PubMed · 13832121
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Q M SMITH, E H PENNELL. 1960. Pricing denticare.. https://doi.org/10.14219/jada.archive.1960.0103
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BACKGROUND: Trauma centers and the services they provide are a unique and necessary component of our health system. By design trauma centers treat all injured patients regardless of their clinical or economic needs. The purpose of this study was to quantify the costs associated with the preparation of the capacity to provide trauma care at trauma centers within the State of Florida. METHODS: Utilizing a survey tool and multiple retreats, we assessed the capability of 20 verified trauma centers throughout the State of Florida. The survey focused on general attributes of each hospital, the costs associated with physician on call coverage, costs associated with verification, and lastly the costs associated with administration, outreach, and prevention. RESULTS: Data were acquired from 10 trauma centers. Ninety percent of the respondents pay on-call coverage. The median annual physician compensation for on-call coverage was approximately 2.1 million US dollars. The total medial cost of readiness for each trauma center approximated 2.7 million US dollars annually. CONCLUSIONS: Trauma centers like fire departments and police services are required to be available 24 hours a day, 7 days a week. This level of commitment by trauma centers and the reciprocal expectation from the community force trauma centers to make considerable investments in readiness. This cost of readiness is expended regardless of the patient volume or insurance status. Thus trauma centers have a large component of costs that are not captured by the traditional billing and cost accounting mechanisms within health systems and this fixed expense is extraordinarily difficult to recover given the current reimbursement environment.
Peracetic acid is a strong disinfectant with a wide spectrum of antimicrobial activity. Due to its bactericidal, virucidal, fungicidal, and sporicidal effectiveness as demonstrated in various industries, the use of peracetic acid as a disinfectant for wastewater effluents has been drawing more attention in recent years. The desirable attributes of peracetic acid for wastewater disinfection are the ease of implementing treatment (without the need for expensive capital investment), broad spectrum of activity even in the presence of heterogeneous organic matter, absence of persistent toxic or mutagenic residuals or by-products, no quenching requirement (i.e., no dechlorination), small dependence on pH, short contact time, and effectiveness for primary and secondary effluents. Major disadvantages associated with peracetic acid disinfection are the increases of organic content in the effluent due to acetic acid (AA) and thus in the potential microbial regrowth (acetic acid is already present in the mixture and is also formed after peracetic acid decomposition). Another drawback to the use of peracetic acid is its high cost, which is partly due to limited production capacity worldwide. However, if the demand for peracetic acid increases, especially from the wastewater industry, the future mass production capacity might also be increased, thus lowering the cost. In such a case, in addition to having environmental advantages, peracetic acid may also become cost-competitive with chlorine.
OBJECTIVE: To identify the costs and economic consequences of expected changes in the demand for health care services for type 2 diabetes in the three main public institutions of the Mexican health care system. RESEARCH DESIGN AND METHODS: The cost evaluation method to estimate direct and indirect costs was based on instrumentation and consensus techniques. To estimate the costs and epidemiological changes for 2003-2005, three probabilistic models were constructed according to the Box-Jenkins technique. RESULTS: Comparing the economic impact in 2003 versus 2005 (P < 0.05), there is a 26% increase in financial requirements. The total amount for diabetes in 2005 (in U.S. dollars) will be 317,631,206, dollars including 140,410,816 dollars in direct costs and 177,220,390 dollars in indirect costs. The total direct costs, representing financial requirements to provide health care for expected cases of type 2 diabetes and its main complications in the three main public institutions in Mexico, up to 2005, will be 37,079,587 dollars for the Ministry of Health (or Secretaría de Salud [SSA], serving the uninsured population) and 103,331,235 dollars for the Mexican Social Security Institute, or Instituto Mexicano del Seguro Social (IMSS), and the Institute for Social Security and Services for State Workers, or Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), both of which serve the insured population. CONCLUSIONS: Our data suggest that changes in the demand for health care services for patients with diabetes will continue with an increasing trend, mainly in the insured population. In economic terms, the results of direct and indirect costs are one of the main challenges to be solved to decrease the economic burden that diabetes represents for the population, the health care institutions, and for society as a whole.