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PubMed1991

Design & construction.

The deepening recession hasn't slowed hospital construction activity--at least not yet. While experts say health care executives should expect fewer large projects within the next two years, as the result of unpredictable sources of capital and increasing censure of hospital capital spending, for the moment hospital projects are helping to shelter some design and construction firms from the recession's fallout.

Costs and Cost Analysis↗
PubMed2004

Cost analysis of the built environment: the case of bike and pedestrian trials in Lincoln, Neb.

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated. Trail length averaged 3.6 miles (range = 1.6-4.6 miles). Annual cost in 2002 dollars ranged from 25,762 to 248,479 (mean = 124,927; median = 171,064). The cost per mile ranged from 5735 to 54,017 (mean = 35,355; median = 37,994). The annual cost per user was 235 (range = 83-592), whereas per capita annual medical cost of inactivity was 622. Construction of trails fits a wide range of budgets and may be a viable health amenity for most communities. To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users should be considered.

Bicycling↗
PubMed1982

Grants to states for construction of state home facilities--VA. Interim regulation.

This revision of a regulation changes from 2 1/2 to 4 beds per thousand veteran population the maximum number of beds which may be necessary based on sufficient justification to provide adequate nursing home care to veterans residing in each State. This regulation implements section 5034(1), title 38, United States Code as amended by Pub. L. 96-330 which now requires the Administrator of Veterans Affairs to prescribe the number of beds required. Prior to enactment of Pub. L. 96-330, the number of beds was prescribed by law. This revision also implements section 5035(b)(4) which provides that an application for Federal assistance for construction of State home facilities shall not result in more than the number of nursing home beds prescribed by the Administrator of Veterans Affairs. It is anticipated that this change will meet the needs of smaller States which were hindered in their plans for construction of additional nursing home beds by the 2 1/2 bed limitation.

Financial Management↗
PubMed1993

Costs and benefits of shell space construction.

"Shell space" is space constructed to meet future needs; it is space enclosed by an exterior building shell, but otherwise unfinished inside. The construction of shell space at the same time another facility is constructed, while adding to overall immediate construction costs, often can lower total expenditures over the long term. This article presents a model for evaluating the financial feasibility of constructing shell space during a capital construction project.

Cost-Benefit Analysis↗
PubMed1980

Federal support for hospital construction in overbedded areas.

This memorandum established policies and procedures to limit Federal financial support for the construction of hospitals in overbedded areas. The policy for Federal hospitals is that no new or replacement hospitals will be built in an overbedded area unless suitable, existing, non-Federal facilities cannot reasonably be acquired through purchase or lease. The policy for non-Federal facilities is that no Federal grants, loans, loan subsidies, or loan guarantees will be provided for hospital construction or renovation in an overbedded area, unless the proposed project is consistent with an approved local hospital facility plan or the Secretary of Health and Human Services (HHS) determines that it is necessary. In addition, legislation and regulations will be proposed to revise the current Medicare and Medicaid reimbursement policies for costs related to hospital construction or renovation. Finally, legislation will be proposed to revise Federal tax exempt bond financing for hospital construction and renovation in overbedded areas. This memorandum also prescribes agency responsibilities and procedures for implementing these policies.

Financial Management↗
PubMedDate not supplied

Hadrontherapy in the world and the programmes of the TERA Foundation.

Hadrontherapy was born in 1938, when neutron beams were used in cancer therapy, but it has become an accepted therapeutical modality only in the last five years. Fast neutrons are still in use, even if their limitations are now apparent. Charged hadron beams are more favorable, since the largest specific energy deposition occurs at the end of their range in matter. The most used hadrons are at present protons and carbon ions. Both allow a dose deposition which conforms to the tumour target. Radiobiological experiments and the results of the first clinical trials indicate that carbon ions have, on top of this macroscopic property, a different way of interacting with cells at the microscopic level. There are thus solid hopes to use carbon beams of about 4500 MeV to control tumours which are radioresistant both to X-rays and protons. After discussing these macroscopic and microscopic properties of hadrontherapy, the hospital-based facilities, running or under construction, are reviewed. The conclusion is that, while in USA and Japan twelve of these centres will be running around the year 2001, in Europe very little is foreseen to use hadrontherapy to treat deep-seated tumours. The most advanced programme is the Italian one, which is described in the last Sections of the report. The main activities concern the construction, near Milano, of a centre for protons and carbon ions called CNAO (National Centre for Oncological Hadrontherapy) and the development of new type of proton accelerators. The Istituto Superiore di Sanita in Rome obtained the initial financing for constructing, in collaboration with ENEA, a 3 GHz linac, which eventually will accelerate protons to 200 MeV, so as to allow deep protontherapy. These, and other hadrontherapy centres in Italy and Europe, will be connected with oncology centres, hospitals and clinics by a multimedial network called RITA, so that before referral each patient's case can be discussed directly by doctors, even located far away, with the experts sitting in the hadrontherapy centres.

Carbon↗
PubMed1978

National health expenditures, fiscal year 1977.

The Nation spent $163 billion for health care in fiscal year 1977 or $737 per person, according to preliminary figures compiled by the Health Care Financing Administration. This figure was 12 percent higher than spending for such purposes in the previous 12 months and represented an 8.8-percent share of the GNP. Public spending, which financed 42 percent of all health care in 1977, increased 11 percent while private spending rose 13 percent. Spending for hospital care went up 14 percent to $68.4 billion, and the total spent for physicians' services ($32.2 billion) reflected a 13-percent rise. Third-party payments financed 70 percent of all personal health care in the country.

Delivery of Health Care↗