anand; Rosella, Laura C; Cadarette, Suzanne M; Sander, Beate

    2016-09-01

    BACKGROUND High-quality cost estimates for hospital-acquired Clostridium difficile infection (CDI) are vital evidence for healthcare policy and decision-making. OBJECTIVE To evaluate the costs attributable to hospital-acquired CDI from the healthcare payer perspective. METHODS We conducted a population-based propensity-score matched cohort study of incident hospitalized subjects diagnosed with CDI (those with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada code A04.7) from January 1, 2003, through December 31, 2010, in Ontario, Canada. Infected subjects were matched to uninfected subjects (those without the code A04.7) on age, sex, comorbidities, geography, and other variables, and followed up through December 31, 2011. We stratified results by elective and nonelective admissions. The main study outcomes were up-to-3-year costs, which were evaluated in 2014 Canadian dollars. RESULTS We identified 28,308 infected subjects (mean annual incidence, 27.9 per 100,000 population, 3.3 per 1,000 admissions), with a mean age of 71.5 years (range, 0-107 years), 54.0% female, and 8.0% elective admissions. For elective admission subjects, cumulative mean attributable 1-, 2-, and 3-year costs adjusted for survival (undiscounted) were $32,151 (95% CI, $28,192-$36,005), $34,843 ($29,298-$40,027), and $37,171 ($30,364-$43,415), respectively. For nonelective admission subjects, the corresponding costs were $21,909 ($21,221-$22,609), $26,074 ($25,180-$27,014), and $29,944 ($28,873-$31,086), respectively. CONCLUSIONS Hospital-acquired CDI is associated with substantial healthcare costs. To the best of our knowledge, this study is the first CDI costing study to present longitudinal costs. New strategies may be warranted to mitigate this costly infectious disease. Infect Control Hosp Epidemiol 2016;37:1068-1078.

  11. The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues

    Directory of Open Access Journals (Sweden)

    Christophi Costas A

    2013-01-01

    Full Text Available Abstract Background Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation’s effect on revenue and employment. Methods Several hospitality venues (n = 35 were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. Results The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p  Conclusion Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

  12. Financial impact of surgical training on hospital economics: an income analysis of 1184 out-patient clinic consultations.

    Science.gov (United States)

    Fitzgerald, J E F; Ravindra, P; Lepore, M; Armstrong, A; Bhangu, A; Maxwell-Armstrong, C A

    2013-01-01

    In many countries healthcare commissioning bodies (state or insurance-based) reimburse hospitals for their activity. The costs associated with post-graduate clinical training as part of this are poorly understood. This study quantified the financial revenue generated by surgical trainees in the out-patient clinic setting. A retrospective analysis of surgical out-patient ambulatory care appointments under 6 full-time equivalent Consultants (Attendings) in one hospital over 2 months. Clinic attendance lists were generated from the Patient Access System. Appointments were categorised as: 'new', 'review' or 'procedure' as per the Department of Health Payment by Results (PbR) Outpatient Tariff (Outpatient Treatment Function Code 104; Outpatient Procedure Code OPRSI1). During the study period 78 clinics offered 1184 appointments; 133 of these were not attended (11.2%). Of those attended 1029 had sufficient detail for analysis (98%). 261 (25.4%) patients were seen by a trainee. Applying PbR reimbursement criteria to these gave a projected annual income of £GBP 218,712 (€EU 266,527; $USD 353,657) generated by 6 surgical trainees (Residents). This is equivalent to approximately £GBP 36,452 (€EU 44,415; $USD 58,943) per trainee annually compared to £GBP 48,732 (€EU 59,378; $USD 78,800) per Consultant. This projected yearly income off-set 95% of the trainee's basic salary. Surgical trainees generated a quarter of the out-patient clinic activity related income in this study, with each trainee producing three-quarters of that generated by a Consultant. This offers considerable commercial value to hospitals. Although this must offset productivity differences and overall running costs, training bodies should ensure hospitals offer an appropriate return. In a competitive market hospitals could be invited to compete for trainees, with preference given to those providing excellence in training. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights

  13. Five-year economic evaluation of non-melanoma skin cancer surgery at the Costa del Sol Hospital (2006-2010).

    Science.gov (United States)

    Aguilar-Bernier, M; González-Carrascosa, M; Padilla-España, L; Rivas-Ruiz, F; Jiménez-Puente, A; de Troya-Martín, M

    2014-03-01

    The cost associated with treatment of non-melanoma skin cancer is expected to rise considerably over the coming decades. This important public health problem is therefore expected to have an enormous economic impact for the various public health services. To estimate the cost of the surgical-care process of non-melanoma skin cancer at the Costa del Sol Hospital and seek areas to improve its efficiency, using the activity-based costing (ABC) method and the tools designed for decision analysis. To compare the costs for hospitalized patients obtained using the ABC method with the data published by the Spanish Ministry of Health, using the diagnosis-related groups (DRG) classification system. Retrospective analysis of the cost of non-melanoma skin cancer surgery at the Costa del Sol Hospital. The total estimated cost from 2006 to 2010 was 3 398 540€. Most of the episodes (47.3%) corresponded to minor outpatient surgery. The costs of the episodes varied greatly according to the type of admission: 423€ (minor outpatient surgery), 1267€ (major outpatient surgery), and 1832€ (inpatient surgery). The average cost of an inpatient episode varied significantly depending on the calculation system used (ABC: 2328€ vs. DRG: 5674€). The ABC cost analysis system favours standardization of the care process for these tumours and the detection of areas to improve efficiency. This would enable more reliable economic studies than those obtained using traditional methods, such as the DRG. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

  14. Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?

    OpenAIRE

    Dutta, Mousumi; Husain, Zakir

    2012-01-01

    In recent years universal health coverage has become an important issue in developing countries. Successful introduction of such a social security system requires knowledge of the relationship between socio-economic status and usage of health care services. This paper examines this relationship, and analyzes the impact of introducing health insurance into the model, using data for India, a major developing country with poor health outcomes. In contrast to similar works undertaken for develope...

  15. Comparative economic evaluation of home-based and hospital-based palliative care for terminal cancer patients.

    Science.gov (United States)

    Kato, Koki; Fukuda, Haruhisa

    2017-11-01

    To quantify the difference between adjusted costs for home-based palliative care and hospital-based palliative care in terminally ill cancer patients. We carried out a case-control study of home-care patients (cases) who had died at home between January 2009 and December 2013, and hospital-care patients (controls) who had died at a hospital between April 2008 and December 2013. Data on patient characteristics were obtained from insurance claims data and medical records. We identified the determinants of home care using a multivariate logistic regression analysis. Cox proportional hazards analysis was used to examine treatment duration in both types of care, and a generalized linear model was used to estimate the reduction in treatment costs associated with home care. The case and control groups comprised 48 and 99 patients, respectively. Home care was associated with one or more person(s) living with the patient (adjusted OR 6.54, 95% CI 1.18-36.05), required assistance for activities of daily living (adjusted OR 3.61, 95% CI 1.12-10.51), non-use of oxygen inhalation therapy (adjusted OR 12.75, 95% CI 3.53-46.02), oral or suppository opioid use (adjusted OR 5.74, 95% CI 1.11-29.54) and transdermal patch opioid use (adjusted OR 8.30, 95% CI 1.97-34.93). The adjusted hazard ratio of home care for treatment duration was not significant (adjusted OR 0.95, 95% CI 0.59-1.53). However, home care was significantly associated with a reduction of $7523 (95% CI $7093-7991, P = 0.015) in treatment costs. Despite similar treatment durations between the groups, treatment costs were substantially lower in the home-care group. These findings might inform the policymaking process for improving the home-care support system. Geriatr Gerontol Int 2017; 17: 2247-2254. © 2017 Japan Geriatrics Society.

  16. The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues.

    Science.gov (United States)

    Christophi, Costas A; Paisi, Martha; Pampaka, Despina; Kehagias, Martha; Vardavas, Constantine; Connolly, Gregory N

    2013-01-27

    Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation's effect on revenue and employment. Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p < 0.0001). Furthermore, in the year following the ban, the hotel turnover rate increased by 4.1% and the restaurant revenue by 6.4%; employment increased that same year by 7.2% and 1.0%, respectively. Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

  17. Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series.

    Science.gov (United States)

    Rodriguez-Jimenez, Roberto; Bagney, Alexandra; Torio, Iosune; Caballero, Montserrat; Ruiz, Pedro; Rivas, Francisco de Paula Jose; Jimenez-Arriero, Miguel Angel

    2015-01-01

    Continuation/maintenance electroconvulsive therapy has been shown to be effective for prevention of relapse in affective and psychotic disorders. However, there is a limited nubber of studies that investigate clinical management, associated costs, and perceived quality variables. A series of 8 cases included during the first 18 months of the Continuation/Maintenance Electroconvulsive Therapy Program of the Psychiatry Department at 12 de Octubre University Hospital is presented. Clinical variables (Clinical Global Impression-Improvement Scale, length of hospitalization, number of Emergency Department visits, number of urgent admissions) before and after inclusion in the continuation/maintenance electroconvulsive therapy program were compared for each patient, as well as associated costs and perceived quality. After inclusion in the program, 50.0% of patients reported feeling « much better » and 37.5% « moderately better » in the Clinical Global Impression-Improvement Scale. In addition, after inclusion in the continuation/maintenance electroconvulsive therapy program, patients were hospitalized for a total of 349 days, visited the Emergency Department on 3 occasions, and had 2 urgent admissions, compared to 690 days of hospitalization (P = .012), 26 Emergency Department visits (P = .011) and 22 urgent admissions (P = .010) during the same period before inclusion in the program. Associated direct costs per day of admission were reduced to 50.6% of the previous costs, and costs associated with Emergency Department visits were reduced to 11.5% of the previous costs. As regards perceived quality, 87.5% of patients assessed the care and treatment received as being « very satisfactory », and 12.5% as « satisfactory ». This continuation/maintenance electroconvulsive therapy program has shown to be clinically useful and to have a favourable economic impact, as well as high perceived quality. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights

  18. Trauma na infância e adolescência: epidemiologia, tratamento e aspectos econômicos em um hospital público Epidemiology, treatment and economical aspects of multiple trauma in children and adolescents in a public hospital

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo da Silveira Franciozi

    2008-01-01

    Full Text Available INTRODUÇÃO: A realização deste trabalho foi motivada pela escassez de artigos encontrados na literatura que estudam o politrauma na infância e na adolescência.. O objetivo é descrever o perfil epidemiológico das lesões traumáticas na infância tratadas num centro de trauma, avaliar os aspectos econômicos relacionados com o gasto hospitalar e o tempo de internação de acordo com o tratamento realizado. MATERIAIS E MÉTODOS: analisamos todos os prontuários do hospital Geral de Pirajussara no período de dezembro de 2005 a dezembro de 2006. Obtivemos 182 pacientes, sendo 71% do sexo masculino e 29% do feminino; 48% brancos e 52% não brancos. RESULTADOS: houve predominância dos indivíduos do sexo masculino com 71% dos pacientes. O mecanismo de trauma mais freqüente foi a queda (36%. A média de dias de internação foi 4,1 dias, com gasto estimado de R$ 649,50 para cada paciente. A taxa de mortalidade foi de 2,74%, sendo o traumatismo crânio-encefálico responsável por 80% da mortalidade e os maus tratos presentes em 40% dos óbitos. CONCLUSÃO: a população pediátrica tem particularidades que a tornam distinta da população adulta em relação à epidemiologia e manejo das lesões.INTRODUCTION: the motivation to conduct this study was the reduced number of articles in literature correlating multiple trauma in childhood and infancy. The objective here was to describe the epidemiological profile of traumatic injuries treated in a trauma center, evaluating the economic aspects associated with hospitalized patients' costs and the period of hospital stay according to the treatment provided. MATERIAL AND METHODS: we assessed all Pirajussara Hospital patients' files in the period of December of 2005 to December 2006. We selected 182 patients, 129 (71% males and 53 (29% females; 88 (48% Caucasian and 94 (52% non-Caucasian children. RESULTS: male patients were prevalent, with 129 (71% cases. The most frequent trauma mechanism was fall

  19. Economic evaluation of a 100% smoke-free law on the hospitality industry in an Argentinean province.

    Science.gov (United States)

    Candioti, Carlos; Rossini, Gustavo; Depetris de Guiguet, Edith; Costa, Oscar; Schoj, Verónica

    2012-06-01

    To assess the economic impact of a 100% smoke-free law on bars and restaurants in an Argentinean province. We conducted a time series analysis of restaurant and bar revenues in the province of Santa Fe 31 months before and 29 months after the implementation of the 100% smoke-free environment law. The neighboring province of Entre Rios without smoking restrictions at the time of this study, was used as the control province. Average taxable revenues post-legislation in the province of Santa Fe as a whole and in the two most important cities were higher when compared to the total provincial revenue pre-legislation. No significant differences were observed with the total revenue from the province of Entre Rios. We found no statistically significant evidence that the 100% smoke-free environment legislation in the province of Santa Fe, Argentina, had a negative impact on the revenues of local bars and restaurants.

  20. Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis.

    Science.gov (United States)

    Charalambous, Marianna; Konstantinos, Mitosis; Talias, Michael A

    2017-04-01

    In this article, we present the data related to motivational factors given by the medical (n=118) and nursing (n=217) staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015) [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial). The data contains 4 parts: (1) demographics, (2) assessment of the degree to which this hospital provided such incentives-rewards, (3) personal assessment of the participants about the significance of these incentive-rewards and (4) to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses) for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

  1. The impact of economic rationalization, prioritization and rationing on job satisfaction, motivation and team cohesion in hospitals: a survey among retired physician executives in Germany.

    Science.gov (United States)

    Schnoor, Joerg; Braehler, Elmar; Ghanem, Mohamed; Heyde, Christoph E

    2017-01-01

    The growing economization of the health care system and implication of market principles in the medical field have risen new and serious questions on the meaning of the medical profession, the doctor-patient relationship and the orientation of medicine itself. The impact of the dynamic clinical structures on the doctor-doctor and the doctor-patient interaction appear even unpredictable. Therefore, the impact of market-based methods, i.e. rationalization, prioritization and rationing, on job satisfaction, motivation and team cohesion should be quantified. The experiences of former and now retired physician executives in numerous hospitals in Saxony were determined. For this purpose, an anonymously written survey using a standardized questionnaire was conducted in the first quarter of 2016. Rationalization measures were confirmed by 88% of respondents. In more than a third of cases, former executives also experienced prioritization and rationing. The impact of these management techniques on job satisfaction, motivation and team cohesion was carried out in a differentiated manner. There was a tendency to regard rationalization and prioritization measures indifferently to rather disadvantageous, while rationing was predominantly rated negatively. In addition to rationalization, prioritization and rationing measures have now been part of working strategy at the hospitals. On one hand, the conceptual distinction between the terms still seems imprecise; on the other hand, a creeping and imperceptible medico-ethical transgression of the prioritization to rationing seems to have already taken place.

  2. Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis

    Directory of Open Access Journals (Sweden)

    Marianna Charalambous

    2017-04-01

    Full Text Available In this article, we present the data related to motivational factors given by the medical (n=118 and nursing (n=217 staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015 [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial. The data contains 4 parts: (1 demographics, (2 assessment of the degree to which this hospital provided such incentives-rewards, (3 personal assessment of the participants about the significance of these incentive-rewards and (4 to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

  3. [Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].

    Science.gov (United States)

    Knobe, M; Böttcher, B; Coburn, M; Friess, T; Bollheimer, L C; Heppner, H J; Werner, C J; Bach, J-P; Wollgarten, M; Poßelt, S; Bliemel, C; Bücking, B

    2018-04-19

    Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). There was a clear tendency to a better overall

  4. Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation.

    Science.gov (United States)

    Gates, Simon; Lall, Ranjit; Quinn, Tom; Deakin, Charles D; Cooke, Matthew W; Horton, Jessica; Lamb, Sarah E; Slowther, Anne-Marie; Woollard, Malcolm; Carson, Andy; Smyth, Mike; Wilson, Kate; Parcell, Garry; Rosser, Andrew; Whitfield, Richard; Williams, Amanda; Jones, Rebecca; Pocock, Helen; Brock, Nicola; Black, John Jm; Wright, John; Han, Kyee; Shaw, Gary; Blair, Laura; Marti, Joachim; Hulme, Claire; McCabe, Christopher; Nikolova, Silviya; Ferreira, Zenia; Perkins, Gavin D

    2017-03-01

    Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA. Pragmatic, cluster randomised trial including adults with non-traumatic OHCA. Ambulance dispatch staff and those collecting the primary outcome were blind to treatment allocation. Blinding of the ambulance staff who delivered the interventions and reported initial response to treatment was not possible. We also conducted a health economic evaluation and a systematic review of all trials of out-of-hospital mechanical chest compression. Four UK ambulance services (West Midlands, North East England, Wales and South Central), comprising 91 urban and semiurban ambulance stations. Clusters were ambulance service vehicles, which were randomly assigned (approximately 1 : 2) to the LUCAS-2 device or manual CPR. Patients were included if they were in cardiac arrest in the out-of-hospital environment. Exclusions were patients with cardiac arrest as a result of trauma, with known or clinically apparent pregnancy, or aged CPR groups [193/2819, 6.8%; adjusted odds ratio (OR) 0.86, 95% confidence interval (CI) 0.64 to 1.15]. Survival with a CPC score of 1 or 2 may have been worse in the LUCAS-2 group (adjusted OR 0.72, 95% CI 0.52 to 0.99). No serious adverse events were noted. The systematic review found no evidence of a survival advantage if mechanical chest compression was used. The health economic analysis showed that LUCAS-2 was dominated by manual chest compression. There was substantial non-compliance in the LUCAS-2 arm. For 272 out of 1652 patients (16.5%), mechanical

  5. Impact of a hand hygiene campaign in a tertiary hospital in South Korea on the rate of hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and economic evaluation of the campaign.

    Science.gov (United States)

    Chun, June Young; Seo, Hye Kyung; Kim, Min-Kyung; Shin, Myoung Jin; Kim, Su Young; Kim, Moonsuk; Kim, Chung-Jong; Song, Kyoung-Ho; Kim, Eu Suk; Lee, Heeyoung; Kim, Hong Bin

    2016-12-01

    Hand hygiene (HH) is the most important factor affecting health care-associated infections. We introduced a World Health Organization HH campaign in October 2010. The monthly procurement of hand sanitizers per 1,000 patient days was calculated, and the monthly incidence of methicillin-resistant Staphylococcus aureus bacteremia (MRSAB), classified into community- and hospital-onset (HO), was measured from a microbiologic laboratory database. Trends of MRSAB incidence were assessed using Bayesian structural time series models. A cost-benefit analysis was also performed based on the economic burden of HO MRSAB in Korea. Procurement of hand sanitizers increased 134% after the intervention (95% confidence interval [CI], 120%-149%), compared with the preintervention period (January 2008-September 2010). In the same manner, HH compliance improved from 33.2% in September 2010 to 92.2% after the intervention. The incidence of HO MRSAB per 100,000 patient days decreased 33% (95% CI, -57% to -7.8%) after the intervention. Because there was a calculated reduction of 65 HO MRSAB cases during the intervention period, the benefit outweighed the cost (total benefit [$851,565]/total cost [$167,495] = 5.08). Implementation of the HH campaign led to increased compliance and significantly reduced HO MRSAB incidence; it was also cost saving. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. ELEMENTAL FORMS OF HOSPITALITY

    OpenAIRE

    Maximiliano Emanuel Korstanje

    2010-01-01

    Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

  7. Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996-2005

    DEFF Research Database (Denmark)

    Hannerz, Harald; Dalhoff, Kim; Burr, Hermann

    2014-01-01

    Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people.......74 for the economic activities groups). We observed, however, one markedly contradictive result; the industrial group entitled 'general practitioner, dentists etc.' was associated both with significantly high rates of medicine usage (SHR = 1.15, 95% CI: 1.12-1.19) and significantly low rates of hospital treatment...... or death due to IHD (SHR = 0.80, 95% CI: 0.71-0.91). CONCLUSION: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine...

  8. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... hospitals and improve access to healthcare by keeping essential services in rural communities. To accomplish this goal, ...

  9. Frequency and risk factors of COPD exacerbations and hospitalizations: a nationwide study in Greece (Greek Obstructive Lung Disease Epidemiology and health ecoNomics: GOLDEN study).

    Science.gov (United States)

    Alexopoulos, Evangelos C; Malli, Foteini; Mitsiki, Eirini; Bania, Eleni G; Varounis, Christos; Gourgoulianis, Konstantinos I

    2015-01-01

    COPD exacerbations and hospitalizations have been associated with poor prognosis for the COPD patient. To evaluate the frequency and risk factors of COPD exacerbations, hospitalizations, and admissions to intensive care units (ICUs) in Greece by a nationwide cross-sectional study. A nationwide observational, multicenter, cross-sectional study was conducted in the clinical practice setting of respiratory medicine physicians over a 6 month-period (October 2010 to March 2011). A total of 6,125 COPD patients were recruited by 199 respiratory physicians. Participants had a median age of 68.0 years, 71.3% were males, and 71.8% suffered from comorbidities. The median disease duration was 10.0 years. Of the patients, 45.3% were classified as having GOLD (Global initiative for chronic Obstructive Lung Disease) stage III or IV COPD. Patients with four or more comorbidities had 78.5% and threefold-higher than expected number of exacerbations and hospitalizations, respectively, as well as fivefold-higher risk of admission to the ICU compared to those with no comorbidities. Obese patients had 6.2% fewer expected exacerbations compared to those with a normal body mass index. Patients with GOLD stage IV had 74.5% and fivefold-higher expected number of exacerbations and hospitalizations, respectively, and nearly threefold-higher risk of admission to the ICU compared to stage I patients. An additional risk factor for exacerbations and hospitalizations was low compliance with treatment: 45% of patients reported forgetting to take their medication, and 81% reported a preference for a treatment with a lower dosing frequency. Comorbidities, disease severity, and compliance with treatment were identified as the most notable risk factors for exacerbations, hospitalizations, and ICU admissions. The results point to the need for a multifactorial approach for the COPD patient and for the development of strategies that can increase patient compliance with treatment.

  10. Frequency and risk factors of COPD exacerbations and hospitalizations: a nationwide study in Greece (Greek Obstructive Lung Disease Epidemiology and health ecoNomics: GOLDEN study

    Directory of Open Access Journals (Sweden)

    Alexopoulos EC

    2015-12-01

    Full Text Available Evangelos C Alexopoulos,1 Foteini Malli,2 Eirini Mitsiki,3 Eleni G Bania,2 Christos Varounis,3 Konstantinos I Gourgoulianis1 1School of Social Sciences, Hellenic Open University, Patras, 2Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa, 3Medical Department, Novartis Hellas, Athens, Greece Background: COPD exacerbations and hospitalizations have been associated with poor prognosis for the COPD patient.Objective: To evaluate the frequency and risk factors of COPD exacerbations, hospitalizations, and admissions to intensive care units (ICUs in Greece by a nationwide cross-sectional study.Materials and methods: A nationwide observational, multicenter, cross-sectional study was conducted in the clinical practice setting of respiratory medicine physicians over a 6 month-period (October 2010 to March 2011. A total of 6,125 COPD patients were recruited by 199 respiratory physicians.Results: Participants had a median age of 68.0 years, 71.3% were males, and 71.8% suffered from comorbidities. The median disease duration was 10.0 years. Of the patients, 45.3% were classified as having GOLD (Global initiative for chronic Obstructive Lung Disease stage III or IV COPD. Patients with four or more comorbidities had 78.5% and threefold-higher than expected number of exacerbations and hospitalizations, respectively, as well as fivefold-higher risk of admission to the ICU compared to those with no comorbidities. Obese patients had 6.2% fewer expected exacerbations compared to those with a normal body mass index. Patients with GOLD stage IV had 74.5% and fivefold-higher expected number of exacerbations and hospitalizations, respectively, and nearly threefold-higher risk of admission to the ICU compared to stage I patients. An additional risk factor for exacerbations and hospitalizations was low compliance with treatment: 45% of patients reported forgetting to take their medication, and 81% reported a

  11. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  12. Hospitality Occupations. Curriculum Guide.

    Science.gov (United States)

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  13. socio-economic population

    African Journals Online (AJOL)

    not ideal, underscores the peculiarities of experience in a general hospital in a low socio-economic setting. In conclusion, hernia surgery in a general hospital setting can be safely performed with the judicious use of intravenous Kctamine in children and emergency adult surgery as long as awareness of its side-effects and.

  14. Retrospective economic analysis of the transfer of services from hospitals to the community: an application to an enhanced eye care service.

    Science.gov (United States)

    Mason, Thomas; Jones, Cheryl; Sutton, Matt; Konstantakopoulou, Evgenia; Edgar, David F; Harper, Robert A; Birch, Stephen; Lawrenson, John G

    2017-07-10

    This research aims to evaluate the wider health system effects of the introduction of an intermediate-tier service for eye care. This research employs the Minor Eye Conditions Scheme (MECS), an intermediate-tier eye care service introduced in two London boroughs, Lewisham and Lambeth, in April 2013. Retrospective difference-in-differences analysis comparing changes over time in service use and costs between April 2011 and October 2014 in two commissioning areas that introduced an intermediate-tier service programme with changes in a neighbouring area that did not introduce the programme. MECS audit data; unit costs for MECS visits; volumes of first and follow-up outpatient attendances to hospital ophthalmology; the national schedule of reference costs. Volumes and costs of patients treated. In one intervention area (Lewisham), general practitioner (GP) referrals to hospital ophthalmology decreased differentially by 75.2% (95% CI -0.918% to -0.587%) for first attendances, and by 40.3% for follow-ups (95% CI -0.489% to -0.316%). GP referrals to hospital ophthalmology decreased differentially by 30.2% (95% CI -0.468% to -0.137%) for first attendances in the other intervention area (Lambeth). Costs increased by 3.1% in the comparison area between 2011/2012 and 2013/2014. Over the same period, costs increased by less (2.5%) in one intervention area and fell by 13.8% in the other intervention area. Intermediate-tier services based in the community could potentially reduce volumes of patients referred to hospitals by GPs and provide replacement services at lower unit costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Economic analysis of two-stage septic revision after total hip arthroplasty: What are the relevant costs for the hospital's orthopedic department?

    Science.gov (United States)

    Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S

    2016-03-01

    The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.

  16. The impact of socio-economic disadvantage on rates of hospital separations for diabetes-related foot disease in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Colman Peter G

    2011-06-01

    Full Text Available Abstract Background Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking. The aim of this study was to investigate variation in rates of hospital separations for diabetes related foot disease and the relationship with levels of social advantage and disadvantage. Methods Using the Index of Relative Socioeconomic Disadvantage (IRSD each local government area (LGA across Victoria was ranked from most to least disadvantaged. Those LGAs ranked at the lowest end of the scale and therefore at greater disadvantage (Group D were compared with those at the highest end of the scale (Group A, in terms of total and per capita hospital separations for peripheral neuropathy, peripheral vascular disease, foot ulceration, cellulitis and osteomyelitis and amputation. Hospital separations data were compiled from the Victorian Admitted Episodes Database. Results Total and per capita separations were 2,268 (75.3/1,000 with diabetes and 2,734 (62.3/1,000 with diabetes for Group D and Group A respectively. Most notable variation was for foot ulceration (Group D, 18.1/1,000 versus Group A, 12.7/1,000, rate ratio 1.4, 95% CI 1.3, 1.6 and below knee amputation (Group D 7.4/1,000 versus Group A 4.1/1,000, rate ratio 1.8, 95% CI 1.5, 2.2. Males recorded a greater overall number of hospital separations across both socioeconomic strata with 66.2% of all separations for Group D and 81.0% of all separations for Group A recorded by males. However, when comparing mean age, males from Group D tended to be younger compared with males from Group A (mean age; 53.0 years versus 68.7 years. Conclusion Variation appears to exist for hospital separations for diabetes related foot disease across socioeconomic strata. Specific strategies should be incorporated into health policy and planning to combat disparities between health outcomes and social status.

  17. ELEMENTAL FORMS OF HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje

    2010-11-01

    Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin.  Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.

  18. The economic costs of intrapartum care in Tower Hamlets: A comparison between the cost of birth in a freestanding midwifery unit and hospital for women at low risk of obstetric complications.

    Science.gov (United States)

    Schroeder, Liz; Patel, Nishma; Keeler, Michelle; Rocca-Ihenacho, Lucia; Macfarlane, Alison J

    2017-02-01

    to compare the economic costs of intrapartum maternity care in an inner city area for 'low risk' women opting to give birth in a freestanding midwifery unit compared with those who chose birth in hospital. micro-costing of health service resources used in the intrapartum care of mothers and their babies during the period between admission and discharge, data extracted from clinical notes. the Barkantine Birth Centre, a freestanding midwifery unit and the Royal London Hospital's consultant-led obstetric unit, both run by the former Barts and the London NHS Trust in Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. maternity records of 333 women who were resident in Tower Hamlets and who satisfied the Trust's eligibility criteria for using the Birth Centre. Of these, 167 women started their intrapartum care at the Birth Centre and 166 started care at the Royal London Hospital. women who planned their birth at the Birth Centre experienced continuous intrapartum midwifery care, higher rates of spontaneous vaginal delivery, greater use of a birth pool, lower rates of epidural use, higher rates of established breastfeeding and a longer post-natal stay, compared with those who planned for care in the hospital. The total average cost per mother-baby dyad for care where mothers started their intrapartum care at the Birth Centre was £1296.23, approximately £850 per patient less than the average cost per mother and baby who received all their care at the Royal London Hospital. These costs reflect intrapartum throughput using bottom up costing per patient, from admission to discharge, including transfer, but excluding occupancy rates and the related running costs of the units. the study showed that intrapartum throughput in the Birth Centre could be considered cost-minimising when compared to hospital. Modelling the financial viability of midwifery units at a local level is important because it can inform the appropriate provision of these

  19. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  20. Increasing hospital admission rates and economic burden for colorectal cancer in Brazil, 1996-2008 Aumento de las tasas de ingresos hospitalarios por cáncer colorrectal y su carga económica en Brasil, 1996-2008

    Directory of Open Access Journals (Sweden)

    Ulysses dos Santos Torres

    2010-10-01

    Full Text Available OBJECTIVE: To determine the trends in hospital admission rates for colorectal cancer (CRC in the Brazilian Public Health System from 1996 to 2008 and to assess the economic costs. METHODS: Data from the Hospital Information Systems database of the Brazilian Unified Health System were used for analysis of all admissions with a primary diagnosis of CRC between 1996 and 2008. RESULTS: There were 297 108 CRC admissions over the study period, with an annual increase from 12 821 in 1996 to 35 040 in 2008. Age-standardized admission rates increased from 8.7 to 23.56 per 100 000 for a percentage increase of 171%. The average length of stay decreased from 11.6 days in 1996 to 7.5 days in 2008. The average hospital mortality declined from 10.4% to 8.5%. Overall costs in United States dollars (US$ of CRC hospitalizations rose from US$ 16.5 million in 1996 to US$ 33.5 million in 2008; the average cost of each admission, however, decreased from US$ 1 283 to US$ 954. CONCLUSIONS: Hospitalization rates for CRC in Brazil significantly increased during a 13-year period, incurring a considerable rise in the inflation-adjusted economic burden; national in-hospital mortality rates have remained relatively high.OBJETIVO: Determinar las tendencias de las tasas de ingresos hospitalarios por cáncer colorrectal (CCR en el sistema de salud pública brasileño de 1996 al 2008 y evaluar sus costos económicos. MÉTODOS: Se utilizó la información de la base de datos de los sistemas de información de los hospitales del Sistema Único de Salud brasileño con objeto de analizar todos los ingresos con diagnóstico primario de CCR entre 1996 y el 2008. RESULTADOS: Durante el período de estudio, se produjeron 297 108 ingresos por CCR, con un aumento anual de 12 821 en 1996 a 35 040 en el 2008. Las tasas de ingresos estandarizadas según la edad aumentaron de 8,7 a 23,56 por 100 000, con un aumento porcentual de 171%. La estancia hospitalaria media disminuyó de 11,6 días en

  1. Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent's University Hospital over a 6-month period.

    Science.gov (United States)

    Lambe, J; Noone, I; Lonergan, R; Tubridy, N

    2018-02-01

    Fabry disease is an X-linked recessive lysosomal storage disorder that provokes multi-organ morbidity, including early-onset stroke. Worldwide prevalence may be greater than previously estimated, with many experiencing first stroke prior to diagnosis of Fabry disease. The aim of this study is to screen a cohort of stroke patients under 70 years of age, evaluating the clinical and economic efficacy of such a broad screening programme for Fabry disease. All stroke patients under 70 years of age who were entered into the Saint Vincent's University Hospital stroke database over a 6-month period underwent enzyme analysis and/or genetic testing as appropriate for Fabry disease. Patients' past medical histories were analysed for clinical signs suggestive of Fabry disease. Cost-effectiveness analysis of testing was performed and compared to overall economic impact of young stroke in Ireland. Of 22 patients tested for Fabry disease, no new cases were detected. Few clinical indicators of Fabry disease were identified at the time of testing. Broad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history.

  2. Research in Hospitality Management: Editorial Policies

    African Journals Online (AJOL)

    Research in Hospitality Management is a peer-reviewed journal publishing papers that ... financial management, marketing, strategic management, economics, ... Articles covering social theory and the history and politics of the hospitality ...

  3. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  4. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  5. Community Economics

    OpenAIRE

    武藤, 宣道; Nobumichi, MUTOH

    2000-01-01

    This paper examines the new field of community economics with respect to Japan. A number of studies in community economics have already been produced in OECD countries including the United States. Although these are of great interest, each country has its own historical, socioeconomic context and must therefore develop its own approach to community economics. Community-oriented economics is neither macro-nor micro-economics in the standard economics textbook sense. Most community economics st...

  6. Introduction: Special Issue on Hospitality

    OpenAIRE

    Ruth Rios-Morales; Ian Jenkins

    2012-01-01

    In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...

  7. Introduction: Special issue in hospitality

    OpenAIRE

    Ríos-Morales, Ruth; Jenkins, Ian

    2012-01-01

    In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...

  8. Hospitals : a design manual

    NARCIS (Netherlands)

    Wagenaar, C.; Mens, N.

    Hospitals as a building type have undergone a substantial evolution in the past years. Changes in healthcare, the impact of evidence-based medicine and aspects of healthcare economics (such as the clustering of diagnostic procedures in specialized clinics) pose new and different challenges for the

  9. Enhancing hospital productivity

    NARCIS (Netherlands)

    van Hulst, B.L.

    2016-01-01

    Healthcare expenditure in Western countries is substantial and outpaces economic growth, therefore cost containment in healthcare is high on the political agenda. One option is to increase productivity in healthcare, do more with less. This thesis uses the Dutch hospitals as a case-study and

  10. Radiobioassay economics and laboratory management

    International Nuclear Information System (INIS)

    Gilchrist, J.

    1983-01-01

    The economic situation faced by laboratories in the US is less than ideal. Inflation/interest rates are in the area of 10 to 20% per year, reimbursement policies are putting pressures on the laboratories, hospitals are in a cost-containment mode in the best of cases, and in the worst, are closing for a lack of funds. In the past six years, there has been a national net loss of 186 hospitals, according to American Hospital Association figures. The pressure is acute on community hospitals; 135 have failed. Many hospitals (160) have applied for federal grants as financially distressed hospitals. Since the community hospitals account for 85% of all admissions in the US, it is obvious that the pressure has been greatest on the hospitals that account for the greatest number of admissions. To put the general economic scene in perspective, according to 1977 Medicare data, 24% of all community hospitals had total expenses that exceeded their total revenues. Many social and economic factors contribute to this picture, but the rapidly rising operating expenses due to inflation, new high cost medical technology, surplus of hospital beds, and inadequate planning, purchasing, accounting, and hiring practices play a noticeable part in contributing to this problem

  11. Hospital 360°.

    Science.gov (United States)

    Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

    2015-01-01

    There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.

  12. La cogeneración aplicada a la climatización de hospitales. Particularidades en el marco económico cubano // The cogeneration applied to the hospital air conditioning. Particularities in the Cuban economic situation

    Directory of Open Access Journals (Sweden)

    J. Madariaga Arrizurieta

    1999-01-01

    Full Text Available En el trabajo se desarrolla un análisis para la implementación de la Cogeneración como solución energética integral, quepermite elevar la eficiencia de determinados centros hospitalarios.Se lleva a cabo una valoración que demuestra la efectividad económica de la Cogeneración y se realizan importantescomparaciones encaminadas a la aplicación de este proceso en centros con características similares.Palabras claves: Cogeneración, cl imat ización, ef iciencia, hospi tales._________________________________________________________________________AbstractAn analysis is developed for implementation of cogeneration as integral energy solution that it allows elevating the efficiencyof certain hospital centers. It is carried out a valuation that demonstrates the economic effectiveness of the cogeneration.Several important comparisons are made for the application of this process in centers with characteristic similar.Key words: Cogenerat ion, ef f iciency energy, hospi tal center, air condi t ioning.

  13. Quantum economics

    Directory of Open Access Journals (Sweden)

    Vukotić Veselin

    2011-01-01

    Full Text Available The globalization is breaking-down the idea of national state, which was the base for the development of economic theory which is dominant today. Global economic crisis puts emphasis on limited possibilities of national governments in solving economic problems and general problems of society. Does it also mean that globalization and global economic crisis points out the need to think about new economic theory and new understanding of economics? In this paper I will argue that globalization reveals the need to change dominant economic paradigm - from traditional economic theory (mainstream with macroeconomic stability as the goal of economic policy, to the “quantum economics“, which is based on “economic quantum” and immanent to the increase of wealth (material and non-material of every individual in society and promoting set of values immanent to the wealth increase as the goal of economic policy. Practically the question is how we can use global market for our development!

  14. Hospitality, Tourism, and Politics

    Directory of Open Access Journals (Sweden)

    Stephen W. Litvin

    2012-09-01

    Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.

  15. Global Dynamics in Travel, Tourism, and Hospitality

    OpenAIRE

    Pappas, Nikolaos; Bregoli, Ilenia

    2016-01-01

    Worldwide, tourism is the third largest economic activity in direct earnings after petroleum and automobile industries, and by far the largest one if indirect earnings are also taken into consideration. Taking into account the profound economic impact the tourism and hospitality industries can have on regions and cities around the world, further research in this area is critical.\\ud \\ud Global Dynamics in Travel, Tourism, and Hospitality takes a holistic approach to tourism and hospitality op...

  16. Economic Theory, Economic Reality And Economic Policy

    Directory of Open Access Journals (Sweden)

    Dmitry Evgenievich Sorokin

    2015-03-01

    Full Text Available This paper analyzes the opposition between the «liberals» and «statists» in the Russian political and economic thought. It demonstrates that the economic liberalization is an absolute prerequisite for the transition to sustainable socio-economic development. Such development must rely on investment activities of the state, which in the current circumstances is a necessary but not sufficient measure for reversing the negative trends. The negative developments can be prevented only through implementation, along with the institutional changes in the economic area that form a strata of economically independent entrepreneurs-innovators, of no less profound transformation in political institutions aimed at democratization of public life

  17. Internet economics

    DEFF Research Database (Denmark)

    Henten, Anders; Skouby, Knud Erik; Øst, Alexander Gorm

    1997-01-01

    A paper on the economics of the Internet with respect to end user pricing and pricing og interconnect.......A paper on the economics of the Internet with respect to end user pricing and pricing og interconnect....

  18. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  19. Economic Development

    Science.gov (United States)

    Recruitment Events Community Commitment Giving Campaigns, Drives Economic Development Employee Funded : Environmental Documents, Reports LANL Home Calendar Search Contacts Community » Economic Development LANL 75th logo Economic Development Los Alamos National Laboratory is committed to investing and partnering in

  20. Economic Studies

    Directory of Open Access Journals (Sweden)

    A. V. Kholopov

    2014-01-01

    Full Text Available The establishment of the School of Economic Science at MGIMO was due to the necessity of the world economy research, and the need to prepare highly skilled specialists in international economics. The school is developing a number of areas, which reflect the Faculty structure. - Economic theory is one of the most important research areas, a kind of foundation of the School of Economic Science at MGIMO. Economic theory studies are carried out at the chair of Economic theory. "The course of economic theory" textbook was published in 1991, and later it was reprinted seven times. Over the past few years other textbooks and manuals have been published, including "Economics for Managers" by Professor S.N. Ivashkovskaya, which survived through five editions; "International Economics" - four editions and "History of Economic Thought" - three editions. - International Economic Relations are carried out by the Department of International Economic Relations and Foreign Economic Activity. Its establishment is associated with the prominent economist N.N. Lyubimov. In 1957 he with his colleagues published the first textbook on the subject which went through multiple republications. The editorial team of the textbook subsequently formed the pride of Soviet economic science - S.M. Menshikov, E.P. Pletnev, V.D. Schetinin. Since 2007, the chair of Foreign Economic Activities led by Doctor of Economics, Professor I. Platonova has been investigating the problems of improving the architecture of foreign economic network and the international competitiveness of Russia; - The history of the study of problems of the world economy at MGIMO begins in 1958 at the chair baring the same name. Since 1998, the department has been headed by Professor A. Bulatov; - The study of international monetary relations is based on the chair of International Finance, and is focused on addressing the fundamental scientific and practical problems; - The chair "Banks, monetary circulation

  1. Economic Darwinism

    DEFF Research Database (Denmark)

    Sloth, Birgitte; Whitta-Jacobsen, Hans Jørgen

    2011-01-01

    We define an evolutionary process of "economic Darwinism" for playing the field, symmetric games. The process captures two forces. One is "economic selection": if current behavior leads to payoff differences, behavior yielding lowest payoff has strictly positive probability of being replaced...... in the literature. Using this result, we demonstrate that generally under positive (negative) externalities, economic Darwinism implies even more under- (over-)activity than does Nash equilibrium....

  2. Economic Darwinism

    DEFF Research Database (Denmark)

    Sloth, Birgitte; Whitta-Jacobsen, Hans Jørgen

    We define an evolutionary process of “economic Darwinism” for playing-the-field, symmetric games. The process captures two forces. One is “economic selection”: if current behavior leads to payoff differences, behavior yielding lowest payoff has strictly positive probability of being replaced...... in the literature. Using this result, we demonstrate that generally under positive (negative) externalities, economic Darwinism implies even more under- (over-) activity than does Nash equilibrium...

  3. Qualitative Economics

    DEFF Research Database (Denmark)

    Fast, Michael; Clark, Woodrow

    2012-01-01

    the everyday economic life is the central issue and is discussed from the perspective of interactionism. It is a perspective developed from the Lifeworld philosophical traditions, such as symbolic interactionism and phenomenology, seeking to develop the thinking of economics. The argument is that economics...... and the process of thinking, e.g. the ontology and the epistemology. Keywords: qualitative, interaction, process, organizing, thinking, perspective, epistemology....

  4. ECOLOGICAL ECONOMICS VS ECONOMIC(AL ECOLOGY

    Directory of Open Access Journals (Sweden)

    G. Kharlamova

    2015-10-01

    Full Text Available Currently world faces the dilemma – ecological economy or economic(al ecology. The researchers produce hundreds of surveys on the topic. However the analyses of recent most cited simulations had shown the diversity of results. Thus, for some states the Kuznets environmental curve has place, for others – no. Same could be said about different years for the same state. It provokes the necessity of drawing new group analyses to reveal the tendencies and relationships between economic and environmental factors. Most flexible and mirror factor of environmental sustainability is the volume of CO2 emissions. The econometric analysis was used for detecting the economic impact on this indicator at the global level and in the spectra of group of states depending on their income. The hypothesis of the existence of environmental Kuznets curve for the analysed data is rejected. Real GDP per capita impact on carbon dioxide emissions is considered only at the global level. The impact of openness of the economy is weak. Rejection happened also to the hypothesis that for the developed countries there is a reverse dependence between the environmental pollution and economic openness. Indicator “energy consumption per capita” impacts on greenhouse gas emissions only in countries with high income. Whereby it should be noted that the more developed a country is, the more elastic is this influence. These results have a potential usage for environmental policy regulation and climate strategy.

  5. Qualitative Economics

    DEFF Research Database (Denmark)

    Fast, Michael; Clark II, Woodrow W

                         This book is about science -- specifically, the science of economics. Or lack thereof is more accurate. The building of any science, let alone economics, is grounded in the understanding of what is beneath the "surface" of economics. Science, and hence economics, should...... be concerned with formulating ideas that express theories which produce descriptions of how to understand phenomenon and real world experiences.                       Economics must become a science, because the essence of economics in terms of human actions, group interactions and communities are in need...... of scientific inquiry. Academics and scholars need a scientific perspective that can hypothesize, theorize document, understand and analyze human dynamics from the individual to more societal interactions. And that is what qualitative economics does; it can make economics into becoming a science. The economic...

  6. "New Economics"?

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller

    1999-01-01

    The United States, the United Kingdom and Denmark have all enjoyed a long period of high stable growth and low inflation in the 1990s. Attempts to determine the implications of this have led to the so-called "New Economics", whose advocates claim that the relationship between economic growth...

  7. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  8. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  9. Ecological economics and economic growth.

    Science.gov (United States)

    Victor, Peter A

    2010-01-01

    Boulding's 1966 paper on the economics of spaceship Earth established the framework for ecological economics and an understanding of economic growth. In ecological economics, economies are conceptualized as open subsystems of the closed biosphere and are subject to biophysical laws and constraints. Economic growth measured as an increase in real gross domestic product (GDP) has generally been associated with increases in the use of energy and materials and the generation of wastes. Scale, composition, and technology are the proximate determinants of environmental impacts. They are often reduced to two: scale (GDP) and intensity (impact per unit GDP). New work described in this paper defines "green" growth as intensity that declines faster than scale increases. Similarly, "brown" growth occurs when intensity declines more slowly than increases in scale, and "black" growth happens when both scale and intensity increase. These concepts are then related to the environmental Kuznets curve, which can be understood as a transition from brown to green growth. Ecological economics provides a macroperspective on economic growth. It offers broad policy principles, and it challenges the primacy of economic growth as a policy objective, but many important questions remain.

  10. Development economics

    International Nuclear Information System (INIS)

    Roebuck, F.

    1992-01-01

    This paper discusses term development economics which refers to the economic evaluation of investment opportunities that occur after the discovery well is drilled and completed. with specific regard to the techniques used and the economic yardsticks available for investment decisions. Three potential situations are considered in this paper: the incorporation of development wells into the outcomes of the original exploration project, mutually exclusive or alternative investment opportunities, and the installation of improved or enhanced recovery projects during or at the end of the primary producing life of a property

  11. Economics of childbirth.

    Science.gov (United States)

    Fahy, Michael; Doyle, Orla; Denny, Kevin; McAuliffe, Fionnuala M; Robson, Michael

    2013-05-01

    Increasing birth rates have raised questions for policy makers and hospital management about the economic costs of childbirth. The purpose of this article is to identify and review all existing scientific studies in relation to the economic costs of alternative modes of childbirth delivery and to highlight deficiencies in the existing scientific research. We searched Cochrane, Centre for Reviews and Dissemination, EconLit, the Excerpta Medica Database, the Health Economic Evaluations Database, MEDLINE and PubMed. Thirty articles are included in this review. The main findings suggest that there is no internationally acceptable childbirth cost and clinical outcome classification system that allows for comparisons across different delivery modes. This review demonstrates that a better understanding and classification of the costs and associated clinical outcomes of childbirth is required to allow for valid comparisons between maternity units, and to inform policy makers and hospital management. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. [Controlling and operation management in hospitals].

    Science.gov (United States)

    Vagts, Dierk A

    2010-03-01

    The economical pressure on the health system and especially on hospitals is growing rapidly. Hence, economical knowledge for people in medical executive positions becomes imperative. In advanced and forward-looking hospitals controlling is gaining more and more weight, because it takes over a coordinative responsibility. Ideally controlling is navigating the teamwork of managers (CEOs) and medical executives by weighing medical necessities and economical framework. Controlling is contributing to evaluate an optimal efficiency of a hospital in a highly competitive surrounding by providing medical and economical data on a regular basis. A close, open-minded and trusting cooperation between all people, who are involved, is imperative. Hence, controlling in the proper meaning of the word can not flourish in dominant and hierarchic hospital structures. Georg Thieme Verlag Stuttgart * New York.

  13. Environmental Economics

    International Development Research Centre (IDRC) Digital Library (Canada)

    David Glover, Bhim Adhikari and Isabelle Proulx

    Economy and Environment Program for Southeast Asia. ERF. Economic ... economists can contribute to this work by estimating the monetary value of such environment-related benefits ... One of the few safe places to put money has been land, ...

  14. "New Economics"?

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller

    1999-01-01

    The United States, the United Kingdom and Denmark have all enjoyed a long period of high stable growth and low inflation in the 1990s. Attempts to determine the implications of this have led to the so-called "New Economics", whose advocates claim that the relationship between economic growth and ...... and inflation has fundamentally changes. The following article tests this thesis against current data for the USA.......The United States, the United Kingdom and Denmark have all enjoyed a long period of high stable growth and low inflation in the 1990s. Attempts to determine the implications of this have led to the so-called "New Economics", whose advocates claim that the relationship between economic growth...

  15. Exploration economics

    International Nuclear Information System (INIS)

    Mcgill, R.E.

    1992-01-01

    This paper deals with determining the economic viability of the play or prospect. At the outset, one point is important. Preexploration economists are important because they enable geologists to see if their assumptions will prove profitable. Their assumptions must consider the full range of possible outcomes, even if only some portion of that range may contain prospects or plays that are estimated to be profitable. Play economics are preferable to prospect economics because, being the sum of several prospects, they give a broader view of the investment opportunity. Finally, remember that play and prospect economics are always slightly optimistic. They seldom include all of the exploration and overhead changes that must ultimately be borne by the successful prospects

  16. Behavioral Economics

    OpenAIRE

    Sendhil Mullainathan; Richard H. Thaler

    2000-01-01

    Behavioral Economics is the combination of psychology and economics that investigates what happens in markets in which some of the agents display human limitations and complications. We begin with a preliminary question about relevance. Does some combination of market forces, learning and evolution render these human qualities irrelevant? No. Because of limits of arbitrage less than perfect agents survive and influence market outcomes. We then discuss three important ways in which humans devi...

  17. Building economics

    DEFF Research Database (Denmark)

    Pedersen, D.O.(red.)

    Publikationen er på engelsk. Den omfatter alle indlæg på det fjerde internationale symposium om byggeøkonomi, der blev arrangeret af SBI for det internationale byggeforskningsråd CIB. De fem bind omhandler: Methods of Economic Evaluation, Design Optimization, Ressource Utilization, The Building...... Market og Economics and Technological Forecasting in Construction. Et indledende bind bringer statusrapporter for de fem forskningsområder, og det sidste bind sammenfatter debatten på symposiet....

  18. Behavioral economics

    OpenAIRE

    Camerer, Colin F.

    2014-01-01

    Economics, like behavioral psychology, is a science of behavior, albeit highly organized human behavior. The value of economic concepts for behavioral psychology rests on (1) their empirical validity when tested in the laboratory with individual subjects and (2) their uniqueness when compared to established behavioral concepts. Several fundamental concepts are introduced and illustrated by reference to experimental data: open and closed economies, elastic and inelastic demand, and substitutio...

  19. Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil

    Directory of Open Access Journals (Sweden)

    Alvaro Koenig

    2010-09-01

    Full Text Available OBJETIVO: Analisar o impacto econômico de um protocolo de detecção precoce de sepse em dois hospitais gerais. MÉTODOS: Analisamos os dados colhidos em um estudo prospectivo em pacientes sépticos antes e após a implantação do protocolo de detecção precoce de sepse grave. Realizamos uma análise de custo-efetividade comparando: taxa de mortalidade, custo do tratamento da sepse e custos indiretos atribuídos a anos de vida produtiva perdidos por óbito prematuro em ambas as fases. RESULTADOS: Foram incluídos 217 pacientes, 102 na Fase I e 115 na Fase II. Após a implantação do protocolo, em hospital privado e em hospital público, as taxas de mortalidade caíram de 50% para 32,2%, e de 68,6% para 41% (pOBJECTIVE: To analyze the economic impact of an early sepsis detection protocol in two general hospitals. METHODS: We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a cost-effectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases. RESULTS: Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05. The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05, with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9.7 billion US dollars, varying based on the incidence of sepsis. Hospital costs were similar in both phases. CONCLUSION: A protocol for early detection and treatment of in-hospital septic patients is highly cost-effective from a societal

  20. HOSPITALITY TODAY AND TOMORROW

    Directory of Open Access Journals (Sweden)

    Ray F. IUNIUS

    2017-08-01

    Full Text Available As a wise man once said, “Don’t worry about what you don’t know. Be worried about what you think you know, but don’t.” Regarding different ways “hospitality” is understood, the root of the problem lies in part in the different interpretations that hospitality has in different cultures and languages. In American English, for example, when we speak about “hospitality” we first think of it as an industry and only secondarily as an attribute of an individual or community. In other cultures, the primary meaning of hospitality is more a characteristic of people, or of a country or city, etc., and encompasses such ideas as welcome, reception, amiability, generosity, etc. – not an industry! Even in American English, other words are sometimes used to describe the same economic activity: lodging, accommodation, etc.

  1. All-Round Marketing Increases Hospital Popularity.

    Science.gov (United States)

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  2. Voodoo Economics:Voodoo Economics

    OpenAIRE

    Briones Alonso, Elena

    2017-01-01

    This dissertation collects three essays that aim to contribute to the field of cultural economics. There is growing recognition among economists and policy makers that culture matters for economic development, but in many cases this trend has not resulted in a thorough understanding of the role of culture, or a proper integration of existing knowledge in policy. This is particularly true for the area of food security. The second chapter addresses this issue by reviewing existing cross-discipl...

  3. Segmentation in local hospital markets.

    Science.gov (United States)

    Dranove, D; White, W D; Wu, L

    1993-01-01

    This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice.

  4. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  5. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  6. Economic fables

    OpenAIRE

    Moran, Shane

    2010-01-01

    I had the good fortune to grow up in a wonderful area of Jerusalem, surrounded by a diverse range of people: Rabbi Meizel, the communist Sala Marcel, my widowed Aunt Hannah, and the intellectual Yaacovson. As far as I'm concerned, the opinion of such people is just as authoritative for making social and economic decisions as the opinion of an expert using a model. Part memoir, part crash-course in economic theory, this deeply engaging book by one of the world's foremost economists looks at ...

  7. The economic burden of Clostridium difficile

    Science.gov (United States)

    McGlone, S. M.; Bailey, R. R.; Zimmer, S. M.; Popovich, M. J.; Tian, Y.; Ufberg, P.; Muder, R. R.; Lee, B. Y.

    2013-01-01

    Although Clostridium difficile (C. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. We developed an economic computer simulation model to determine the costs attributable to healthcare-acquired C. difficile infection (CDI) from the hospital, third-party payer and societal perspectives. Sensitivity analyses explored the effects of varying the cost of hospitalization, C. difficile-attributable length of stay, and the probability of initial and secondary recurrences. The median cost of a case ranged from $9179 to $11 456 from the hospital perspective, $8932 to $11 679 from the third-party payor perspective, and $13 310 to $16 464 from the societal perspective. Most of the costs incurred were accrued during a patient’s primary CDI episode. Hospitals with an incidence of 4.1 CDI cases per 100 000 discharges would incur costs ≥$3.2 million (hospital perspective); an incidence of 10.5 would lead to costs ≥$30.6 million. Our model suggests that the annual US economic burden of CDI would be ≥$496 million (hospital perspective), ≥$547 million (third-party payer perspective) and ≥$796 million (societal perspective). Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease. PMID:21668576

  8. Economic considerations

    International Nuclear Information System (INIS)

    Burns, W.A. Jr.

    1980-01-01

    A brief qualitative comparison of the technical differences between liquid membranes and three other technologies: biological treatment, ion exchange and solvent extraction is presented. It is shown how the differences can result in substantial economic advantages. For uranium recovery from phosphoric acid a lower organic loss is achieved by the liquid membrane than by the solvent extraction process. (U.K.)

  9. Food economics

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    and issues and such as food security, quality, obesity and health are ever important factors. This book describes the link between food markets and food companies from a theoretical and a business economics perspective. The relationships, trends and impacts on the international food market are presented...

  10. Mystical Economics

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2012-04-01

    Full Text Available The world envisioned by Economics resembles the Garden of Eden, where everything came from God, the pre-primordial sin people having nothing else to do but wait for the natural rhythms, set by the invisible hand, which is moved by the will and the power of the Creator.

  11. Economic impact

    Energy Technology Data Exchange (ETDEWEB)

    Technology Transfer Department

    2001-06-01

    In federal fiscal year 2000 (FY00), Berkeley Lab had 4,347 full- and part-time employees. In addition, at any given time of the year, there were more than 1,000 Laboratory guests. These guests, who also reside locally, have an important economic impact on the nine-county Bay Area. However, Berkeley Lab's total economic impact transcends the direct effects of payroll and purchasing. The direct dollars paid to the Lab's employees in the form of wages, salaries, and benefits, and payments made to contractors for goods and services, are respent by employees and contractors again and again in the local and greater economy. Further, while Berkeley Lab has a strong reputation for basic scientific research, many of the Lab's scientific discoveries and inventions have had direct application in industry, spawning new businesses and creating new opportunities for existing firms. This analysis updates the Economic Impact Analysis done in 1996, and its purpose is to describe the economic and geographic impact of Laboratory expenditures and to provide a qualitative understanding of how Berkeley Lab impacts and supports the local community. It is intended as a guide for state, local, and national policy makers as well as local community members. Unless otherwise noted, this analysis uses data from FY00, the most recent year for which full data are available.

  12. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  13. Revisiting the relevance of economic theory to hotel revenue ...

    African Journals Online (AJOL)

    This paper explores the role of economics in hospitality education and industry practice, with a particular focus on revenue management, and puts forward an argument for a return to the inclusion of economic theory in UK hospitality education, not seen since the 1990s. Given the increasing amounts of pricing data available ...

  14. Economic enterprise during economic dowturn

    Directory of Open Access Journals (Sweden)

    Eugeniusz Niedzielski

    2015-12-01

    The analysis showed, among others, that after a marked deterioration in the small and medium-sized enterprises sector in 2009 there was a gradual improvement of the financial situation and development of companies. Also, last year the level of optimism of entrepreneurs in the perception of the economic situation increased significantly.

  15. Economic analysis

    International Nuclear Information System (INIS)

    Owen, P.S.; Parker, M.B.; Omberg, R.P.

    1979-03-01

    The methodology used to arrive at the conclusions in the U.S. papers WG 5A-19 and WG 5A-22 with respect to the economics of fast breeders relative to LWR's is developed in detail in this contribution. In addition, sample calculations of the total levelized power cost of a standard LWR at $40/pound for U 3 O 8 and an FBR at a capital cost of 1.5 times that of an LWR are included. The respective total levalized power costs of the above two examples are 21.29 mills/kwh for the standard LWR and 28.48 mills/kwh for the FBR. It should be noted that the economic data used in these analyses are contained in the U.S. contribution, WG 5A-41

  16. Circulation economics

    DEFF Research Database (Denmark)

    Ingebrigtsen, Stig; Jakobsen, Ove

    2006-01-01

    Purpose - This paper is an attempt to advance the critical discussion regarding environmental and societal responsibility in economics and business. Design/methodology/approach - The paper presents and discusses as a holistic, organic perspective enabling innovative solutions to challenges...... concerning the responsible and efficient use of natural resources and the constructive interplay with culture. To reach the goal of sustainable development, the paper argues that it is necessary to make changes in several dimensions in mainstream economics. This change of perspective is called a turn towards...... sustainability. To illustrate the theoretical discussion, the paper gives some practical examples from the reprocessing industry in Norway. Findings - The paper finds, first, effective and efficient use of natural resources is necessary to implement circular value chains. Second, sustainable development...

  17. Integrated economics

    International Nuclear Information System (INIS)

    Bratton, T.J.

    1992-01-01

    This article offers ideas for evaluating integrated solid waste management systems through the use of a conceptual cost overview. The topics of the article include the integrated solid waste management system; making assumptions about community characteristics, waste generation rates, waste collection responsibility, integrated system components, sizing and economic life of system facilities, system implementation schedule, facility ownership, and system administration; integrated system costs; integrated system revenues; system financing; cost projections; and making decisions

  18. Economic analysis

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-06-01

    The Energy Policy and Conservation Act (EPCA) mandated that minimum energy efficiency standards be established for classes of refrigerators and refrigerator-freezers, freezers, clothes dryers, water heaters, room air conditioners, home heating equipment, kitchen ranges and ovens, central air conditioners, and furnaces. EPCA requires that standards be designed to achieve the maximum improvement in energy efficiency that is technologically feasible and economically justified. Following the introductory chapter, Chapter Two describes the methodology used in the economic analysis and its relationship to legislative criteria for consumer product efficiency assessment; details how the CPES Value Model systematically compared and evaluated the economic impacts of regulation on the consumer, manufacturer and Nation. Chapter Three briefly displays the results of the analysis and lists the proposed performance standards by product class. Chapter Four describes the reasons for developing a baseline forecast, characterizes the baseline scenario from which regulatory impacts were calculated and summarizes the primary models, data sources and assumptions used in the baseline formulations. Chapter Five summarizes the methodology used to calculate regulatory impacts; describes the impacts of energy performance standards relative to the baseline discussed in Chapter Four. Also discussed are regional standards and other program alternatives to performance standards. Chapter Six describes the procedure for balancing consumer, manufacturer, and national impacts to select standard levels. Details of models and data bases used in the analysis are included in Appendices A through K.

  19. Economic analysis of intravenous immunoglobulin and plasma exchange therapies for the treatment of Guillain-Barré Syndrome in a university-based hospital in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Alexandre Paulo Machado de Brito

    2011-10-01

    Full Text Available Introduction: Direct costs for treating Guillain-Barré Syndrome (GBS represent a significant financial burden to public hospitals. Few studies compared the cost of plasma exchange (PE treatment with human intravenous immunoglobulin (IVIg. Objectives: To compare the cost of two therapies for GBS: IVIg and PE. Secondary objective was to evaluate compliance to IVIg prescription guidelines of the Pharmacy and Therapeutics Committee (PTC. Methods: A cross-sectional study included 25 patients with GBS admitted in a university affiliated hospital from June, 2003 through June, 2008. The costs of IVIg (n=20 and PE (n=5 were evaluated through the cost minimization method, considering direct medical costs yield by the management of the institution. Patients receiving treatments other than PE or IVIg were excluded. Data were collected by medical records review. Clinical endpoint was disability on discharge, established by the 7-point scale of Hughes. Compliance to the PTC guidelines was evaluated considering the dose and prescription regime of IVIg. Results: Twenty-five participants, ranging from 2 to 70 years of age, were included. No difference occurred in any medical variables related to the treatment or in the main clinical outcome measured by the Hughes’ scale. The mean direct cost of PE treatment was US$ 6,059± 1,701 per patient, and the same expense for IVIg was US$ 18,344±12,259 (P = 0.035. Total inpatient cost was US$ 25,730± 18,714 in the PE group, and 34,768± 27,766 (p=0.530 in the IVIg group. Conclusions: In a university-based hospital, PE is equally effective and less expensive than IVIg to treat GBS.

  20. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  1. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline.

    Science.gov (United States)

    Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J

    2017-03-01

    Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine

  2. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  3. Applied evolutionary economics and economic geography

    NARCIS (Netherlands)

    Frenken, K.

    2007-01-01

    Applied Evolutionary Economics and Economic Geography" aims to further advance empirical methodologies in evolutionary economics, with a special emphasis on geography and firm location. It does so by bringing together a select group of leading scholars including economists, geographers and

  4. ECONOMIC SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Aurel MARIN

    2013-12-01

    Full Text Available This article aims to highlight the quality of life that depends on necessary, harmonious and simultaneous satisfying of all human needs, instead of „one at a time”, health and economic insecurity being at the very foundation of it. A society that is focused on quality of life will be a society centered on the individual, their needs and aspirations. It needs to offer alternatives and choices of the individual and not to impose models. Coercion of society over the individual is an objective and necessary phenomenon. Its deepening is not, however, as required. Social environment based on quality of life must be characterized by the maximum possible degree of permissiveness in which the individual is educated in its contribution to social awareness.

  5. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    -certainty evidence).Studies recruiting people undergoing elective surgeryThree studies did not report higher rates of mortality with hospital at home compared with inpatient care (data not pooled, N = 856, low-certainty evidence; mainly orthopaedic surgery). Hospital at home may lead to little or no difference in readmission to hospital for people who were mainly recovering from orthopaedic surgery (N = 1229, low-certainty evidence). We could not establish the effects of hospital at home on the risk of living in institutional care, due to a lack of data. The intervention might slightly improve patient satisfaction (N = 1229, low-certainty evidence). People recovering from orthopaedic surgery allocated to early discharge hospital at home were discharged from the intervention on average four days earlier than people allocated to usual inpatient care (4.44 days earlier, 95% CI 6.37 to 2.51 days earlier, , N = 411, 4 trials, moderate-certainty evidence). It is uncertain whether hospital at home has an effect on cost (very low-certainty evidence). Despite increasing interest in the potential of early discharge hospital at home services as a less expensive alternative to inpatient care, this review provides insufficient evidence of economic benefit (through a reduction in hospital length of stay) or improved health outcomes.

  6. An ideal hospital.

    Science.gov (United States)

    Chandrasiri, Singithi Sidney

    2017-07-03

    Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform. Findings The key themes isolated from the Inquiry into Australian and New Zealand surgical practice ranged from abuse of power by those in leadership positions, gender inequity in the surgical workforce, opaque and corrupt complaints handling processes, excessive surgical trainee working hours to bystander silence secondary to a fear of reprisal. A workforce engagement perspective has elicited the potential to counter various impacts, that of clinical ineffectiveness, substandard quality and safety, inefficient medical workforce management outcomes, adverse economic implications and the operational profitability of a hospital. Generic strategies grounded in evidence-based literature were able to then be aligned with specific action areas to provide a new leadership framework for addressing these impacts. Originality/value To the author's knowledge, this is one of the first responses providing a framework on how medical managers and hospital executives can begin to lead a comprehensive and practical strategy for changing the existing culture of bullying, harassment and discrimination in surgical practice by using a staff engagement framework.

  7. Economic considerations

    International Nuclear Information System (INIS)

    Bradley, W.G. Jr.

    1987-01-01

    The increasing costs of medical imaging procedures such as MRI and the dwindling capital funds of many hospitals have induced many centers to enter into financial partnerships with their referring physicians. Although limited partnerships may be expedient in the short term, they may constitute a conflict of interest, increasing the potential for unethical self-referral by physician-investors. Even this appearance of conflict of interest may diminish public trust in the medical profession (which is already being perceived as increasingly entrepreneurial). Thus, the initial unbridled enthusiasm for MRI as a miraculous new diagnostic tool has been blunted by concern over its cost and by the increasing potential for unethical behavior in the medical community. This may have contributed to the slower diffusion of MRI technology, which has occurred at only 20% of the rate for diffusion of X-ray computed tomography (CT). To understand this mixed perception of MRI, one must evaluate its efficacy in the context of preexisting CT and increasing controls on costs

  8. The new wave of hospital consolidation.

    Science.gov (United States)

    Goldstein, Lisa

    2012-04-01

    Reimbursement challenges, spiraling healthcare costs, and a slow economic recovery are driving the latest wave of hospital consolidation. Health insurance companies and provider systems are forming partnerships in the consolidation field with the goal of reducing healthcare costs and improving quality. The "cost" of the acquisition may include debt and other obligations of the acquired hospital, such as pension liabilities, along with a multiyear capital commitment.

  9. Economic growth, ecological economics, and wilderness preservation

    Science.gov (United States)

    Brian Czech

    2000-01-01

    Economic growth is a perennial national goal. Perpetual economic growth and wilderness preservation are mutually exclusive. Wilderness scholarship has not addressed this conflict. The economics profession is unlikely to contribute to resolution, because the neoclassical paradigm holds that there is no limit to economic growth. A corollary of the paradigm is that...

  10. EARNINGS MANAGEMENT IN U.S. HOSPITALS.

    Science.gov (United States)

    Dong, Gang Nathan

    2016-01-01

    This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.

  11. Behavioral economics.

    Science.gov (United States)

    Chambers, David W

    2009-01-01

    It is human nature to overestimate how rational we are, both in general and even when we are trying to be. Such irrationality is not random, and the search for and explanation of patterns of fuzzy thinking is the basis for a new academic discipline known as behavioral economics. Examples are given of some of the best understood of our foibles, including prospect theory, framing, anchoring, salience, confirmation bias, superstition, and ownership. Humans have two cognitive systems: one conscious, deliberate, slow, and rational; the other fast, pattern-based, emotionally tinged, and intuitive. Each is subject to its own kind of error. In the case of rational thought, we tend to exaggerate our capacity; for intuition, we fail to train it or recognize contexts where it is inappropriate. Humans are especially poor at estimating probabilities, or even understanding what they are. It is a common human failing to reason backwards from random outcomes that are favorable to beliefs about our power to predict the future. Five suggestions are offered for thinking within our means.

  12. Do Catalan private hospitals enjoy financial health?

    Directory of Open Access Journals (Sweden)

    Judit Creixans Tenas

    2016-02-01

    Full Text Available Purpose: The present study reflects the economic and financial analysis of  private hospitals with non-charitable character in Catalonia 2008-2013. The private health sector is considered to be a service activity that develops an important social role. The study positions these analysed centers in the Catalan and Spanish health sector and presents the main economic and financial indicators to diagnose the situation of these companies during the period indicated by analysing short and long-term results and analysis of changes in equity and cash flows of the wineries. Design/methodology/approach: The data used comes from the statements of the Catalan hospital centers in the period 2008-2013 and in particular, it contains a sample of 94 Catalan private hospitals, that mostly are considered large-level accounting (according to the General Accounting Plan. The economic and financial  analysis has carried out using descriptive statistics and analysis results and conclusions have been reached. Findings: The study noted that enables private hospitals in this period have a healthy economic and financial status, although it should improve the management of assets. Most sales are concentrated with a small number of hospitals and, regarding the evolution of the results, produces two distinct stages, the first period of decrease (2008-2010 and the second period of growth and recovery from 2011.. Research limitations/implications: It would be desirable to perform the same study by the Spanish private hospitals in order to compare the economic and financial analysis of the Catalan private sector with the Spanish private sector. Practical implications: It allows us to assess the projection of this sector in recent years in Catalonia in order to take the appropriate economic decisions in this regard. Social implications: The results show the changes that have occurred over the years in the economic crisis of the period analysed. Originality / value: For

  13. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  14. French Economics of Convention and Economic Sociology

    DEFF Research Database (Denmark)

    Jagd, Søren

    foundation of markets and of money may be an occasion for economic sociology to focus even more on elaborating on the institutional void created by traditional economic theory. A second point is that economic sociology could benefit from the perspective of a plurality of forms of coordination involved......The French Economics of convention tradition has developed to be an influential research tradition situated in the area between economics and sociology. The aim of the paper is to explore some of the themes that may be common to economics of conventions and economic sociology by looking more...... closely into three recent texts from the economics of convention tradition discussing, in slightly different ways, differences and similarities between economics of convention and economic sociology. It is argued that André Orléan’s point that a common aim could be to ‘denaturalise’ the institutional...

  15. Economics of Convention and New Economic Sociology

    DEFF Research Database (Denmark)

    Jagd, Søren

    2007-01-01

    The aim of the article is to explore potential common themes in economic sociology and economics of conventions. The article explores two issues raised by economics of conventions that may be of particular importance to economic sociology. First, the explicit exploration of the consequences...... of a plurality of forms of justification, as elaborated in économie de la grandeur. This perspective was recently taken up in economic sociology by David Stark's introduction of the notion ‘sociology of worth'. The second issue, recently suggested by André Orléan, is the need to denaturalize economic theory...... and economic action to demonstrate the social constructed nature of economic action. It is argued that these two issues demonstrate that a fruitful dialogue is indeed possible between economic sociology and economics of convention and should be encouraged....

  16. Training Hospital Managers as to Fire Management

    Directory of Open Access Journals (Sweden)

    Roya Khalili

    2015-01-01

    Full Text Available Fire is one of the most dangerous phenomena in the world which yields main damages, healthy and economical, and is thus a major threat to hospitals. Since, most of the residents in hospitals are the individuals who cannot rescue themselves in such situations, fire in hospitals is more hazardous than any other public place; hence, it can endanger several sophisticated medical equipment. Therefore, security against fire plays a very vital role in hospitals and has to be taken into account by authorities. Among the personnel, hospital manager and the security guard supervisor are much more responsible. One of their responsibilities includes planning fire security scheme in hospitals to reduce the death rate caused by fire so that there is less threat to the building of hospital admits content. Due to the significance of this issue in hospitals, it seems necessary for the personnel to be aware of security measures against fire. Therefore, a study was carried out in Isfahan University of Medical Sciences teaching hospitals on all managers, their awareness about this issue was measured through a questionnaire. The results indicated that of a total of 60, the obtained average was (37.63+7.36 in the medium level. Also, most of the managers believed that proper and updated training by skillful trainers regarding hospital security measures and its application can be truly effective on their productivity. Thus, it is concluded that practical training the mentioned target group (hospital personnel especially clerks and the managers about the security plans can be effective in the control of fire and security measures, resulting in reduction of accidents and human and economic loss in the future.

  17. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  18. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  19. Validating the use of Hospital Episode Statistics data and comparison of costing methodologies for economic evaluation: an end-of-life case study from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP).

    Science.gov (United States)

    Thorn, Joanna C; Turner, Emma L; Hounsome, Luke; Walsh, Eleanor; Down, Liz; Verne, Julia; Donovan, Jenny L; Neal, David E; Hamdy, Freddie C; Martin, Richard M; Noble, Sian M

    2016-04-29

    To evaluate the accuracy of routine data for costing inpatient resource use in a large clinical trial and to investigate costing methodologies. Final-year inpatient cost profiles were derived using (1) data extracted from medical records mapped to the National Health Service (NHS) reference costs via service codes and (2) Hospital Episode Statistics (HES) data using NHS reference costs. Trust finance departments were consulted to obtain costs for comparison purposes. 7 UK secondary care centres. A subsample of 292 men identified as having died at least a year after being diagnosed with prostate cancer in Cluster randomised triAl of PSA testing for Prostate cancer (CAP), a long-running trial to evaluate the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. Both inpatient cost profiles showed a rise in costs in the months leading up to death, and were broadly similar. The difference in mean inpatient costs was £899, with HES data yielding ∼8% lower costs than medical record data (differences compatible with chance, p=0.3). Events were missing from both data sets. 11 men (3.8%) had events identified in HES that were all missing from medical record review, while 7 men (2.4%) had events identified in medical record review that were all missing from HES. The response from finance departments to requests for cost data was poor: only 3 of 7 departments returned adequate data sets within 6 months. Using HES routine data coupled with NHS reference costs resulted in mean annual inpatient costs that were very similar to those derived via medical record review; therefore, routinely available data can be used as the primary method of costing resource use in large clinical trials. Neither HES nor medical record review represent gold standards of data collection. Requesting cost data from finance departments is impractical for large clinical trials. ISRCTN92187251; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use

  20. Help prevent hospital errors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000618.htm Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...

  1. A preliminary economic analysis of a small-scale cogeneration system to be used in the UFSC - Universidade Federal de Santa Catarina hospital; Estudo de pre-viabilidade economica de uma planta de cogeracao de pequena escala para uso no hospital da UFSC

    Energy Technology Data Exchange (ETDEWEB)

    Francisco Junior, Roberto Wolf; Matelli, Jose Alexandre; Bazzo, Edson [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil). Lab. de Combustao e Engenharia de Sistemas Termicos (LabCET)

    2004-07-01

    In this work a small scale cogeneration plant to be installed at the HU is presented. The study consists in a preliminary technical and economical analysis regarding the electrical demands and the hot water supply to the HU. A 90 kWe and a 280 kWe gensets based on internal combustion engines are considered.The heat associated to the jacket water is recovered in a heat exchanger to pre-heat the water to be used in the HU. The heat associated to the gases is recovered in another heat exchanger to increase the water temperature up to 60 deg C. Considering the 90 kWe engine operating 3 h/day in the peak period, it is obtained a saving around R$ 18.000/year and a 10 % internal rate of return. Since HU is not connected to the gas pipeline, currently compressed natural gas is considered as energy source. (author)

  2. The changing role of the hospital chief financial officer.

    Science.gov (United States)

    Freitag, T R; Freitag, W

    1980-01-01

    Things are changing. That statement is obviously true of things political, economic and scientific. Not surprisingly, therefore, the statement applies to the activities, responsibilities, qualifications and, ultimately, status of the hospital chief financial officer (CFO).

  3. Revisiting the relevance of economic theory to hotel revenue ...

    African Journals Online (AJOL)

    Keywords: economic theory, hotels, revenue management, Big Data, hospitality education ... and the ease and quality in which pricing information is delivered to ...... Cornell Hotel and Restaurant Administration Quarterly, 25(2), 27–40.

  4. Economic Sociology and Economics of Convention

    DEFF Research Database (Denmark)

    Jagd, Søren

    This paper is part of a larger exploration of the French Economics of Convention tradition. The aim of the paper is to explore potential themes of common interest to economic sociology and Economics of Conventions. The paper is in two parts. First, I summarise the main theoretical features of EC...... the institutional framework of social action. Second, I explore two issues raised by economics of conventions that may be particularly important to consider for economic sociology. The first issue is the explicit exploration of the consequences of a plurality of forms of justification suggested by Luc Boltanski...... and Laurent Thévenot in ‘économie de la grandeur’. This perspective has already been taken up in economic sociology in David Stark’s notion of a ‘Sociology of Worth’. The second issue, recently suggested by André Orléan, is the need to denaturalise economic theory and economic action to demonstrate the social...

  5. The economic metabolism

    NARCIS (Netherlands)

    Heijman, W.J.M.

    1998-01-01

    Students in Technical and Agricultural faculties spend only a limited amount of time on general economics, environmental economics and resource economics. However, while their knowledge of economics may be limited, they often have adequate mathematical skills. The objective of The Economic

  6. Ethiopian Journal of Economics

    African Journals Online (AJOL)

    The Ethiopian Economic Journal of Economics is a publication of the Ethiopian Economic Association. It is a bi annual publication devoted to the advancement of economics as a scientific discipline in Ethiopia. However, contributions of articles by non-Ethiopian and on economic experience of other countries are ...

  7. Economic Growth, Economic Freedom, and Governance

    OpenAIRE

    Cebula, Richard; Ekstrom, Marcus

    2008-01-01

    This exploratory study examines the impact of various forms of economic freedom and various dimensions of governance, as well as a number of economic factors, on economic growth among OECD nations. Empirical estimation finds that the natural log of per capita purchasing-power-parity adjusted real GDP in OECD nations is positively impacted by business freedom, monetary freedom, trade freedom, and property rights security. Economic growth is found to be negatively affected by perceived governme...

  8. Applied evolutionary economics and economic geography

    OpenAIRE

    Peter Sunley

    2008-01-01

    Applied Evolutionary Economics and Economic Geography aims to further advance empirical methodologies in evolutionary economics, with a special emphasis on geography and firm location. It does so by bringing together a select group of leading scholars including economists, geographers and sociologists, all of whom share an interest in explaining the uneven distribution of economic activities in space and the historical processes that have produced these patterns.

  9. Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh.

    Science.gov (United States)

    Mashreky, S R; Rahman, A; Khan, T F; Faruque, M; Svanström, L; Rahman, F

    2010-04-01

    To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. Cross-sectional study. The study was carried out in February and March 2001. To estimate the burden of RTI patients and the length of stay in hospital, the discharge records of primary and secondary level hospitals were used as data sources. Records from 16 district hospitals and 45 Upazila health complexes (subdistrict level hospitals), selected at random, were included in this study. A direct interview method was adopted to estimate the patient costs of RTI; this involved interviewing patients or their attendants. In this study, patient costs included money spent by the patient for medicine, transport, food and lodging (including attendants). Approximately 33% of the beds in primary and secondary level hospitals in Bangladesh were occupied by injury-related patients, and more than 19% of the injury patients had been injured in a road traffic accident. People aged 18-45 years were the major victims of RTI, and constituted 70% of the total RTI-related admissions in primary and secondary level hospitals. More than two-thirds of RTI patients were male. The average duration of hospital stay was 5.7 days, and the average patient cost for each RTI patient was US$86 (5834 BDT). RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. QUALITY ASSURANCE IN THE HOSPITALITY INDUSTRY: QUALITATIVE ASSESMENT OF NIGERIA

    OpenAIRE

    OFOBRUKU SYLVESTER ABOMEH; Amagbakhan Omoghan Roland

    2013-01-01

    Hospitality is currently the fasted growing economic activity in Abuja-Nigeria. It has also been instrumental in creating jobs and has significant impact on other sectors of economic growth. Based on the above factors much attention need to be placed on the quality of the hospitality industry in Abuja-Nigeria in other to systematic compete with other destinations. Quality assurance is becoming an increasing integral component of the service industry. However, despite some indication that qual...

  11. CURRENT TRENDS IN HOSPITALITY INDUSTRY

    Directory of Open Access Journals (Sweden)

    Ivica Batinić

    2013-10-01

    Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.

  12. Hospital board structure: changing form and changing issues.

    Science.gov (United States)

    Tregoning, S

    2000-01-01

    Economic and social pressures are compelling many hospitals to consider their current board structure in an effort to position their hospital to meet changing demands. A national profile of the structures of hospital boards has been compiled from a questionnaire completed by hospital board representatives from both government and non-government sectors. Results show that hospital board structures are a hybrid of both philanthropic and corporate models. New structures may be required to meet future challenges. In developing new structures, consideration should be given to identifying the skills and processes required to undertake board business.

  13. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  14. Hospital Library Administration.

    Science.gov (United States)

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  15. China Report, Economic Affairs

    National Research Council Canada - National Science Library

    1987-01-01

    .... This report from China contains the topics: NATIONAL POLICY AND ISSUES, PROVINCIAL AFFAIRS, ECONOMIC DEVELOPMENT ZONES, ECONOMIC PLANNING, ECONOMIC MANAGEMENT, FINANCE AND BANKING, INDUSTRY, SMALL- SCALE ENTERPRISES, CONSTRUCTION, DOMESTIC...

  16. Economic theories of dictatorship

    OpenAIRE

    Alexandre Debs

    2010-01-01

    This article reviews recent advances in economic theories of dictatorships and their lessons for the political stability and economic performance of dictatorships. It reflects on the general usefulness of economic theories of dictatorship, with an application to foreign relations.

  17. The Economics of Minorities

    Science.gov (United States)

    Coles, Flournoy A., Jr.

    1973-01-01

    This article discusses some of the more important economic problems of minorities in the United States, identifying the economics of minorities with the economics of poverty, discrimination, exploitation, urban life, and alienation. (JM)

  18. Market economic systems

    OpenAIRE

    Pryor, Frederic L.

    2004-01-01

    The new comparative economics has focused on individual institutions, rather than the economic system as a whole. This essay argues that economic systems should be defined in terms of clusters of complementary or covarying institutions. A cluster analysis of OECD countries using data on forty different economic institutions shows that four economic systems characterize these nations. Further, these systems have no significant impact on economic growth or inflation, but they do have an importa...

  19. The hospital meal - Feeding or treating the elderly

    DEFF Research Database (Denmark)

    Røjel, Terkel

    Geriatric malnutrition is a significant problem for hospital patients in affluent countries, and is associated with severe personal consequences and economic bearing. We need to facilitate interventions focused on the multisensory and psychosocial quality of the hospital meals along with enhanced...

  20. New tax law hobbles tax-exempt hospitals.

    Science.gov (United States)

    Goldblatt, S J

    1982-03-01

    The Economic Recovery Tax Act of 1981 left tax-exempt hospitals at a significant disadvantage in the competition for capital. Although the new law's accelerated depreciation schedules and liberalized investment tax credits contain some marginal benefits for tax-exempt hospitals, these benefits are probably more than offset by the impact of the law on charitable giving.

  1. China Report, Economic Affairs

    National Research Council Canada - National Science Library

    1987-01-01

    .... This report contains articles from China dealing with Economic Affairs. The Topics include National Affairs and Policy, Foreign Trade and Investment, Economic Zones, Finance and Banking, and Agriculture.

  2. Nuclear power economic database

    International Nuclear Information System (INIS)

    Ding Xiaoming; Li Lin; Zhao Shiping

    1996-01-01

    Nuclear power economic database (NPEDB), based on ORACLE V6.0, consists of three parts, i.e., economic data base of nuclear power station, economic data base of nuclear fuel cycle and economic database of nuclear power planning and nuclear environment. Economic database of nuclear power station includes data of general economics, technique, capital cost and benefit, etc. Economic database of nuclear fuel cycle includes data of technique and nuclear fuel price. Economic database of nuclear power planning and nuclear environment includes data of energy history, forecast, energy balance, electric power and energy facilities

  3. How do nonprofit hospitals manage earnings?

    Science.gov (United States)

    Leone, Andrew J; Van Horn, R Lawrence

    2005-07-01

    We hypothesize that, unlike for-profit firms, nonprofit hospitals have incentives to manage earnings to a range just above zero. We consider two ways managers can achieve this. They can adjust discretionary spending [Hoerger, T.J., 1991. 'Profit' variability in for-profit and not-for-profit hospitals. Journal of Health Economics 10, 259-289.] and/or they can adjust accounting accruals using the flexibility inherent in Generally Accepted Accounting Principles (GAAP). To test our hypothesis we use regressions as well as tests of the distribution of earnings by Burgstahler and Dichev [Burgstahler, D., Dichev, I., 1997. Earnings management to avoid earnings decreases and losses. Journal of Accounting and Economics 24, 99-126.] on a sample of 1,204 hospitals and 8,179 hospital-year observations. Our tests support the use of discretionary spending and accounting accrual management. Like Hoerger (1991), we find evidence that nonprofit hospitals adjust discretionary spending to manage earnings. However, we also find significant use of discretionary accruals (e.g., adjustments to the third-party-allowance, and allowance for doubtful accounts) to meet earnings objectives. These findings have two important implications. First, the previous evidence by Hoerger that nonprofit hospitals show less variation in income may at least partly be explained by an accounting phenomenon. Second, our findings provide guidance to users of these financial statements in predicting the direction of likely bias in reported earnings.

  4. Management strategies in hospitals: scenario planning

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-06-01

    Full Text Available Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.

  5. How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals.

    Science.gov (United States)

    Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

    2014-07-01

    Our aim was to investigate contractual mechanisms in physician-hospital exchanges. The concepts of risk-sharing and the nature of physician-hospital exchanges - transactional versus relational - were studied. Two qualitative case studies were performed in Belgium. Hospital executives and physicians were interviewed to develop an in-depth understanding of contractual and relational issues that shape physician-hospital contracting in acute care hospitals. The underlying theoretical concepts of agency theory and social exchange theory were used to analyse the data. Our study found that physician-hospital contracting is highly complex. The contract is far more than an economic instrument governing financial aspects. The effect of the contract on the nature of exchange - whether transactional or relational - also needs to be considered. While it can be argued that contractual governance methods are increasingly necessary to overcome the difficulties that arise from the fragmented payment framework by aligning incentives and sharing financial risk, they undermine the necessary relational governance. Relational qualities such as mutual trust and an integrative view on physician-hospital exchanges are threatened, and may be difficult to sustain, given the current fragmentary payment framework. Since health care policy makers are increasing the financial risk borne by health care providers, it can be argued that this also increases the need to share financial risk and to align incentives between physician and hospital. However, our study demonstrates that while economic alignment is important in determining physician-hospital contracts, the corresponding impact on working relationships should also be considered. Moreover, it is important to avoid a relationship between hospital and physician predominantly characterized by transactional exchanges thereby fostering an unhealthy us-and-them divide and mentality. Relational exchange is a valuable alternative to contractual

  6. Chronic suppurative otitis media: Socio-economic implications in a ...

    African Journals Online (AJOL)

    Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria. ... This paper highlights the socio-economic burden of chronic suppurative otitis media on a ... minimum wage for individuals in our environment where the cost of health care is the sole responsibility of the patient.

  7. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  8. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  9. The Future Hospital: A Business Architecture View.

    Science.gov (United States)

    Mokhtar, Ariffin Marzuki

    2017-10-01

    The future hospital is a resilient, physical learning facility featuring digital enhancement and leveraging an ecosystem of platforms for the Internet of Things (IoT) and analytics, achieving patient-centric care delivery via multidisciplinary healthcare provider teams coordinated to meet patients' medical, psychological, social and economic needs. It exists in a just ecosystem that assimilates the care spectrum from healthy living, the prevention of disease to acute care and the rehabilitation of patients recuperating from illnesses. It will take some time for these future hospitals to be built or for current hospitals to evolve and/or transform, but efforts to spread wisdom among the stakeholders, healthcare providers and patients must start now. The development of the digital components can also begin today, as can competency building for the healthcare providers who will be staffing these future hospitals, ensuring that they are equipped with competent staff employing patient-centric care processes that cater to patients' current and future needs.

  10. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  11. Engaging Undergraduates in Economics

    Science.gov (United States)

    Gajwani, Kiran; Miron, Jeffrey

    2015-01-01

    Siegfried and Stock (2007) explore the undergraduate training of PhD economists. Their findings show that among U.S. undergraduate economics programs, the Harvard University Economics Department produces many eventual economics PhD recipients. In this article, the authors discuss Harvard's undergraduate economics program and highlight some key…

  12. Economic and Policy Review

    African Journals Online (AJOL)

    The NESG Economic and Policy Review (EPR) is a quarterly publication of the Nigerian Economic Summit Group (NESG), established to serve as an avenue for constructive analysis of economic policies and their impacts on different aspects of the business and economic environment. The EPR aims to provide unbiased, ...

  13. The economic aspect

    International Nuclear Information System (INIS)

    MacKerron, G.

    1984-01-01

    The subject is covered in sections: introduction (indicating the importance of 'back end' operations in the economics of nuclear power production); irradiated fuel transport costs in the UK (the Sizewell PWR; existing UK reactors); economic appraisal; past nuclear economics; future nuclear economics; (electricity demand; technological maturity; social and political factors; competition to nuclear power). (U.K.)

  14. Economic Design of Things

    NARCIS (Netherlands)

    Can, Burak

    2017-01-01

    Economics is a social science, so is economic design as a field. This short article discusses, in particular, the future of economic design, and of economic theory in general. By suggesting some examples, I hope to convince the readers that the recent technological advances in science and technology

  15. On religion and hospitality cultures in economic relations

    DEFF Research Database (Denmark)

    Greve, Anni

    Recently prominent scholars (as Beckford 2003, Casanova 2004, Habermas 2008) have offered an argument for integrating the sociology of religion into the corpus of sociology and to rethink religion sociologically. This has given rise to questioning the fact that after the European Enlightenment th...... the role of these intermediaries in disseminating the rules of the marketplace from other port cities with direct access to the Atlantic and Indian Ocean. And it takes a closer look into how these rules have structured particular ‘spaces of hospitality’ in the city of Copenhagen....

  16. GLOBAL CRISIS’ IMPACT UPON THE EMPLOYED NUMBER IN HOSPITALITY INDUSTRY

    OpenAIRE

    MARIAN ZAHARIA; ANIELA BALACESCU; RODICA MANUELA GOGONEA

    2014-01-01

    TThe globalization, complex interconnection process of the economies of states, is a reality of the XXI century. However, at the end of the first decade of this century, besides the positive effects of this process, due to the economic interconnections created, it has favored also a rapid propagation of a negative economic phenomenon: the global economic crisis. Its impact significantly influenced the hospitality industry, important component of modern economies. This paper examines over a pe...

  17. Finding the economics in economic entomology.

    Science.gov (United States)

    Onstad, David W; Knolhoff, Lisa M

    2009-02-01

    To recommend new pest management tactics and strategies to farmers and policy makers, economic entomologists must evaluate the economics of biologically reasonable approaches. We collected data to determine how frequently these economic evaluations occur. We discovered from our survey of entomological journals representing the discipline of economic entomology that papers published since 1972 include economic evaluations of pest management tactics. At least 85% of these analyses were performed by entomologists and not economists. Much of the research on economic evaluations is performed without special funds granted by agencies separate from the authors' institutions. In the United States, USDA competitive grants supported 20% of the economic evaluations published since 2000. However, only approximately 12% of the projects funded since 2000 by three sections of the USDA (Crops at Risk, Risk Avoidance and Mitigation Program, and Pest Management Alternatives Program) resulted in publications concerning economic evaluations. If the purpose of economic entomology is to ultimately determine the value of different kinds of tactics, the discipline may need to take steps to enhance the research that supports these evaluations.

  18. The effect of chain membership on hospital costs.

    Science.gov (United States)

    Menke, T J

    1997-06-01

    To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

  19. Earthquakes and economic growth

    OpenAIRE

    Fisker, Peter Simonsen

    2012-01-01

    This study explores the economic consequences of earthquakes. In particular, it is investigated how exposure to earthquakes affects economic growth both across and within countries. The key result of the empirical analysis is that while there are no observable effects at the country level, earthquake exposure significantly decreases 5-year economic growth at the local level. Areas at lower stages of economic development suffer harder in terms of economic growth than richer areas. In addition,...

  20. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  1. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

    School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.

  2. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  3. Unplanned Hospital Visits - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...

  4. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

    This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...

  5. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

  6. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  7. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...

  8. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  9. Corporate governance in Czech hospitals after the transformation.

    Science.gov (United States)

    Pirozek, Petr; Komarkova, Lenka; Leseticky, Ondrej; Hajdikova, Tatana

    2015-08-01

    This contribution is a response to the current issue of corporate governance in hospitals in the Czech Republic, which draw a significant portion of funds from public health insurance. This not only has a significant impact on the economic efficiency of hospitals, but ultimately affects the whole system of healthcare provision in the Czech Republic. Therefore, the effectiveness of the corporate governance of hospitals might affect the fiscal stability of the health system and, indirectly, health policy for the whole country. The main objective of this paper is to evaluate the success of the transformation in connection with the performance of corporate governance in hospitals in the Czech Republic. Specifically, there was an examination of the management differences in various types of hospitals, which differed in their ownership structure and legal form. A sample of 100 hospitals was investigated in 2009, i.e., immediately after the transformation had been completed, and then three years later in 2012. With regard to the different public support of individual hospitals, the operating subsidies were removed from the economic results of the corporations in the sample. The adjusted economic results were first of all examined in relationship to the type of hospital (according to owner and legal form), and then in relation to its size, the size of the supervisory board and the education level of the senior hospital manager. A multiple median regression was used for the evaluation. One of the basic findings was the fact that the hospital's legal form had no influence on economic results. Successful management in the form of adjusted economic results is only associated with the private type of facility ownership. From the perspective of our concept of corporate governance other factors were under observation: the size of the hospital, the size of the supervisory board and the medical qualifications of the senior manager had no statistically verifiable influence on the

  10. Cost variation in diabetes care delivered in English hospitals

    DEFF Research Database (Denmark)

    Kristensen, Troels

    2009-01-01

    the hospital fixed effect and adjust for hospital characteristics such as number of patients treated, factor prices and number of specialties involved in diabetes care. We rank hospitals by their adjusted fixed effect, which measures the extent to which their costs vary from the average after controlling......Background: Many diabetic patients are admitted to hospital, where care is costly and where there may be scope to improve efficiency. Aims: We analyse the costs and characteristics of diabetic patients admitted to English hospitals and aim to assess what proportions of cost variation are explained...... by patient and hospital characteristics. Methods: We apply a multilevel approach recognising that patients are clustered in hospitals. We first analyse the relationship between patient costs and their characteristics, such as HRG, age, gender, diagnostic markers and socio-economic status. We derive...

  11. Economic Equilibrium and Soviet Economic Reform

    OpenAIRE

    Herbert E. Scarf

    1991-01-01

    The paper, prepared for a Roundtable on Major Economic Problems in the U.S. and the U.S.S.R., discusses some aspects of price theory ñ in particular, the theory of general equilibrium -ñ which may offer some theoretical insights about the economic problems to be encountered during the transition from Socialism to private markets in the Soviet Union.

  12. Ranking economic history journals

    DEFF Research Database (Denmark)

    Di Vaio, Gianfranco; Weisdorf, Jacob Louis

    2010-01-01

    This study ranks-for the first time-12 international academic journals that have economic history as their main topic. The ranking is based on data collected for the year 2007. Journals are ranked using standard citation analysis where we adjust for age, size and self-citation of journals. We also...... compare the leading economic history journals with the leading journals in economics in order to measure the influence on economics of economic history, and vice versa. With a few exceptions, our results confirm the general idea about what economic history journals are the most influential for economic...... history, and that, although economic history is quite independent from economics as a whole, knowledge exchange between the two fields is indeed going on....

  13. Ranking Economic History Journals

    DEFF Research Database (Denmark)

    Di Vaio, Gianfranco; Weisdorf, Jacob Louis

    This study ranks - for the first time - 12 international academic journals that have economic history as their main topic. The ranking is based on data collected for the year 2007. Journals are ranked using standard citation analysis where we adjust for age, size and self-citation of journals. We...... also compare the leading economic history journals with the leading journals in economics in order to measure the influence on economics of economic history, and vice versa. With a few exceptions, our results confirm the general idea about what economic history journals are the most influential...... for economic history, and that, although economic history is quite independent from economics as a whole, knowledge exchange between the two fields is indeed going on....

  14. Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.

    Science.gov (United States)

    Chen, Han-Yang; Chauhan, Suneet P; Blackwell, Sean C

    2018-05-03

     The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.  Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.  The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  16. Hospitality and prosumption | Ritzer | Research in Hospitality ...

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  17. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We......Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...

  18. Hospitality and Institutional Meals

    DEFF Research Database (Denmark)

    Justesen, Lise; Strøjer, Anna-Lise

    2017-01-01

    Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...

  19. Hospital turnaround strategies.

    Science.gov (United States)

    Langabeer, James

    2008-01-01

    Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

  20. Perspectives of economics – behavioural economics

    Directory of Open Access Journals (Sweden)

    Paula-Elena DIACON

    2013-07-01

    Full Text Available The present turning point, accentuated by the crisis, has revitalized the interdisciplinary study of economics and determined the reconsideration of its fundamental bases as a social science. The economists have abandoned the traditional neoclassical sphere and have directed towards understanding the behaviour resorting to psychology and developing in this manner a new field - behavioural economics. This article examines whether this economic sub-discipline is a viable research direction and the extent to which it may increase the explanatory power of science by providing a realistic database for analysis, taking into account the complexity of the human factor.

  1. Botswana Journal of Economics

    African Journals Online (AJOL)

    The Botswana Journal of Economics is a professional journal established for the dissemination of contemporary economic issues–theoretical, methodological, and ... of both the immediate environment and the wider international community.

  2. China's Economic Conditions

    National Research Council Canada - National Science Library

    Morrison, Wayne M

    2008-01-01

    .... The Chinese government has indicated that it intends, over time, to create a "harmonious society" that would promote more balanced economic growth and address a number of economic and social issues...

  3. Globalization and economic cooperation

    Directory of Open Access Journals (Sweden)

    Javier Divar

    2006-12-01

    Full Text Available Economic globalization is nothing, really, that the universality of capitalism. Not globalized culture, and economic participation, and human rights, ... has only globalized market. We must react by substituting those materialistic values with cooperative economy.

  4. STRUCTURE OF ECONOMIC MECHANISM

    Directory of Open Access Journals (Sweden)

    L. I. Podderegina

    2006-01-01

    Full Text Available The paper considers and analyzes scientific approaches of economists to the essence and contents of the economic mechanism. Proposals for methodological formation of economic mechanism structure are substantiated in the paper.

  5. Teaching About Economics.

    Science.gov (United States)

    Paine, Carolyn; Arnold, Anne Jurmu

    1983-01-01

    A teaching unit on economics discusses basic background information, suggests classroom activities, and lists sources of instructional resources. Reproducible masters for two instructional levels are included and introduce economics law and basic financial management. (FG)

  6. Economic Creativity Development

    Directory of Open Access Journals (Sweden)

    Nasseroddin Kazemi Haghighi

    2014-06-01

    Full Text Available As a new concept in the literature, the authors discuss the conception of “Economic Creativ-ity” (EC. The authors explain psychological characteristics of “Economic Creativity”: atti-tudes, motivation, personality traits, and abili-ties. They propose a design based on Emotion of Thought Theory (Kazemi, 2007 for Economic Creativity Development (ECD. This theory is an affective-cognitive approach that tries to ex-plain creativity. Emotion of Thought involves “Poyaei” and “Bitabi” (in Persian meaning Dy-namism and Restlessness. According to this theory, ECD relates to connections between emotion and thought. The ECD includes pro-moting individual readiness, utilization of eco-nomic resources, attitude towards economic af-fairs development, enhancing the utilization of economic experiences, conducting economic ac-tivity education, development of economic thinking and development of emotion of thought.

  7. The Economic Burden Attributable to a Child’s Inpatient Admission for Diarrheal Disease in Rwanda

    Science.gov (United States)

    Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M.; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

    2016-01-01

    Background Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. Methods This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child’s caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Results Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Conclusion Households often bear the largest share

  8. The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

    Science.gov (United States)

    Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

    2016-01-01

    Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Households often bear the largest share of the economic burden attributable to

  9. The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

    Directory of Open Access Journals (Sweden)

    Fidele Ngabo

    Full Text Available Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$.Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction.Households often bear the largest share of the economic burden

  10. Advances in mathematical economics

    CERN Document Server

    Maruyama, Toru

    2015-01-01

    The series is designed to bring together those mathematicians who are seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking effective mathematical tools for their research. A lot of economic problems can be formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories.

  11. Advances in mathematical economics

    CERN Document Server

    Maruyama, Toru

    2014-01-01

    A lot of economic problems can be formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories. The series is designed to bring together those mathematicians who are seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking effective mathematical tools for their research.

  12. Advances in mathematical economics

    CERN Document Server

    Yamazaki, Akira

    2006-01-01

    A lot of economic problems can formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories. The series is designed to bring together those mathematicians who were seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking for effective mathematical tools for their researchers.

  13. Antithetic Foundations of Economics

    OpenAIRE

    Marin DINU

    2011-01-01

    This paper aims at decrypting the manner in which the foundations of Economics as a science and the meanings of the relevant explanatory formulas are being shaped. My analytical endeavor focuses on understanding the peculiarities of what is referred to as the object of study of the science known as Economics, an academic synthesis of concept-related breakthroughs regarding economicity. The explicit purpose of this analysis is to identify perennial benchmarks in economic c...

  14. Advances in mathematical economics

    CERN Document Server

    Yamazaki, Akira

    2006-01-01

    A lot of economic problems can formulated as constrained optimizations and equilibration of their solutions.Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories. The series is designed to bring together those mathematicians who were seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking for effective mathematical tools for their researchers.

  15. The Economics of Networking

    DEFF Research Database (Denmark)

    Sørensen, Olav Jull

    The literature on business networks is often oversocialized. The economic side of business is implicitly assumed. This paper analyses the economics of network behavior by loking at each of the key concepts in the Network Theory.......The literature on business networks is often oversocialized. The economic side of business is implicitly assumed. This paper analyses the economics of network behavior by loking at each of the key concepts in the Network Theory....

  16. Advances in mathematical economics

    CERN Document Server

    Maruyama, Toru

    2017-01-01

    The series is designed to bring together those mathematicians who are seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking effective mathematical tools for their research. A lot of economic problems can be formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories.

  17. Advances in mathematical economics

    CERN Document Server

    Maruyama, Toru

    2016-01-01

    The series is designed to bring together those mathematicians who are seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking effective mathematical tools for their research. A lot of economic problems can be formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories.

  18. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  19. Essays on economic cycles

    NARCIS (Netherlands)

    Groot, de E.A. (Bert)

    2006-01-01

    Schumpeter’s line of thought of multiple economic cycles is further investigated. The existence of multiple cycles in economic variables is demonstrated. In basic innovations five different cycles are found. Multiple cycle structures are shown in various macro-economic variables from the United

  20. Space and economics

    NARCIS (Netherlands)

    Klijs, Jeroen; Heijman, Wim J.M.; Peerlings, Jack H.M.; Rouwendal, Jan; Schipper, Rob A.

    2017-01-01

    The subject area Regional Economics has become topical. This means that in economic analyses the production factor 'space' is of increasing importance. This study book aims to integrate space in the area of General Economics in an analytical way. Models and their applications play a major role in

  1. Economic and demographic outlook

    International Nuclear Information System (INIS)

    Darby, P.M.

    1995-01-01

    Economic forecasts were produced and past trends were examined. Information was presented as a series of figures only, without accompanying text. Information provided included current exchange rates, economic growth, interest rates, housing starts, unemployment rates, personal savings rates and other economic indicators. 40 figs

  2. Economics: It's Your Business.

    Science.gov (United States)

    Billings, Henry

    This document is a text for teaching economics. The book is divided into seven units. Unit 1 is called "What is Economics?" Its seven chapters discuss economics and scarcity, money, the role of the consumer, the role of the producer, capitalism and the free enterprise system, and the circular flow of the economy. The second unit is "How the United…

  3. Teaching Economics. Second Edition.

    Science.gov (United States)

    Lee, Norman, Ed.

    The purpose of this book is to review the place of economics education in the curriculum and to investigate the significance of developments in educational theory and practice for the teaching of economics. It consists of a collection of studies on different aspects of economics education, prepared by 24 contributors from British and North…

  4. Comparing Economic Systems.

    Science.gov (United States)

    Wolken, Lawrence C.

    1984-01-01

    Defines the predominate classifications of economic systems: traditional, command, market, capitalism, socialism, and communism. Considers property rights, role of government, economic freedom, incentives, market structure, economic goals and means of achieving those goals for each classification. Identifies 26 print and audio-visual sources for…

  5. Economic Components of Grief

    Science.gov (United States)

    Corden, Anne; Hirst, Michael

    2013-01-01

    This article investigates the nature, context, and impact of economic stressors associated with loss, drawing on a mixed-methods study of changes in financial circumstances and economic roles following death of a life partner. Findings show how economic changes, and the practicalities of dealing with such transitions, shaped individual responses…

  6. Behavioral Economics and Consumption

    DEFF Research Database (Denmark)

    Reisch, Lucia A.; Sunstein, Cass R.

    2015-01-01

    Behavioral economics explores why people sometimes fail to make rational decisions, and how their behavior departs from the predictions of standard economic models. Insights gained from studies in behavioral economics are used in consumer research and consumer policy to understand and improve ind...

  7. Regional Economic Development

    Science.gov (United States)

    ; Sponsored Work Regional Economic Development Technology Opportunities User Facilities About Us Metrics In the News Publications Policies Feynman Center » Deploying Innovation » Regional Economic Development Regional Economic Development Supporting companies in every stage of development through access to

  8. Does India's Economic Transformation Promote Women's Economic ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This has been accompanied by a narrowing of the gender gap in education. ... in which economic growth can affect women's access to, and control over, resources. ... In partnership with UNESCO's Organization for Women in Science for the ...

  9. The European economic community and economic assosiation

    Directory of Open Access Journals (Sweden)

    S. Meijer

    1959-03-01

    Full Text Available I am grateful to the Afrika-Seminaar of the Potchefstroom University for inviting me to give a talk on the European Economic Community and the Association of the Overseas Countries and Territories.

  10. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  11. The ecological economics: An ecological economics

    International Nuclear Information System (INIS)

    Castiblanco R, Carmenza

    2007-01-01

    Ecological Economics arise as a scientific discipline aimed to integrate concepts of economics, ecology, thermodynamics, ethic and other natural and social sciences in order to incorporate a biophysical and integrated perspective of the inter dependences between economies and environment, from a plural conception and a methodology beyond disciplines. Ecological Economics studies the black box of economic processes usually excluded of the traditional economics: thermodynamics and ecology. Although it is relatively a new field of study, it has been strengthening its theoretical framework with scientific basis and analytic principles that lead to its identification as a new discipline that show a whole new paradigm. The scope of this article is to show the conceptual and methodological bases, the main founders, approaches and central debates of this new discipline. This brief introduction is a preamble to the papers of the meeting Ecological Economics: a perspective for Colombia included in this number, that took place on September 22 - 27 of 2007, at the National University of Colombia at Bogota. During tree days national and international experts, professors, researchers, workers of environmental sector and people interested on environmental issues joined together to know the conceptual and methodological achievements reached of this discipline; as well as to analyse and evaluate the environmental problems of the country, from the systemic, interdisciplinary and general perspective that it promotes

  12. STATE OF BUSINESS IN HOSPITALITY IN CHINA

    OpenAIRE

    Yi Yu

    2014-01-01

    The article deals with the state of business in the hospitality industry in China, domestic tourism, inbound tourism in China as entrepreneurial activity, outbound tourism from China to other countries. Hospitalityis one of the most important parts of thevast services market, and is a fast-growingand highly profitable industry that coulddirectly, indirectly, so as to infl uence the formation of conditions for sustainable socio-economic growth.

  13. STATE OF BUSINESS IN HOSPITALITY IN CHINA

    Directory of Open Access Journals (Sweden)

    Yi Yu

    2014-01-01

    Full Text Available The article deals with the state of business in the hospitality industry in China, domestic tourism, inbound tourism in China as entrepreneurial activity, outbound tourism from China to other countries. Hospitalityis one of the most important parts of thevast services market, and is a fast-growingand highly profitable industry that coulddirectly, indirectly, so as to infl uence the formation of conditions for sustainable socio-economic growth.

  14. Hospital Viability during a Pandemic Influenza Outbreak

    Science.gov (United States)

    2009-06-01

    intentional release may be a naturally occurring disease such as smallpox, or it may be a genetically engineered virus with no known cure . Whatever...be overwhelmed with a myriad of issues as well as, absenteeism , which will require prior planning on the hospitals‘ part to ensure adequate...logistical resupply, but when economic systems may be hanging by a thread due to absenteeism , it is likely hospitals will not be receiving regular

  15. Access to capital: implications for hospital consolidation.

    Science.gov (United States)

    Grauman, Daniel M; Harris, John M; Martin, Christine

    2010-04-01

    Recent economic challenges have left many independent hospitals and their boards concerned about long-term viability of their organizations as stand-alone facilities. The CFO's role should be to facilitate a candid, objective assessment of the organization's ability to continue to go it alone. Key indicators that should be considered in such an assessment include patient volume, degree of physician alignment, profitability, current debt burden, cash, available capital versus capital requirements, and credit rating changes.

  16. Is hospital care of major importance for outcome after out-of-hospital cardiac arrest? Experience acquired from patients with out-of-hospital cardiac arrest resuscitated by the same Emergency Medical Service and admitted to one of two hospitals over a 16-year period in the municipality of Göteborg.

    Science.gov (United States)

    Engdahl, J; Abrahamsson, P; Bång, A; Lindqvist, J; Karlsson, T; Herlitz, J

    2000-02-01

    To describe patient characteristics, hospital investigations and interventions and early mortality among patients being hospitalized after out-of-hospital cardiac arrest in two hospitals. Municipality of Göteborg, Sweden. All patients suffering an out-of-hospital cardiac arrest who were successfully resuscitated and admitted to hospital between 1 October 1980 and 31 December 1996. All patients were resuscitated by the same Emergency Medical Service and admitted alive to one of the two city hospitals in Göteborg. Of 579 patients admitted to Sahlgrenska Hospital, 253 (44%) were discharged alive and of 459 patients admitted to Ostra Hospital, 152 (33%) were discharged alive (P percentage of patients admitted to Sahlgrenska Hospital underwent coronary angiography (P < 0.001), electrophysiological testing (P < 0.001), Holter recording (P < 0.001), echocardiography (P = 0.004), percutaneous transluminal coronary angioplasty (PTCA, P = 0.009), implantation of automatic implantable cardioverter defibrillator (AICD, P = 0.03) and exercise stress tests (P = 0.003). Inhabitants in the catchment area of Ostra Hospital had a less favourable socio-economic profile. Survival after out-of-hospital cardiac arrest may be affected by the course of hospital management. Other variables that might influence survival are socio-economic factors and cardiorespiratory status on admission to hospital. Further investigation is called for as more patients are being hospitalised alive after out-of-hospital cardiac arrest.

  17. Pre-hospitalization, hospitalization, and post-hospitalization costs of patients with neurocysticercosis treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN in Mexico City, Mexico

    Directory of Open Access Journals (Sweden)

    Rachana Bhattarai

    2018-05-01

    Full Text Available ABSTRACT The objective of this study was to estimate the direct costs associated with the diagnosis and treatment of neurocysticercosis (NCC during pre-hospitalization, hospitalization, and post-hospitalization periods for 108 NCC patients treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN in Mexico City, Mexico. Information on clinical manifestations, diagnostic tests, hospitalizations, surgical procedures, prescription medication, and other treatments was collected via medical chart reviews. Uncertain values for costs and frequency of treatments were imputed using bootstrap techniques. The average per-patient pre-hospitalization and hospitalization costs were US$ 257 (95% CI: 185 – 329 and US$ 2,576 (95% CI: 2,244 – 2,908, respectively. Post-hospitalization costs tended to decrease over time, with estimates for the first five years post-hospitalization of US$ 475 (95% CI: 423 – 527, US$ 228 (95% CI: 167 – 288, US$ 157 (95% CI: 111 – 202, US$ 150 (95% CI: 106 – 204, and US$ 91 (95% CI: 27 – 154, respectively. NCC results in a significant economic burden for patients requiring hospitalization, with this burden continuing years post-hospitalization.

  18. The burden of hospital malnutrition in Spain: methods and development of the PREDyCES® study.

    Science.gov (United States)

    Planas Vila, M; Álvarez Hernández, J; García de Lorenzo, A; Celaya Pérez, S; León Sanz, M; García-Lorda, P; Brosa, M

    2010-01-01

    It is well known that hospital malnutrition is a highly prevalent condition associated to increase morbidity and mortality as well as related healthcare costs. Although previous studies have already measured the prevalence and/or costs of hospital nutrition in our country, their local focus (at regional or even hospital level) make that the true prevalence and economic impact of hospital malnutrition for the National Health System remain unknown in Spain. The PREDyCES® (Prevalence of hospital malnutrition and associated costs in Spain) study was aimed to assess the prevalence of hospital malnutrition in Spain and to estimate related costs. Some aspects made this study unique: a) It was the first study in a representative sample of hospitals of Spain; b) different measures to assess hospital malnutrition (NRS2002, MNA as well as anthropometric and biochemical markers) where used both at admission and discharge and, c) the economic consequences of malnutrition where estimated using the perspective of the Spanish National Health System.

  19. Hospital Dermatology, Introduction.

    Science.gov (United States)

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

  20. Hospital-acquired listeriosis.

    Science.gov (United States)

    Graham, J C; Lanser, S; Bignardi, G; Pedler, S; Hollyoak, V

    2002-06-01

    We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting. Copyright 2002 The Hospital Infection Society.

  1. Hospital Management Software Development

    OpenAIRE

    sobogunGod, olawale

    2012-01-01

    The purpose of this thesis was to implement a hospital management software which is suitable for small private hospitals in Nigeria, especially for the ones that use a file based system for storing information rather than having it stored in a more efficient and safer environment like databases or excel programming software. The software developed within this thesis project was specifically designed for the Rainbow specialist hospital which is based in Lagos, the commercial neurological cente...

  2. Economic Thinking for Strategic Leaders

    Science.gov (United States)

    2011-03-24

    unprepared to analyze certain complex, ambiguous issues and craft informed decisions. 15. SUBJECT TERMS Behavioral Economics, Public Choice Theory ...COUNT: 7,668 PAGES: 38 KEY TERMS: Behavioral Economics, Public Choice Theory , Army Profession CLASSIFICATION: Unclassified Military senior...various economic fields, including Identity Economics, Neoclassical Economics, Behavioral Economics, and Public Choice Economics. Finally, it

  3. Impacto de la inmigración sobre la asistencia hospitalaria: frecuentación, casuística y repercusión económica Impact of immigration on hospital care: utilization, case-mix, and economic effects

    Directory of Open Access Journals (Sweden)

    Lauro Hernando Arizaleta

    2009-06-01

    Full Text Available Objetivos: Establecer el impacto de la inmigración sobre los servicios sanitarios, analizando la frecuentación hospitalaria, la casuística y su repercusión económica, comparadas con las de la población autóctona. Métodos: Estudio longitudinal retrospectivo de los ingresos en hospitales de agudos de la Región de Murcia notificados al Conjunto Mínimo Básico de Datos al Alta Hospitalaria (CMBD-AH durante 2004 y 2005. Los grupos de comparación, establecidos atendiendo al país de nacimiento, son «España», «Europa-25» y «resto de países». Los motivos de ingreso se codificaron con la CIE-9-MC y se agruparon mediante AP-GRD-v18. Se calcularon las tasas de frecuentación ajustadas al tiempo de aseguramiento y el impacto económico mediante los pesos de los grupos relacionados por el diagnóstico (GDR de 2004. Resultados: Se contabilizaron 196.275 altas, con 2.590.376 años de seguimiento y una frecuentación del 75,8‰ entre los españoles, el 64,3‰ entre los de Europa-25 y el 73,8‰ entre los del resto de los países. Las causas de ingreso más frecuentes se deben a embarazo, parto y puerperio. El coste por ingreso es de 3.529 € para los españoles, 3.231 € para los de Europa-25 y 2.423 € para los del resto de los países. El coste medio por año de aseguramiento estandarizado y truncado es de 263 € para los españoles, 217 € para los de Europa-25 y 219 € para los del resto de los países. Conclusiones: La frecuentación y los costes por ingreso y por año de seguimiento de los españoles son superiores a los de los inmigrantes, especialmente a los del grupo «resto de países»; la casuística también difiere en este grupo.Objectives: To identify the impact of immigration on health services by comparing hospital discharges, case-mix, and economic effects between immigrants and the native population. Methods: We performed a retrospective longitudinal study of acute-care hospital admissions in Murcia (Spain

  4. Efficiency, ownership, and financing of hospitals: the case of Austria.

    Science.gov (United States)

    Czypionka, Thomas; Kraus, Markus; Mayer, Susanne; Röhrling, Gerald

    2014-12-01

    While standard economic theory posits that privately owned hospitals are more efficient than their public counterparts, no clear conclusion can yet be drawn for Austria in this regard. As previous Austrian efficiency studies rely on data from the 1990s only and are based on small hospital samples, the generalizability of these results is questionable. To examine the impact of ownership type on efficiency, we apply a Data Envelopment Analysis which extends the existing literature in two respects: first, it evaluates the efficiency of the Austrian acute care sector, using data on 128 public and private non-profit hospitals from the year 2010; second, it additionally focusses on the inpatient sector alone, thus increasing the comparability between hospitals. Overall, the results show that in Austria, private non-profit hospitals outperform public hospitals in terms of technical efficiency. A multiple regression analysis confirms the significant association between efficiency and ownership type. This conclusive result contrasts some international evidence and can most likely be attributed to differences in financial incentives for public and private non-profit hospitals in Austria. Therefore, by drawing on the example of the Austrian acute care hospital sector and existing literature on the German acute care hospital sector, we also discuss the impact of hospital financing systems and their incentives on efficiency. This paper thus also aims at providing a proof of principle, pointing out the importance of the respective market conditions when internationally comparing hospital efficiency by ownership type.

  5. Network versus Economic Incentives

    DEFF Research Database (Denmark)

    Larsen, Christian Albrekt

    The article supplements the traditional economic line of reasoning with an economic sociological account of the transition from unemployment to employment. The lack of full information is recognised by economic theory while the focus on network within the tradition of economic sociology has...... not been adopted. The article argues that the importance of network actually might be very well understood within recent economic theories that emphasise the lack of full information. The empirical evidence for the importance of network both for employed and unemployed is provided by analysing a best case...... might be an important part of the vicious circles of unemployment. Finally, the article analyse the importance of network versus the importance of economic incentives. The result supports the thesis that economic sociology provides a better account of the transition from unemployment to employment than...

  6. History of Economic Rationalities

    DEFF Research Database (Denmark)

    This book concentrates upon how economic rationalities have been embedded into particular historical practices, cultures, and moral systems. Through multiple case-studies, situated in different historical contexts of the modern West, the book shows that the development of economic rationalities...... takes place in the meeting with other regimes of thought, values, and moral discourses. The book offers new and refreshing insights, ranging from the development of early economic thinking to economic aspects and concepts in the works of classical thinkers such as Thomas Hobbes, John Locke and Karl Marx......, to the role of economic reasoning in contemporary policies of art and health care. With economic rationalities as the read thread, the reader is offered a unique chance of historical self-awareness and recollection of how economic rationality became the powerful ideological and moral force that it is today....

  7. Fraud in Hospitals

    OpenAIRE

    Musau, Steve; Vian, Taryn

    2008-01-01

    Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...

  8. Economics of population versus economic demography

    Directory of Open Access Journals (Sweden)

    A. A. Tkachenko

    2017-01-01

    Full Text Available The article specifies the correlation between economic demography and the economy of population as the most important scientific areas of modern research. It is concluded that the Russian scientific community lags in the development of these sciences from the world scientific thought. Special attention is paid to the works and ideas of S. Kuznets and Amartya Sen as outstanding researchers of the interrelationships between the population and the economy. It is emphasized that their contribution was not only theoretical but also of practical importance. The importance of G. Myrdal’s works for modern studies of the consequences of population aging is considered. The article examines foreign training courses on “Population Economics”, presented at the Universities of Wisconsin and McMaster, their analysis led to the conclusion that the preparation of textbooks on courses is less productive than the use of scientific articles in journals, containing more recent ideas and achievements of science. The author considers the system, proposed in the course Michel Grignon and Byron G. Spencer «The Economics of Population» more preferable. The article substantiates the opinion that the economic theory of well-being should be the core of the population economy. It is concluded that the differences between economic demography and the economy of population are not just differences between the micro- and macro levels, as some authors write, but the transition to large scales and entropy.The author identifies three most important areas of demo-economic research, which include research in the field of human capital, international economic migration, especially remittance, analysis of the stratification of the population and society by the income in the global and national economies. One can single out the general area of interests of the population economy and economic demography in which these sciences are almost impossible to divide and in which only

  9. Hospital infection prevention and control issues relevant to extensive floods.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

    2013-02-01

    The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.

  10. Hospitalizations and Deaths Caused by Methicillin-Resistant Staphylococcus aureus, United States, 1999?2005

    OpenAIRE

    Klein, Eili; Smith, David L.; Laxminarayan, Ramanan

    2007-01-01

    Hospital-acquired infections with Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA) infections, are a major cause of illness and death and impose serious economic costs on patients and hospitals. However, the recent magnitude and trend of these infections have not been reported. We used national hospitalization and resistance data to estimate the annual number of hospitalizations and deaths associated with S. aureus and MRSA from 1999 through 2005. During this period, t...

  11. Management strategies in hospitals: scenario planning.

    Science.gov (United States)

    Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph

    2015-01-01

    Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a "Stakeholder Feedback". Two key uncertainties were identified and considered in this study: the development of workload for the medical staff the profit oriented performance of the medical staff. According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and "blind spots". This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.

  12. Orthopedic specialty hospitals: centers of excellence or greed machines?

    Science.gov (United States)

    Badlani, Neil; Boden, Scott; Phillips, Frank

    2012-03-07

    Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. Copyright 2012, SLACK Incorporated.

  13. Exposure measurement in the neighboring hospital beds during an x-ray procedure in hospitalization unit

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Rafael E.; Capeleti, Felipe F.; Cabete, Henrique V., E-mail: rafael.goto@fcmsantacasasp.edu.br, E-mail: felipe.capeleti@fcmsantacasasp.edu.br, E-mail: henrique@gmpbrasil.com.br [Faculdade de Ciencias Medicas da Santa Casa Sao Paulo, SP (Brazil); GMP Consultoria em Radioprotecao e Fisica Medica e Assessoria LTDA, Sao Paulo, SP (Brazil)

    2017-11-01

    There are lots of discussion about the exposure in hospitalization units in Brazil, especially around labor legislation and economic advantages of unhealthiness. With the attention focused on hospitalized patients, there were measured the exposure in neighboring beds of the patient submitted to an X-ray procedure with a mobile X-ray system that could be used to illustrate the discussion with consistent values. The most common X-ray procedure made in hospitalization units are chests images with techniques between 70 to 120 kV and 5 to 20 mAs. The measurement was made during routine exposure and simulations using a scattering phantom with Radcal AccuPro electrometer and 1800cc ionization chamber in a private hospital and a philanthropic hospital, both in Sao Paulo, Brazil. The ionization chambers are placed at 2 meters distance of the patient exposed of both sides during the routine procedure. During the simulation, a nylon phantom of 20 centimeters thick and 30 x 30 cm² size was placed on the bed, a typical exposure technique was used and the exposure was measured surrounding the phantom at 0.6, 1.0 and 2.0 meters distance for scattered radiation characterization. Initial results showed that the neighboring exposure at about 2 meters distance from the exposed patient bed have low values, even when exposure is integrated during the length of hospital stay. Therefore, the exposure in hospitalization units are very low compared to the exams doses. (author). (author)

  14. Going to the Hospital

    Science.gov (United States)

    ... and therapists will show you how to use pieces of equipment, like crutches, if you need them. Some hospitals have child life specialists. Their job is to make sure kids in the hospital understand what's going on around them and help them feel more ...

  15. Hospitality Services Reference Book.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  16. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

    In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

  17. Hospitality services generate revenue.

    Science.gov (United States)

    Bizouati, S

    1993-01-01

    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.

  18. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  19. The improving efficiency frontier of religious not-for-profit hospitals.

    Science.gov (United States)

    Harrison, Jeffrey P; Sexton, Christopher

    2006-01-01

    By using data-envelopment analysis (DEA), this study evaluates the efficiency of religious not-for-profit hospitals. Hospital executives, healthcare policy makers, taxpayers, and other stakeholders benefit from studies that improve hospital efficiency. Results indicate that overall efficiency in religious hospitals improved from 72% in 1998 to 74% in 2001. What is more important is that the number of religious hospitals operating on the efficiency frontier increased from 40 in 1998 to 47 in 2001. This clearly documents that religious hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the healthcare industry.

  20. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper

    2015-01-01

    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...

  1. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...

  2. Hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L

    1989-01-01

    During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...

  3. QUALITY ASSURANCE IN THE HOSPITALITY INDUSTRY: QUALITATIVE ASSESMENT OF NIGERIA

    Directory of Open Access Journals (Sweden)

    OFOBRUKU SYLVESTER ABOMEH

    2013-06-01

    Full Text Available Hospitality is currently the fasted growing economic activity in Abuja-Nigeria. It has also been instrumental in creating jobs and has significant impact on other sectors of economic growth. Based on the above factors much attention need to be placed on the quality of the hospitality industry in Abuja-Nigeria in other to systematic compete with other destinations. Quality assurance is becoming an increasing integral component of the service industry. However, despite some indication that quality assurances are receiving attention in the hospitality industry, its adoption continues to be very slow. This paper examine the usefulness of quality assurance in hospitality operations and how to encourage it’s observances in the industry.

  4. Non-equilibrium Economics

    Directory of Open Access Journals (Sweden)

    Katalin Martinás

    2007-02-01

    Full Text Available A microeconomic, agent based framework to dynamic economics is formulated in a materialist approach. An axiomatic foundation of a non-equilibrium microeconomics is outlined. Economic activity is modelled as transformation and transport of commodities (materials owned by the agents. Rate of transformations (production intensity, and the rate of transport (trade are defined by the agents. Economic decision rules are derived from the observed economic behaviour. The non-linear equations are solved numerically for a model economy. Numerical solutions for simple model economies suggest that the some of the results of general equilibrium economics are consequences only of the equilibrium hypothesis. We show that perfect competition of selfish agents does not guarantee the stability of economic equilibrium, but cooperativity is needed, too.

  5. Environmentally Sustainable Economic Growth

    Directory of Open Access Journals (Sweden)

    Stelian Brad

    2016-05-01

    Full Text Available Economic growth and sustainable development are important issues for social prosperity. Sustainable development strives for moderate and responsible use within the economic activity of the limited resources of our planet, whereas economic growth does not limit the resource exploitation and energy, being mainly focused on productivity increase. From this perspective, both conceptual and operational contradictions occur between the two pillars of prosperity. This paper looks to these contradictions and proposes some streams of intervention such as economic growth and environmental sustainability to operate in harmony. A structured framework for innovative problem solving is considered in this respect. Results of this research show that it is possible to induce smart measures in the economic system for directing businesses towards new paradigms where economic growth is possible without negative effects on environmental sustainability.

  6. Economics and obesity policy.

    Science.gov (United States)

    Lusk, J L

    2017-06-01

    This paper elucidates the challenges surrounding the economics of some popular obesity-related policy proposals. Solid economic justifications for anti-obesity policies are often lacking, and evidence suggests policies like fat and soda taxes or restrictions on food stamp spending are unlikely to substantively affect obesity prevalence. In short, many of the same factors that make obesity such a complicated and multifaceted issue extend to the economic analysis of public health policies.

  7. Principles of (Behavioral) Economics

    OpenAIRE

    David Laibson; John A. List

    2015-01-01

    Behavioral economics has become an important and integrated component of modern economics. Behavioral economists embrace the core principles of economics—optimization and equilibrium—and seek to develop and extend those ideas to make them more empirically accurate. Behavioral models assume that economic actors try to pick the best feasible option and those actors sometimes make mistakes. Behavioral ideas should be incorporated throughout the first-year undergraduate course. Instructors should...

  8. Models of Economic Analysis

    OpenAIRE

    Adrian Ioana; Tiberiu Socaciu

    2013-01-01

    The article presents specific aspects of management and models for economic analysis. Thus, we present the main types of economic analysis: statistical analysis, dynamic analysis, static analysis, mathematical analysis, psychological analysis. Also we present the main object of the analysis: the technological activity analysis of a company, the analysis of the production costs, the economic activity analysis of a company, the analysis of equipment, the analysis of labor productivity, the anal...

  9. EXPERIMENT IN ECONOMICS

    OpenAIRE

    Basilgan, Müslüm

    2011-01-01

    In contrast to sciences such as physics, chemistry and psychology, using experimental methods in economics has encountered significant resistance reaching as far back as Mill. The basic reason for the resistance is the widely accepted view that experiment is not suited to analyzing complex human activity including economic behaviors. However, experimental studies, which started to test economics theories from the 1940s, have now reached an important point. The purpose of this study is to show...

  10. Forecasting oilfield economic performance

    International Nuclear Information System (INIS)

    Bradley, M.E.; Wood, A.R.O.

    1994-01-01

    This paper presents a general method for forecasting oilfield economic performance that integrates cost data with operational, reservoir, and financial information. Practices are developed for determining economic limits for an oil field and its components. The economic limits of marginal wells and the role of underground competition receive special attention. Also examined is the influence of oil prices on operating costs. Examples illustrate application of these concepts. Categorization of costs for historical tracking and projections is recommended

  11. Emotions and Economic Preference

    OpenAIRE

    Todorova, Tamara; Ramachandran, Bharath

    2005-01-01

    We wish to examine critically the viewpoint that: a) economists take too narrow a view of rationality and do not recognize the role of emotions as a component of rationality and b) do not address the question of whether preferences are rational or not, and instead take them as just given. We trace the relationship between economics and emotions showing some economic dimensions of emotional states. We illustrate them with examples of economic behavior based on emotional reactions.

  12. The economics of health

    OpenAIRE

    Beck, V; Quinn, M; Dunn, A; Edmunds Otter, M; Hammer, N; Pitchforth, E

    2008-01-01

    Health economics has, in recent years, become a major area of research in economics. This important collection presents a careful selection of the best articles and is classified according to eight fields within health economics. It thus provides a comprehensive cross-section of the large and disparate literature on the subject. It forms, in a real sense, a book which will be invaluable for teachers and researchers who wish to have these frequently cited articles easily to hand. It will be es...

  13. Gender and Economic Globalization

    OpenAIRE

    Harcourt, Wendy

    2016-01-01

    The following article draws on the discussion of the iuéd Colloquium on Gender and Economic Globalization. The Colloquium aimed to draw out the impact of economic globalization on gender relations, with a particular focus on poor women in developing countries. Globalization – for or against women? In order to look at the impact of economic globalization on gender relations, and more particularly on poor women’s lives, we are confronted with a complex set of interlinked dynamics. Inequitable g...

  14. Agroforestry Economics and Policy

    Science.gov (United States)

    L.D. Godsey; D. Evan Mercer; Robert K. Grala; Stephen C. Grado; Janaki R.R. Alavalapati

    2009-01-01

    Essentially every living thing on Earth has applied the basic concepts of economics. That is, every living thing has had to use a limited set of resources to meet a minimum set of needs or wants. Although the study of economics is often confused with the study of markets or finance, economics is simply a social science that studies the choices people make. As a social...

  15. Politico-economic equivalence

    DEFF Research Database (Denmark)

    Gonzalez Eiras, Martin; Niepelt, Dirk

    2015-01-01

    Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime and a st......Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime...... their use in the context of several applications, relating to social security reform, tax-smoothing policies and measures to correct externalities....

  16. Industrial Economics in Scandinavia

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Møllgaard, Peter

    2004-01-01

    Based on diverse research methods, we trace and map industrial economics research in Denmark, Norway and Sweden in the periode of 1880 to 1908. After describing this research in terms of key contributors, we argue that industrial economics developed rather unevenly in the Scandinavian countries....... Danish research was mainly theoretical and strongly oriented towards the international context, whereas Norwegian research was largely industry analysis with a strong leaning towards managerial economics. Swedish research in industrial economics is very scant until the end of the 1960s.JEL Code: B1, B2...

  17. Foundations of economic change

    DEFF Research Database (Denmark)

    Cantner, Uwe

    2016-01-01

    This paper employs the Schumpeterian approach to the development of economies in order to identify the core building blocks of a theory of endogenous economic change. Borders and insights are widened by combining concepts and findings from behavioral economics, from evolutionary economics, and from...... complexity economics. Actor heterogeneity, on the one hand, and mechanisms of actors’ interaction, on the other, are suggested to be fundamental elements of that theory. Theoretical analyses and empirical accounts are presented, achievements are discussed, and further avenues of research are suggested....

  18. Globalization and Economic Freedom

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    2006-01-01

    This paper employs a panel data set to estimate the effect of globalization on four measures of economic freedom. Contrary to previous studies, the paper distinguishes between three separate types of globalization: economic, social and political. It also separates effects for poor and rich...... countries, and autocracies and democracies. The results show that economic globalization is negatively associated with government size and positively with regulatory freedom in rich countries; social globalization is positively associated with legal quality in autocracies and with the access to sound money...... in democracies. Political globalization is not associated with economic freedom...

  19. CDBG Economic Development Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to economic development, including commercial or industrial rehab, commercial or industrial land acquisition, commercial or industrial...

  20. Contemporary engineering economics

    CERN Document Server

    Park, Chan S

    2011-01-01

    Contemporary Engineering Economics, 5/e, is intended for undergraduate engineering students taking introductory engineering economics while appealing to the full range of engineering disciplines for which this course is often required: industrial, civil, mechanical, electrical, computer, aerospace, chemical, and manufacturing engineering, as well as engineering technology. This edition has been thoroughly revised and updated while continuing to adopt a contemporary approach to the subject, and teaching, of engineering economics. This text aims not only to build a sound and comprehensive coverage of engineering economics, but also to address key educational challenges, such as student difficulty in developing the analytical skills required to make informed financial decisions.

  1. Six hospitals describe decentralization, cost containment, and downsizing.

    Science.gov (United States)

    Lineweaver, L A; Battle, C E; Schilling, R M; Nall, C M

    1999-01-01

    Decentralization, cost containment, and downsizing continue in full force as healthcare organizations continue to adapt to constant economic change. Hospitals are forced to take a second and third look at how health care is managed in order to survive. Six Northwest Florida hospitals were surveyed in an effort to explore current changes within the healthcare delivery system. This article provides both managers and staff with an overview of recent healthcare changes in an area of the country with implications for staff development.

  2. Male factor in infertility: study from a tertiary care hospital

    OpenAIRE

    Kalavathi D. Biradar

    2016-01-01

    Background: Infertility is a condition with important psychological, economic, demographic and medical implications. Male infertility refers to a male's inability to result pregnancy in a fertile female. Methods: The present hospital based study was conducted in the Department of Obstetrics and Gynaecology, East Point Hospital, Bangalore. Duration of the study was for 6 months from October 2015 to March 2016. A total of 250 infertile couples couple coming for evaluation to the outpatient d...

  3. Essays in health economics and labor economics

    NARCIS (Netherlands)

    Palali, Ali

    2015-01-01

    The economics literature presents a growing number of studies focusing on risky health behaviors such as tobacco use or cannabis use. One of the most important characteristics of these risky health behaviors is that they harm the users and the people around the users, causing great social and

  4. Economic Engagement Framework: Economic Impact Guidelines

    Science.gov (United States)

    Ambargis, Zoë; Mead, Charles Ian; Rzeznik, Stanislaw J.; Swenson, David; Weisenberger, Janet

    2014-01-01

    The Association of Public and Land-grant Universities' (APLU's) Commission on Innovation, Competitiveness, and Economic Prosperity (CICEP) views university contributions to the economy across a spectrum of activity--from educating students and creating the talent necessary for the 21st century workforce to developing innovation ecosystems and…

  5. Economic Modelling in Institutional Economic Theory

    Directory of Open Access Journals (Sweden)

    Wadim Strielkowski

    2017-06-01

    Full Text Available Our paper is centered around the formation of theory of institutional modelling that includes principles and ideas reflecting the laws of societal development within the framework of institutional economic theory. We scrutinize and discuss the scientific principles of this institutional modelling that are increasingly postulated by the classics of institutional theory and find their way into the basics of the institutional economics. We propose scientific ideas concerning the new innovative approaches to institutional modelling. These ideas have been devised and developed on the basis of the results of our own original design, as well as on the formalisation and measurements of economic institutions, their functioning and evolution. Moreover, we consider the applied aspects of the institutional theory of modelling and employ them in our research for formalizing our results and maximising the practical outcome of our paper. Our results and findings might be useful for the researchers and stakeholders searching for the systematic and comprehensive description of institutional level modelling, the principles involved in this process and the main provisions of the institutional theory of economic modelling.

  6. Economic globalisation and economic justice: Covenanting for ...

    African Journals Online (AJOL)

    The premise of this article is that ethical moral formation or 'covenanting for justice' leads to action. The covenanting church itself, in conjunction with other movements, works for justice in all areas of life. The article uses the six aspects of ethical moral formation of Heinz Tödt to analyse some aspects of economic ...

  7. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  8. Antithetic Foundations of Economics

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2011-03-01

    Full Text Available This paper aims at decrypting the manner in which the foundations of Economics as a science and the meanings of the relevant explanatory formulas are being shaped. My analytical endeavor focuses on understanding the peculiarities of what is referred to as the object of study of the science known as Economics, an academic synthesis of concept-related breakthroughs regarding economicity. The explicit purpose of this analysis is to identify perennial benchmarks in economic cognition whereby this ensures its consistency. The implicit purpose is to shape a cognitive model in line with the specifics of the conceptual universe of Economics, as well as with the sources of the economic realities that are subject to a sui-generis relativism. The primary benefit of this endeavor consists in systemizing the conceptual prospects with an antithetic nature that allow for the explanations of the state of economic rationality and generate the understanding of what the source of economicity is and how it behaves. As such, the conclusions are marked by the stringent need of more precisely defining economic knowledge in order to match the changing nature of economic reality, as an expression that embraces the meeting point of two ontological vistas that are methodologically separated by some theories: human nature and human condition. Economics as a science thus features, apart from a conceptual substrate that needs to be spotted, an ontological background that needs to be revealed. The role played by this background appears to be most frequently ignored. The joint identification of both direct and contextual determinants for a sensitive area of humankind, i.e. the economy, is a direction to be followed by the royal path of rational knowledge.

  9. The economics of cardiac biomarker testing in suspected myocardial infarction.

    Science.gov (United States)

    Goodacre, Steve; Thokala, Praveen

    2015-03-01

    Suspected myocardial infarction (MI) is a common reason for emergency hospital attendance and admission. Cardiac biomarker measurement is an essential element of diagnostic assessment of suspected MI. Although the cost of a routinely available biomarker may be small, the large patient population and consequences in terms of hospital admission and investigation mean that the economic impact of cardiac biomarker testing is substantial. Economic evaluation involves comparing the estimated costs and effectiveness (outcomes) of two or more interventions or care alternatives. This process creates some difficulties with respect to cardiac biomarkers. Estimating the effectiveness of cardiac biomarkers involves identifying how they help to improve health and how we can measure this improvement. Comparison to an appropriate alternative is also problematic. New biomarkers may be promoted on the basis of reducing hospital admission or length of stay, but hospital admission for low risk patients may incur significant costs while providing very little benefit, making it an inappropriate comparator. Finally, economic evaluation may conclude that a more sensitive biomarker strategy is more effective but, by detecting and treating more cases, is also more expensive. In these circumstances it is unclear whether we should use the more effective or the cheaper option. This article provides an introduction to health economics and addresses the specific issues relevant to cardiac biomarkers. It describes the key concepts relevant to economic evaluation of cardiac biomarkers in suspected MI and highlights key areas of uncertainty and controversy. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  10. Surveillance of multidrug resistant suppurative infection causing bacteria in hospitalized patients in an Indian tertiary care hospital

    OpenAIRE

    Nabakishore Nayak; Rajesh K. Lenka; Rabindra N. Padhy

    2014-01-01

    Objective: To examine antibiograms of a cohort of suppurative bacteria isolated from wound-swabs from hospitalized patients of all economic groups of a typical Indian teaching hospital. Methods: In surveillance, antibiotic resistance patterns of 10 species of suppurative bacteria isolated from wound-swabs over a period of 24 months were recorded. Those were subjected to antibiotic sensitivity test, using 16 prescribed antibiotics of 5 different groups (3 aminoglycosides, 4 beta-lactams, 3 ...

  11. Teaching Writing in Economics

    Science.gov (United States)

    Schmeiser, Katherine

    2017-01-01

    In this article, the author provides motivation and a template for integrating and teaching writing in a variety of economics courses: core theory or introductory courses, topic courses, and economic writing/research courses. For each assignment, pedagogical reasoning and syllabus integration are discussed. Additionally, the author shows that…

  12. Economic Theory and Broadcasting.

    Science.gov (United States)

    Bates, Benjamin J.

    Focusing on access to audience through broadcast time, this paper examines the status of research into the economics of broadcasting. The paper first discusses the status of theory in the study of broadcast economics, both as described directly and as it exists in the statement of the basic assumptions generated by prior work and general…

  13. Economics in Detention

    Science.gov (United States)

    Elonge, Michael

    2013-01-01

    Economics in Detention is a University of Maryland Extension program that teaches inmates essential principles of economics as a foundation to a spectrum of decision making. Also, the program includes an emphasis on starting a small business after incarceration. The idea of this program emanates from an invitation by the Baltimore City Detention…

  14. Economics of Agroforestry

    Science.gov (United States)

    D. Evan Mercer; Frederick W. Cubbage; Gregory E. Frey

    2014-01-01

    This chapter provides principles, literature and a case study about the economics of agroforestry. We examine necessary conditions for achieving efficiency in agroforestry system design and economic analysis tools for assessing efficiency and adoptability of agroforestry. The tools presented here (capital budgeting, linear progranuning, production frontier analysis...

  15. Marketization and Economic Performance

    DEFF Research Database (Denmark)

    Hansen, Morten Balle

    2010-01-01

    . A reform enforcing compulsory competitive tendering in homecare for elderly people in Denmark is analysed and its relation to measures of economic performance is explored. Two competing models of marketization are contrasted in the analysis: a problem solving model inspired by public choice ideology...... little impact on economic performance is found, which lends support to an institutional interpretation of the findings....

  16. Economic and tax issues

    Science.gov (United States)

    Steverson O. Moffat; John L. Greene

    2002-01-01

    Economic conditions and tax policies affect land use decisions everywhere, but their effects on the rate of change in land use are particularly large in the wildland-urban interface. We begin this chapter with a brief economic history of the South and a description of the macroeconomic trends and conditions that affect microeconomics at the wildlandurban interface....

  17. Economics in Context

    Science.gov (United States)

    Evensky, Jerry

    2004-01-01

    Academic departmentalization has limited the dimensionality and thus the richness of analysis in the social sciences. The author examines the case of a modern economics as an example. He reviews the ideas of Williamson (2000), who cites the limits of scope in the New Institutional Economics; Buchanan, who lays bare the ethical foundations of…

  18. Essays in antitrust economics

    NARCIS (Netherlands)

    Verouden, V.C.H.M.

    2001-01-01

    Competition law - or antitrust law, as it is called in the United States - is a field of law to which economic concepts, such as "restriction of competition" and "anti-competitive effect", are of central importance. This thesis analyses a number of such concepts, both from an economic and a legal

  19. The Culture of Economics

    OpenAIRE

    Stephen Marglin

    2009-01-01

    Stephen Marglin examines how the culture of economics has impacted on Third World cultures. He argues that economics is possessed by its own theory of culture based on the market as the organizing principle of life, one that we need to go beyond.

  20. Sustainable economic structures

    NARCIS (Netherlands)

    Dellink, R.B.; Bennis, M.; Verbruggen, H.

    1999-01-01

    The paper introduces four scenarios for sustainable economic structures in the Netherlands for 2030. The aim of this paper is to provide possible answers to what a sustainable future might look like in terms of alternative economic structures. To this end, an empirical economy-ecology model is

  1. Internet Economics IV

    Science.gov (United States)

    2004-08-01

    edts.): Internet Economics IV Technical Report No. 2004-04, August 2004 Information Systems Laboratory IIS, Departement of Computer Science University of...level agreements (SLA), Information technology (IT), Internet address, Internet service provider 16. PRICE CODE 17. SECURITY CLASSIFICATION 18... technology and its economic impacts in the Internet world today. The second talk addresses the area of AAA protocol, summarizing authentication

  2. Behavioral Economics of Education

    DEFF Research Database (Denmark)

    Koch, Alexander Karl; Nafziger, Julia; Nielsen, Helena Skyt

    2015-01-01

    -dimensional rather than one-dimensional. Explicitly accounting for soft skills often implies departing from the standard economic model by integrating concepts studied in behavioral and experimental economics, such as self-control, willingness to compete, intrinsic motivation, and self-confidence. We review how...

  3. Nuclear power economics

    International Nuclear Information System (INIS)

    Moynet, G.

    1987-01-01

    The economical comparison of nuclear power plants with coal-fired plants in some countries or areas are analyzed. It is not difficult to show that nuclear power will have a significant and expanding role to play in providing economic electricity in the coming decades. (Liu)

  4. Capabilities, economic development, sustainability

    Czech Academy of Sciences Publication Activity Database

    Fagerberg, J.; Srholec, Martin

    2017-01-01

    Roč. 41, č. 3 (2017), s. 905-926 ISSN 0309-166X R&D Projects: GA ČR GAP402/10/2310 Institutional support: RVO:67985998 Keywords : national innovation systems * growth * technology Subject RIV: AH - Economics OBOR OECD: Applied Economics, Econometrics Impact factor: 1.338, year: 2016

  5. Capabilities, economic development, sustainability

    Czech Academy of Sciences Publication Activity Database

    Fagerberg, J.; Srholec, Martin

    2017-01-01

    Roč. 41, č. 3 (2017), s. 905-926 ISSN 0309-166X Institutional support: Progres-Q24 Keywords : national innovation systems * growth * technology Subject RIV: AH - Economics OBOR OECD: Applied Economics, Econometrics Impact factor: 1.338, year: 2016

  6. Purposeful engineering economics

    CERN Document Server

    Chadderton, Ronald A

    2015-01-01

    This textbook/course supplement stands as a unique and highly original complement to the traditional engineering economics curriculum. Its primarily narrative approach conveys the essence of an “Austrian" economic perspective on cash flow analysis and decision making in engineering, without extensive tables and graphs, and requires very little mathematics. The book’s objective is to add a new perspective to the usual study of cash flow analysis and solely econometric engineering decision making. The author draws on the methodology of the Austrian Economists—a school of economic thought that bases its study of economic phenomena on the interpretation and analysis of the purposeful actions of individuals. The book includes an array of illustrative case studies examined in detail by the author and emphasizes the importance of market processes and price signals to coordinate engineering plans. Purposeful Engineering Economics is an ideal resource for students, teaching faculty, and practicing professional ...

  7. 15. Basic economic indicators

    International Nuclear Information System (INIS)

    Carless, J.; Dow, B.; Farivari, R.; O'Connor, J.; Fox, T.; Tunstall, D.; Mentzingen, M.

    1992-01-01

    The clear value of economic data and analysis to decisionmakers has motivated them to mandate the creation of extensive global economic data sets. This chapter contains a set of these basic economic data, which provides the context for understanding the causes and the consequences of many of the decisions that affect the world's resources. Many traditional economic indicators fail to account for the depletion or deterioration of natural resources, the long-term consequences of such depletion, the equitable distribution of income within a country, or the sustainability of current economic practices. The type of measurement shown here, however, is still useful in showing the great differences between the wealthiest and the poorest countries. Tables are given on the following: Gross national product and official development assistance 1969-89; External debt indicators 1979-89; Central government expenditures; and World commodity indexes and prices 1975-89

  8. What is sustainability economics?

    Energy Technology Data Exchange (ETDEWEB)

    Baumgaertner, Stefan [Department of Sustainability Sciences, Leuphana University of Lueneburg (Germany); Department of Economics, Leuphana University of Lueneburg (Germany); Quaas, Martin [Department of Economics, University of Kiel (Germany)

    2010-01-15

    While economists have been contributing to the discussion of various aspects of sustainability for decades, it is just recently that the term 'sustainability economics' was used explicitly in the ecological, environmental, and resource economics community. Yet, the contributions that use the term 'sustainability economics' do not refer to any explicit definition of the term, and are not obviously joined by common or unifying characteristics, such as subject focus, methodology, or institutional background. The question thus arises: what is 'sustainability economics'? In this essay, we systematically define and delineate 'sustainability economics' in terms of its normative foundation, aims, subject matter, ontology, and genuine research agenda. (author)

  9. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    critical factor for many poor and remote households who attend the hospital for delivery. Current remuneration (10-15 USD for normal delivery, 30 USD for complicated delivery and 70 USD for caesarean section delivery) for maternity incentive needs to account the hidden costs by increasing it to 250 USD for normal delivery and 350 USD for C-section. Decentralization of the obstetric care to remote and under-privileged population might reduce the economic burden of pregnant women and can facilitate their attendance at the health care centers.

  10. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    Jeevan Acharya

    critical factor for many poor and remote households who attend the hospital for delivery. Current remuneration (10-15 USD for normal delivery, 30 USD for complicated delivery and 70 USD for caesarean section delivery for maternity incentive needs to account the hidden costs by increasing it to 250 USD for normal delivery and 350 USD for C-section. Decentralization of the obstetric care to remote and under-privileged population might reduce the economic burden of pregnant women and can facilitate their attendance at the health care centers.

  11. Premier Hospital Historical Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  12. [Ryazan hospital--80 years].

    Science.gov (United States)

    Klimov, A S; Gromov, M F

    2012-02-01

    In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.

  13. Hospital Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...

  14. Hospital Outpatient PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...

  15. VT Hospital Site Locations

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...

  16. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  17. Hospitals as health educators

    Science.gov (United States)

    ... offer discounts to healthy activities in the area: Biking, hiking, or walking tours Museums Fitness clubs Farms Festivals Your hospital may offer discounts for: Retail stores such as sporting goods, health food, and art stores Acupuncture Skin care Eye ...

  18. Hospital Readmission Reduction

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  19. Hospital Readmissions Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  20. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  1. Allegheny County Hospitals

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

  2. Practice Hospital Bed Safety

    Science.gov (United States)

    ... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...

  3. Bureaucracy, institutional theory and institutionaucracy: applications to the hospital industry.

    Science.gov (United States)

    Bolon, D S

    1998-01-01

    The health care industry is experiencing rapid change and uncertainty. Hospitals, in particular, are redesigning structures and processes in order to maximize efficiencies and remain economically viable. This article uses two organizational theory perspectives (bureaucracy and institutional theory) to examine many of the trends and transitions which are occurring throughout the hospital industry. It suggests that many of the key tenets of bureaucracy (rationality, efficiency, productivity, control, etc.) have been incorporated into the institutional environment as normative expectations. This synthesis or blending of these two perspectives is labeled institutionaucracy, implying that, as productivity and efficiency considerations become institutionalized, hospitals conforming to such operational standards will gain legitimacy and additional resources from their environment.

  4. Ionizing radiation in hospitals

    International Nuclear Information System (INIS)

    Blok, K.; Ginkel, G. van; Leun, K. van der; Muller, H.; Oude Elferink, J.; Vesseur, A.

    1985-10-01

    This booklet dels with the risks of the use of ionizing radiation for people working in a hospital. It is subdivided in three parts. Part 1 treats the properties of ionizing radiation in general. In part 2 the various applications are discussed of ionizing radiation in hospitals. Part 3 indicates how a not completely safe situation may be improved. (H.W.). 14 figs.; 4 tabs

  5. Preventing falls in hospital.

    Science.gov (United States)

    Pearce, Lynne

    2017-02-27

    Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

  6. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  7. [Hospital organizational structure].

    Science.gov (United States)

    Bittar, O J

    1994-01-01

    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  8. Private finance initiative hospital architecture: towards a political economy of the Royal Liverpool University Hospital.

    Science.gov (United States)

    Jones, Paul

    2018-02-01

    Sociological analysis has done much to illuminate the architectural contexts in which social life takes place. Research on care environments suggests that the built environment should not be understood as a passive backdrop to healthcare, but rather that care is conditioned by the architecture in which it happens. This article argues for the importance of going beyond the hospital walls to include the politics that underwrite the design and construction of hospital buildings. The article assesses the case of the yet-to-be-realised Liverpool Royal University Hospital, and the private finance initiative (PFI) funding that underpins the scheme, which is suggested as a salient 'external' context for understanding architecture's role in the provision of healthcare of many kinds for many years to come. PFI has major implications for democratic accountability and local economy, as well as for the architecture of the hospital as a site of care. Critical studies can illuminate these paradoxically visible-but-opaque hospital spaces by going beyond that which is immediately empirically evident, so as to reveal the ways in which hospital architecture is conditioned by political and economic forces. © 2018 Foundation for the Sociology of Health & Illness.

  9. Hospital waste management in nonteaching hospitals of Lucknow City, India

    Directory of Open Access Journals (Sweden)

    Manish Kumar Manar

    2014-01-01

    Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

  10. Case mix planning in hospitals: a review and future agenda.

    Science.gov (United States)

    Hof, Sebastian; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

    2017-06-01

    The case mix planning problem deals with choosing the ideal composition and volume of patients in a hospital. With many countries having recently changed to systems where hospitals are reimbursed for patients according to their diagnosis, case mix planning has become an important tool in strategic and tactical hospital planning. Selecting patients in such a payment system can have a significant impact on a hospital's revenue. The contribution of this article is to provide the first literature review focusing on the case mix planning problem. We describe the problem, distinguish it from similar planning problems, and evaluate the existing literature with regard to problem structure and managerial impact. Further, we identify gaps in the literature. We hope to foster research in the field of case mix planning, which only lately has received growing attention despite its fundamental economic impact on hospitals.

  11. A Model of the Costs of Community and Nosocomial Pediatric Respiratory Syncytial Virus Infections in Canadian Hospitals

    Directory of Open Access Journals (Sweden)

    Philip Jacobs

    2013-01-01

    Full Text Available BACKGROUND: Approximately one in 10 hospitalized patients will acquire a nosocomial infection (NI after admission to hospital, of which 71% are due to respiratory viruses, including the respiratory syncytial virus (RSV. NIs are concerning and lead to prolonged hospitalizations. The economics of NIs are typically described in generalized terms and specific cost data are lacking.

  12. [Economic aspects of epilepsy].

    Science.gov (United States)

    Argumosa, A; Herranz, J L

    2000-06-01

    The economic magnitude of epilepsy is determined by its effect on the employment status of the patients, the cost of drug treatment for them and the healthcare system and the repercussion worldwide. Studies of the cost of the disease show that it has economic importance due to the sum of the direct and indirect costs caused by it. In the case of epilepsy, the results of studies in various countries led to the creation of a Commission on Economic Aspects of Epilepsy. The lack of epidemiological studies regarding epilepsy in Spain may explain the lack of publications on this subject in our country. The percentage of the total cost due to antiepileptic drugs is considerable and will probably increase in the future. The pharmaco-economic evaluation made by cost-benefit, cost-effectiveness, cost-usefulness analysis and studies to minimize costs should serve to use healthcare resources in the most effective manner and justify the rational use of the new antiepileptic drugs. The economic impact of epilepsy is added to the repercussion of the disease itself on the patient and his family. The different distribution of costs in children and adults with epilepsy suggest the need for intervention at an early age to try to reduce the long term economic and personal repercussions. The pharmaco-economic evaluation of the new antiepileptic drugs will make it clear whether their considerable cost is worth paying for their greater effectivity.

  13. Economic and clinical value of levofloxacin

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2006-12-01

    Full Text Available Levofloxacin is a newer fluoroquinolone, with broad spectrum of antibacterial activity and good tolerability. This drug has a pharmacokinetic and pharmacodynamic profile that allows a once-a-day administration and offers the potential for intravenous-to-oral switch therapy. Due to these characteristics, the principal guidelines recommend it, as an option for the empirical therapy of patients with mild or more severe community acquired pneumonia (CAP, acute exacerbation of chronic bronchitis (AECB, complicated urinary tract infection (cUTI and skin and soft tissue infection (SSTI. These pathologies are common causes of morbidity and mortality and place a large burden on medical and economic resources, specially if hospitalization is required. The implementation of a critical pathway, based on levofloxacin use and on a risk prediction rule to establish the need for hospitalization, has the potential to decrease healthcare resource consumption without impairment of clinical outcomes, with respect to conventional management. The possibility of switch therapy allows to reduce length of hospital stay, with a saving in both direct and indirect costs, and an increase in patient satisfaction. In summary, when used according to appropriateness criteria and for approved indications, levofloxacin offers favorable economic features for the healthcare provider, whilst guaranteeing a positive impact on patient functioning and quality of life.

  14. Non-economic determinants of economic development: methodology and influence

    OpenAIRE

    Barashov, N.

    2011-01-01

    The paper deals with research methodology of non-economic determinants of economic development. The author considers various theoretical approaches to definition of economic growth factors. Considerable attention is given to studying possible influence of non-economic determinants on quality of economic development.

  15. Quantification classification and management of hospital waste in Lahore city

    International Nuclear Information System (INIS)

    Khan, M.R.; Riaz, M

    2010-01-01

    Systematic disposal of hospital waste is a major problem encountered by different countries including Pakistan. Efforts are on the way to achieve this objective techno-economically. To quantify infectious and total waste produced by the hospitals of Lahore, classify it to know the nature of their components and to collect information about its management. The background information and secondary data were collected by consultation of literature in the libraries and visiting different websites on Internet. The primary data were collected by gathering the responses of the Chief Executives, Medical Superintendents and Medical and Environmental Staff of all hospitals scheduled as reference models through interview. The total quantity of infectious waste produced by the hospitals and other health care units is approximately 785 million tons per annum while the total waste including municipal component is approximately 3,925 million tons per annum. The current status of awareness about proper health care waste disposal is improving but at a slow pace. It may be concluded that the management of hospital waste in five hospitals of Lahore city is systematic. However, the staff handling the waste was not fully trained for proper segregation of the hospital wastes. Incinerators being used for waste disposal are a major source of secondary air pollution therefore, this method should be discouraged. Instead, the feasibility of thermoelectric power generation may be looked into. Proper disposal of hospital wastes should be in placed in every hospital and trained staff should be employed for the job. (author)

  16. The economic burden of schizophrenia in Malaysia

    Directory of Open Access Journals (Sweden)

    Teoh SL

    2017-07-01

    Full Text Available Siew Li Teoh,1 Huey Yi Chong,1 Salina Abdul Aziz,2 Norliza Chemi,2 Abdul Razak Othman,2 Nurzuriana Md Zaki,2 Possatorn Vanichkulpitak,3 Nathorn Chaiyakunapruk1,4–6 1School of Pharmacy, Monash University Malaysia, Selangor, 2Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 3Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 4Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 5School of Pharmacy, University of Wisconsin, Madison, WI, USA; 6Health and Well-being Cluster, Global Asia in the 21st Century (GA21 Platform, Monash University Malaysia, Selangor, MalaysiaIntroduction: Schizophrenia (SCZ is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.Methods: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL. The medical charts were identified electronically by matching the unique patient’s identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.Results: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million

  17. Thermodynamics extends economics potentials

    Energy Technology Data Exchange (ETDEWEB)

    Bandura, Alexander V. [Kiev Technical Univ., Dept. of Marketing and Management, Kiev (Ukraine); Brodiansky, Victor M. [Moscow Energy Inst., Dept. of Cryogen Machines, Moscow (Russian Federation)

    2001-08-01

    In this paper we consider the use of exergy in economic valuation and its correlation with money. Exergy-based determination of production expenses provides a new base for 'natural' price determination. A new macroeconomic dynamics approach based on this correlation is proposed. This method is relatively general because it is not restricted by certain assumptions used in traditional economic analysis. The exergy model of macroeconomic dynamics was tested by utilizing data from the US economy. This test, covering a period of about 25 years, confirms this approach and opens new potentials in economic analysis. (Author)

  18. Economic evaluation of reprocessing

    International Nuclear Information System (INIS)

    1978-11-01

    This discussion paper first identifies the main factors which influence the economic assessment of reprocessing. It proposes the use of a diagram - the so-called ''phase diagram'' - which plots the fast reactor premium against the price of uranium. The diagram delineates areas where the once-through fuel cycle, thermal recycle and fast reactor will be the preferred choice from micro-economic considerations. The paper then goes on to consider the circumstances under which a country may or may not wish to introduce thermal recycle or fast reactors. Finally, a procedure for further discussion on economic considerations with WG4 is proposed

  19. Economic Selection Theory

    DEFF Research Database (Denmark)

    Knudsen, Thorbjørn

    2003-01-01

    principles of variation, continuity and selection, it is argued that economic selection theory should mimic the causal structure of neo-Darwinian theory. Two of the most influential explanations of economic evolution, Alchian's and Nelson and Winter's, are used to illustrate how this could be achieved.......The present article provides a minimal description of the causal structure of economic selection theory and outlines how the internal selection dynamics of business organisations can be reconciled with selection in competitive markets. In addition to generic similarity in terms of the Darwinian...

  20. International mineral economics

    International Nuclear Information System (INIS)

    Gocht, W.R.; Eggert, R.G.

    1988-01-01

    International Mineral Economics provides an integrated overview of the important concepts. The treatment is interdisciplinary, drawing on the fields of economics, geology, business, and mining engineering. Part I examines the technical concepts important for understanding the geology of ore deposits, the methods of exploration and deposit evaluation, and the activities of mining and mineral processing. Part II focuses on the economic and related concepts important for understanding mineral development, the evaluation of exploration and mining projects, and mineral markets and market models. Finally, Part III reviews and traces the historical development of the policies of international organizations, the industrialized countries, and the developing countries. (orig.)

  1. FDI- Economic Growth Nexus

    DEFF Research Database (Denmark)

    Bujac, Andreea Ioana; Corado Cretu, Emanuel

    2017-01-01

    Conducting a systematic literature review on the topic of FDI and Economic Growth and investigating this relationship, along with the determinants of an economy that attract FDI and the externalities resulting from Foreign activities, it is found that FDI does have a positive effect on a host...... country’s economic growth but only with the preexistence of certain determinants which facilitate the absorption capacity of the host country on reaping the spillover effects (externalities) of FDI. Lastly, a framework was built to illustrate the interaction between FDI, Determinants and condition...... of the host economy, barriers to growth, economic growth and externalities....

  2. School of Economic French

    Directory of Open Access Journals (Sweden)

    I. S. Franceva

    2014-01-01

    Full Text Available Economic French at MGIMO-University is based on the teaching methods developed by talented Methodist practitioner assistant professor L.L. Potushanskoy. She and her colleagues G.M. Kotova, N. Kolesnikova, I.A. Yudina created well-known in our country methodical complex of three textbooks. This complex is built on clear guidelines to facilitate the natural development of language skills "from simple to complex" and represents the effective approach to language learning: Currently, the department is constantly expanding its boundaries of school teaching economic and business of the French language in accordance with the emerging new special courses on the economics faculties.

  3. Economic bid evaluation

    International Nuclear Information System (INIS)

    Bode, T.

    1975-01-01

    When it is intended to install a new nuclear power station, the usual procedure is to invite for tenders. In due course, bids will be received from various manufacturers, out of which the most favourable one is then to be selected. Appraisal is concluded in the Economic Bid Evaluation, the purpose of which is to define the economically most favourable bid by comparing overall costs and benefits of the various alternatives. Thus, Economic Bid Evaluation is a most important instrument for deciding on award of contract. (orig.) [de

  4. Energy economics and supply

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    This section of the book, Part I, consists of four chapters (1--4). Chapter 1, Energy and the Economic Future, covers the following subjects: general economics of energy; predicting energy demand; a model of energy and the economy; and interpretations. Chapter 2, Uranium and Fossil Fuel Supplies, covers the following subjects: uranium resources; oil and gas supplies; coal resources. Chapter 3, Economics of Nuclear Power, covers information on sources of uncertainty; cost of nuclear power; cost of coal-generated electricity. Chapter 4, Alternative Energy Sources, sums information on solar energy, geothermal energy, fusion power, conservation, and transmission

  5. The economic burden of schizophrenia in Malaysia.

    Science.gov (United States)

    Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

    2017-01-01

    Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

  6. Hospitality industry veteran and Hampton Roads Center team up to present workshop on ensuring success

    OpenAIRE

    Felker, Susan B.

    2008-01-01

    Hospitality industry veteran Howard Feiertag is hosting a workshop aimed at novice and experienced hotel sales managers, directors and general managers looking for ways to reinvigorate their team's efforts and ensuring success during economic shifts.

  7. Revisiting the relevance of economic theory to hotel revenue management education and practice in the era of Big Data

    OpenAIRE

    Haynes, Natalie; Egan, David

    2017-01-01

    Abstract\\ud This paper explores the role of economics in hospitality education and industry practice, with a particular focus on revenue management, and puts forward an argument for a return to the inclusion of economic theory in UK hospitality education, not seen since the 1990s. Given the increasing amounts of pricing data available to both managers and customers and the consequent market complexities now seen, developing economic literacy is demonstrated to be a crucial skill required for ...

  8. Hospitals look to hospitality service firms to meet TQM goals.

    Science.gov (United States)

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  9. Anger Promotes Economic Conservatism.

    Science.gov (United States)

    Kettle, Keri L; Salerno, Anthony

    2017-10-01

    Research suggests that certain facets of people's political ideals can be motivated by different goals. Although it is widely accepted that emotions motivate goal-directed behavior, less is known about how emotion-specific goals may influence different facets of ideology. In this research, we examine how anger affects political ideology and through what mechanisms such effects occur. Drawing on the dual-process motivational model of ideology and the functionalist perspective of emotion, we propose that anger leads people to support conservative economic ideals, which promote economic independence and discourage societal resource sharing. Four studies support our hypothesis that anger can enhance support for an election candidate espousing conservative economic ideals. We find that anger shifts people toward economic conservatism by orienting them toward competition for resources. Implications and future research on the relationship between emotions and political ideology are discussed.

  10. Economic Development of Nigeria

    African Journals Online (AJOL)

    User

    variables of population, health centres, employment and capital water projects were ... reorganization and reorientation of entire economic and social systems. In addition, to ... inequality and eradication of poverty (Todaro and Smith 2006).

  11. China's Economic Conditions

    National Research Council Canada - National Science Library

    Morrison, Wayne M

    2008-01-01

    ... (the fastest annual growth since 1994). While China is expected to continue to enjoy rapid economic growth in the years ahead and could become the world's largest economy within a decade or so, it faces a number of challenges, including...

  12. Advances in mathematical economics

    CERN Document Server

    Yamazaki, Akira

    2005-01-01

    A lot of economic problems can be formulated as constrained optimizations and equilibration of their solutions. Various mathematical theories have been supplying economists with indispensable machineries for these problems arising in economic theory. Conversely, mathematicians have been stimulated by various mathematical difficulties raised by economic theories. The series is designed to bring together those mathematicians who are seriously interested in getting new challenging stimuli from economic theories with those economists who are seeking effective mathematical tools for their research. The editorial board of this series comprises the following prominent economists and mathematicians: Managing Editors: S. Kusuoka (Univ. Tokyo), T. Maruyama (Keio Univ.). Editors: R. Anderson (U.C. Berkeley), C. Castaing (Univ. Montpellier), F.H. Clarke (Univ. Lyon I), G. Debreu (U.C. Berkeley), E. Dierker (Univ. Vienna), D. Duffie (Stanford Univ.), L.C. Evans (U.C. Berkeley), T. Fujimoto (Okayama Univ.), J.-M. Grandmont...

  13. Exploitation by Economic Necessity

    Directory of Open Access Journals (Sweden)

    Kristian F. Braekkan

    2015-10-01

    Full Text Available This study develops and tests a model that proposes economic necessity moderates the relationship between psychological contract violations (PCVs and organizational commitment and trust in the employing organization among non-unionized manufacturing workers (N = 226. Moderated regression analyses revealed that there was a significant interaction between PCV and economic necessity in predicting both outcomes. Specifically, the findings indicated that individuals experiencing high PCV and high economic necessity did not decrease their organizational commitment like their counterparts who endorsed lower economic necessity. They did, however, experience significantly decreased trust in their employer. The findings suggest that individuals who are forced to sell their labor power and obtain what they need through the market are more likely to continue to be exploited by their employer, as they have no other options than to continue the relationship. The importance of the findings is discussed, and recommendations for future research are provided.

  14. How economics shapes science

    National Research Council Canada - National Science Library

    Stephan, Paula E

    2012-01-01

    .... At a time when science is seen as an engine of economic growth, Paula Stephan brings a keen understanding of the ongoing cost-benefit calculations made by individuals and institutions as they compete...

  15. European Economic Integration

    Science.gov (United States)

    Huston, James A.

    1971-01-01

    Recounts the history and problems of European Economic Integration from the first post World War II organization, the OEEC, to the EEC (Common Market) and the EFTA. Suggestions for further reading are included. (JB)

  16. China's Economic Conditions

    National Research Council Canada - National Science Library

    Morrison, Wayne M

    2007-01-01

    .... China is expected to continue to enjoy rapid economic growth over the next several years, provided that it continues to implement needed reforms, particularly in regard to its inefficient state-owned...

  17. Buddhism, Business, and Economics

    DEFF Research Database (Denmark)

    Brox, Trine; Williams-Oerberg, Elizabeth Lane

    2017-01-01

    This chapter takes the relationship that Buddhists have historically had with economic practices as a starting point for discussing contemporary entanglements of Buddhism and economy. Based on a literary review of previous studies on Buddhism and business and building upon our own research, we...... analyze the diverse range of influences that have impacted the manner in which Buddhism and business have been entwined, taking a look at historical as well as regional, national, and global impacts on the formulation of Buddhism within encounters with global market economies. Our review spans lay......-monk exchange relations, Buddhist economic ethics, monastic businesses, spiritual consumerism, globalized Buddhism, secularized Buddhist technologies in the corporate world, and Buddhist branding, all of which testify to the diverse modalities of Buddhism and economic relations, illuminating also the economic...

  18. Walter Isard's Contributions to Environmental Economics and Ecological Economics

    NARCIS (Netherlands)

    Rose, Adam; Folmer, Henk; Nijkamp, Peter

    This article summarizes Walter Isard's important contributions to environmental economics and ecological economics. The former is the traditional field that incorporates some limited aspects of the environment into neoclassical economic theory, while the latter is a more comprehensive integration of

  19. [Philanthropic hospitals and the operation of provider-owned health plans in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Barbosa, Pedro Ribeiro; Gerschman, Silvia; Vasconcellos, Miguel Murat

    2007-02-01

    To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.

  20. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne

    2013-08-01

    Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

  1. [Communication among hospital leaders].

    Science.gov (United States)

    Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie

    2013-12-01

    New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital.

  2. Essays in environmental economics

    OpenAIRE

    Stoerk, Thomas,

    2017-01-01

    The first chapter of the dissertation examines the learning process that economic agents use to update their expectation of an uncertain and infrequently observed event. The standard Bayesian updating model is restrictive in that it reflects the strong neo-classical assumption that economic agents efficiently incorporate new information with all available information when updating beliefs. I consider the case of flooding and estimate the effect of first-hand experience on flood insurance ta...

  3. The Economics of Starvation

    DEFF Research Database (Denmark)

    Stahl, Rune Møller

    2016-01-01

    Stahl investigates the role of liberal economics in the formulation of the disastrous famine policy of the British colonial administration in nineteenth-century India, where millions of Indians starved to death in a series of famines. The chapter examines the influential debates around the Great....... The hegemonic position of free trade ideas and economic liberalism allowed for proponents of a hard laissez-faire line to mobilize considerable intellectual resources, from Adam Smith to Ricardo, to overcome humanitarian critiques....

  4. Introduction to Economic Analysis

    OpenAIRE

    R. Preston McAfee

    2005-01-01

    This book presents introductory economics ("principles") material using standard mathematical tools, including calculus. It is designed for a relatively sophisticated undergraduate who has not taken a basic university course in economics. It also contains the standard intermediate microeconomics material and some material that ought to be standard but is not. The book can easily serve as an intermediate microeconomics text. The focus of this book is on the conceptual tools and not on fluff. M...

  5. Rethinking Development Economics

    OpenAIRE

    Joseph E. Stiglitz

    2011-01-01

    "Twelve years ago, when I was chief economist of the World Bank, I suggested that the major challenge to development economics was learning the lessons of the previous several decades: a small group of countries, mostly in Asia, but a few in other regions, had had phenomenal success, beyond anything that had been anticipated by economists; while many other countries had experienced slow growth, or even worse, stagnation and decline—inconsistent with the standard models in economics which pred...

  6. Personality Psychology and Economics

    OpenAIRE

    Almlund, Mathilde; Duckworth, Angela Lee; Heckman, James J.; Kautz, Tim

    2011-01-01

    This paper explores the power of personality traits both as predictors and as causes of academic and economic success, health, and criminal activity. Measured personality is interpreted as a construct derived from an economic model of preferences, constraints, and information. Evidence is reviewed about the "situational specificity" of personality traits and preferences. An extreme version of the situationist view claims that there are no stable personality traits or preference parameters tha...

  7. Metaphor and economic thought

    DEFF Research Database (Denmark)

    Mouton, Nicolaas T.O.

    2012-01-01

    the biological sciences of their time. If we track the evolution of “economic biology” over time, it turns out that most extensions and elaborations of the metaphor carry subtle but strong traces of their approximate historical provenance. More generally, a historical perspective enables one to see the metaphors...... underlying economic reasoning as flexible and dynamic processes, rather than as fixed and static systems....

  8. Armenia's Economic Growth Sustainability

    OpenAIRE

    Hayakawa, Tatsuji

    2015-01-01

    Armenia enjoyed 15 years of uninterrupted high economic growth prior to the global financial crisis in 2009. Investment, particularly in the mining and metallurgy sectors, played a key role as a driver of economic growth. Remittances,mostly from Russia, had an effect in sustaining consumption and boosting construction. Armenia has shown some weaknesses in the external sector, due to demands for natural gas, mineral products, machinery, and equipment. Armenia's exports and FDI suffer from the ...

  9. Finance and Economic Development

    OpenAIRE

    Panizza, Ugo

    2012-01-01

    Published by Palgrave Macmillan This chapter reviews the literature on finance and economic development. It starts with a description of the roles of finance, a definition of financial efficiency, and a discussion of whether countries may have financial sectors that are ‘too large’ compared to the size of the domestic economy. Next, the author describes several indicators of financial development and reviews the literature on the relationship between financial development and economic growth....

  10. Economics of Metal Markets

    OpenAIRE

    Tilton, J.E.

    1984-01-01

    Simple economic principles can provide useful insights into the behavior of metal markets. In applying these principles, however, the analyst must take into account technology, market structure, government policies, and other institutional factors influencing the nature of metal supply and demand. Knowledge of both economics and the metal markets is essential. One without the other is likely to lead to sterile or even misleading results. In support of the above conclusion, this study exa...

  11. Sraffa and ecological economics

    OpenAIRE

    Verger, Yoann

    2015-01-01

    References to Sraffa and to the neo-Ricardian school is something quite customary in ecological economics. By looking at contributions in this area since the beginning of ecological economics and at contributions on environmental problem from the neo-Ricardian school, we see that a connection between both school still has to be made. This connection should be articulated around the initial aim of Sraffa: to develop a new paradigm, competing against the neoclassical one. Only then it will be p...

  12. The Ghanaian Economic Recovery

    Science.gov (United States)

    2013-12-01

    NY.GDP.MKTP.KD.ZG. 2 Only Syria, Zambia , Myanmar, and Algeria had slower growth rates in 1966. 3 Ferdinand Bakoup, Republic of Ghana Country Strategy Paper (Accra...available economic data from the World Bank (1961 to 2011). During that time, Ghana’s GDP growth rate deviated significantly from the regional growth rate...quantitative controls, and reduce taxes on agriculture. See Ho-Won Jeong, “Ghana: Lurching Toward Economic Rationality,” World Affairs 159, no. 2

  13. DETERMINANTS OF ECONOMIC GROWTH

    OpenAIRE

    Bartosz Totleben

    2013-01-01

    The article is examines the impact of macroeconomic indicators, in particular: human capital, government spending, innovation, political and social stability, on economic growth. In total 12 different indicators describing the economical, political and social conditions are taken into account. The study considers 102 countries between years 1960 and 2012 and two methods of estimation are performed: generalized method of moments (GMM) and fixed effects (FE). The results show the positive impac...

  14. Thermodynamics and economics

    International Nuclear Information System (INIS)

    Mansson, B.A.

    1990-01-01

    Economics, as the social science most concerned with the use and distribution of natural resources, must start to make use of the knowledge at hand in the natural sciences about such resources. In this, thermodynamics is an essential part. In a physicists terminology, human economic activity may be described as a dissipative system which flourishes by transforming and exchanging resources, goods and services. All this involves complex networks of flows of energy and materials. This implies that thermodynamics, the physical theory of energy and materials flows, must have implications for economics. On another level, thermodynamics has been recognized as a physical theory of value, with value concepts similar to those of economic theory. This paper discusses some general aspects of the significance of non-equilibrium thermodynamics for economics. The role of exergy, probably the most important of the physical measures of value, is elucidated. Two examples of integration of thermodynamics with economic theory are reviewed. First, a simple model of a steady-state production system is sued to illustrate the effects of thermodynamic process constraints. Second, the framework of a simple macroeconomic growth model is used to illustrate how some thermodynamic limitations may be integrated in macroeconomic theory

  15. Economic analysis of basiliximab in renal transplantation.

    Science.gov (United States)

    Keown, P A; Balshaw, R; Krueger, H; Baladi, J F

    2001-06-15

    Basiliximab is a chimeric monoclonal directed against the alpha-chain of the interleukin-2 receptor. International studies have shown that it is highly effective in preventing acute rejection in patients receiving Neoral, and causes no measurable incremental toxicity, but its economic value remains unknown. This study employed an economic model to examine the potential economic benefit of basiliximab. Parameter estimates were derived from a randomized, prospective, double-blind study conducted in 21 renal transplant centers in seven countries in which 380 adult primary allograft recipients were randomized within center to receive basiliximab (20 mg i.v.) on days 0 and 4 or placebo in addition to dual immunosuppression with Neoral and steroids. Key clinical events included primary hospitalization, immunosuppressive drug use, patient and graft survival, graft rejection, treatment of rejection, dialysis, and repeat hospitalization. Health resources were valued via a comprehensive electronic cost dictionary, based upon a detailed economic evaluation of renal transplantation in Canada. Medication costs were calculated from hospital pharmacy acquisition costs; basiliximab was assessed a zero cost. The average estimated cost per patient for the first year after transplant was $55,393 (Canadian dollars) for placebo and $50,839 for basiliximab, rising to $141,690 and $130,592, respectively, after 5 years. A principal component of the cost in both groups was accrued during the initial transplant hospitalization ($14,663 for standard therapy and $14,099 for basiliximab). An additional $15,852 and $14,130 was attributable to continued care, graft loss, and dialysis in the two groups, whereas follow-up hospitalization consumed an additional $15,538 for placebo and $13,916 for basiliximab. The mean incremental cost of dialysis was $5,397 for placebo compared with $3,821 for basiliximab, whereas incremental costs of graft loss were $2,548 compared with $2,295 in the two treatment

  16. Risks in hospitals. Assessment and Management

    Directory of Open Access Journals (Sweden)

    Bradea Ioana-Alexandra

    2014-12-01

    Full Text Available In a complex world, characterized by a multitude of risks, managers need to manage the risks they encounter, in an efficient way and in the shortest time possible. In the current economic crisis, the concept of hospital risk management, as the process in which is identified, analyzed, reduced, or avoided a risk that may affect the hospital, gained great importance. The Romanian health system, distinguished by: lack of transparency, poor funding, the loss of the valuable medical staff, lack of hospitals in villages and small towns, inability to engage patients due to the old and poor equipment, lack of research and problems in information privacy and cyber-security, requires an appropriate management, enabling risk managers to take decisions in order to avoid the occurrence of risks. Important for the functioning of every hospital is the perception of patients and their degree of satisfaction, regarding the quality of services, which depend largely on the quality of human resources. But what are the human resources weaknesses and risks from the patient point of view? What are the risk indicators which must be monitored to avoid risks? And also, which is the most useful method for measurement and assessment of risk?

  17. An energy saving system for hospital laundries

    Energy Technology Data Exchange (ETDEWEB)

    Katsanis, J.S.; Tsarabaris, P.T.; Polykrati, A.D.; Proios, A.N. [National Technical Univ. of Athens, Athens (Greece). School of Electrical and Computer Engineering; Koufakis, E.I. [Public Power Corp. S.A., Crete (Greece)

    2009-07-01

    Hospital laundries are one of the largest consumers of water and electrical and thermal energy. This paper examined the energy savings achieved by a system using the hot wastewater from the washing process. Hospital laundries consume thermal energy using steam, which is produced in boilers by burning diesel oil or natural gas. Electrical energy for the mechanical drives, ventilation and also the lighting required in the laundry area are big consumers of energy. The paper presented the proposed system and discussed the parameters of the system and system dimensioning. The paper also provided and discussed an interpretation of steam and energy savings. The proposed system was considered to be economically viable, simple in its construction, installation and operation. From the application of the suggested system, the cost savings resulted in a satisfactory payback period for the capital invested of approximately three to five years. 14 refs., 4 tabs., 2 figs.

  18. The health care market: can hospitals survive?

    Science.gov (United States)

    Goldsmith, J C

    1980-01-01

    Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations.

  19. Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

    African Journals Online (AJOL)

    OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

  20. Economic analysis model for total energy and economic systems

    International Nuclear Information System (INIS)

    Shoji, Katsuhiko; Yasukawa, Shigeru; Sato, Osamu

    1980-09-01

    This report describes framing an economic analysis model developed as a tool of total energy systems. To prospect and analyze future energy systems, it is important to analyze the relation between energy system and economic structure. We prepared an economic analysis model which was suited for this purpose. Our model marks that we can analyze in more detail energy related matters than other economic ones, and can forecast long-term economic progress rather than short-term economic fluctuation. From view point of economics, our model is longterm multi-sectoral economic analysis model of open Leontief type. Our model gave us appropriate results for fitting test and forecasting estimation. (author)

  1. Hospital management principles applicable to the veterinary teaching hospital.

    Science.gov (United States)

    Harris, Donna L; Lloyd, James W; Marrinan, Mike

    2004-01-01

    The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.

  2. Key economic sectors and services

    NARCIS (Netherlands)

    Arent, Douglas J.; Tol, Richard S.J.; Faust, Eberhard; Hella, Joseph P.; Kumar, Surender; Strzepek, Kenneth M.; Tóth, Ferenc L.; Yan, Denghua; Abdulla, Amjad; Kheshgi, Haroon; Xu, He; Ngeh, Julius

    2015-01-01

    Introduction and Context This chapter discusses the implications of climate change on key economic sectors and services, for example, economic activity. Other chapters discuss impacts from a physical, chemical, biological, or social perspective. Economic impacts cannot be isolated; therefore, there

  3. Economic integration in the Americas

    OpenAIRE

    Uitdewilligen, G.

    1997-01-01

    This pioneering study shows that economic integration in the Americas is not simply a matter of removing trade barriers. Economic Integration in the Americas addresses the pervasive effects of economic integration on the economy as a whole.

  4. AFRICAN JOURNAL OF ECONOMIC REVIEW

    African Journals Online (AJOL)

    Dr Kazungu

    regional trade and the region's economic growth remain unknown. ... knowledge, and therefore, contributes to innovation and economic growth. ... The role of agricultural sector in economic development and welfare improvement in EAC states.

  5. Rural hospital wages

    Science.gov (United States)

    Hendricks, Ann M.

    1989-01-01

    Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454

  6. Hospital mergers: a panacea?

    Science.gov (United States)

    Weil, Thomas

    2010-10-01

    Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.

  7. Costs of hospital malnutrition.

    Science.gov (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

    2017-10-01

    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  8. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... a correlation matrix. The correlation factor defines the framework for conceptual design, whereby the design considers functionalities and their requirements and preferences. It facilitates implementation of evidence-based design as it is prepared for ongoing update and it is based on actual data. Hence......, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences....

  9. Organization structure and the performance of hospital emergency services.

    Science.gov (United States)

    Georgopoulos, B S

    1985-07-01

    A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

  10. Materiality and Visualization in Hospital Design

    DEFF Research Database (Denmark)

    Harty, Chris; Tryggestad, Kjell

    healthcare systems, single bed rooms are being seen as the preferred alternative to more traditional ward-style accommodation, as it has advantages for privacy and dignity for patients, less disruption to other patients and better control of hospital acquired infections. But fundamentally, single rooms mean...... of different representations and visualizations – economic calculations, drawings, and virtual and physical models. We use these cases to discuss the roles of different sorts of representations and visualizations in design process, in terms of opening up and settling controversies (such as room size), in terms...

  11. Economic Analysis of Social Common Capital

    Science.gov (United States)

    Uzawa, Hirofumi

    2005-06-01

    Social common capital provides members of society with those services and institutional arrangements that are crucial in maintaining human and cultural life. The term æsocial common capital' is comprised of three categories: natural capital, social infrastructure, and institutional capital. Natural capital consists of all natural environment and natural resources including the earth's atmosphere. Social infrastructure consists of roads, bridges, public transportation systems, electricity, and other public utilities. Institutional capital includes hospitals, educational institutions, judicial and police systems, public administrative services, financial and monetary institutions, and cultural capital. This book attempts to modify and extend the theoretical premises of orthodox economic theory to make them broad enough to analyze the economic implications of social common capital. It further aims to find the institutional arrangements and policy measures that will bring about the optimal state of affairs.

  12. Organizational economics and health care markets.

    Science.gov (United States)

    Robinson, J C

    2001-04-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership.

  13. Home-based intermediate care program vs hospitalization

    Science.gov (United States)

    Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

    2008-01-01

    OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

  14. Performance Measurement in Belgian Hospitals : a state-of-the-art

    OpenAIRE

    Van Caillie, Didier; Rouhana, Rima; Santin, Sarah

    2007-01-01

    This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.

  15. Optimized biofilm-based systems for removal of pharmaceuticals from hospital waste water

    DEFF Research Database (Denmark)

    Andersen, Henrik R; Chhetri, Ravi; Hansen, Kamilla

    Discharge of hospital wastewater is of increasing concern, as hospitals are identified as chemical pollution source due to pharmaceutical content. This project seeks to develop the most efficient and economically feasible technology to remove pharmaceuticals from wastewater, regardless of the poi...

  16. Critical Access Hospitals and Retail Activity: An Empirical Analysis in Oklahoma

    Science.gov (United States)

    Brooks, Lara; Whitacre, Brian E.

    2011-01-01

    Purpose: This paper takes an empirical approach to determining the effect that a critical access hospital (CAH) has on local retail activity. Previous research on the relationship between hospitals and economic development has primarily focused on single-case, multiplier-oriented analysis. However, as the efficacy of federal and state-level rural…

  17. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia.

    NARCIS (Netherlands)

    Hadi, U.; Duerink, D.O.; Lestari, E.S.; Nagelkerke, N.J.; Keuter, M.; Huis in 't Veld, D.; Suwandojo, E.; Rahardjo, E.; Broek, P. van den; Gyssens, I.C.J.

    2008-01-01

    This article estimates the magnitude and quality of antibiotic prescribing in Indonesian hospitals and aims to identify demographic, socio-economic, disease-related and healthcare-related determinants of use. An audit on antibiotic use of patients hospitalized for 5 days or more was conducted in two

  18. Significant Trends Are Now Reshaping the Industry Training for Foodservice and Hospitality.

    Science.gov (United States)

    Reiman, Tyrus

    1984-01-01

    The hospitality industry is one that is not adversely affected by the information revolution. As tourism is stimulated by government economic development efforts, opportunities in the food service and hospitality occupations are increasing, both for the young and for the unemployed who need retraining. (SK)

  19. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  20. Recent Developments in Ecological Economics

    DEFF Research Database (Denmark)

    Reader with published articles within the field of ecological economics, mostly from 1997 - 2007......Reader with published articles within the field of ecological economics, mostly from 1997 - 2007...