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Implications of the method of capital cost payment on the weighted average cost of capital.

The author develops a theoretical and mathematical model, based on published financial management literature, to describe the cost of capital structure for health care delivery entities. This model is then used to generate the implications of changing the capital cost reimbursement mechanism from a cost basis to a prospective basis. The implications are that the cost of capital is increased substantially, the use of debt must be restricted, interest rates for borrowed funds will increase, and, initially, firms utilizing debt efficiently under cost-basis reimbursement will be restricted to the generation of funds from equity only under a prospective system.

Capital Financing↗

Capitalizing on capital purchases.

The acquisition of capital equipment is considerably more involved than the purchase of supply items. Because of the long life of capital equipment, errors in judgment at the time of acquisition can haunt a purchasing manager for years. But if he exercises good judgment and does not lose sight of the particular needs of his hospital, capital equipment can be acquired in a manner that will be in the continuing best interests of the hospital.

Capital Expenditures↗

Sexual capital: an extension of Grossman's concept of health capital.

This essay extends Grossman's concept of health capital to the domain of sexual behavior. Two components of "sexual capital" are discussed, both pertaining to health. One is the person's assets that are effective in preventing contraction of sexually transmitted infections, such as habits in selecting sex partners and the social networks from which those partners are selected, and sexual practices including use of condoms. A second is the person's assets useful in achieving sexual intimacy, an element in positive health. Like other forms of human capital, these embedded assets are acquired through strategic choice and experience as well as inheritance.

Condoms↗

A capital approach: Tobacco treatment and cessation within Nova Scotia's Capital Health District.

Inspired by Nova Scotia's comprehensive Tobacco Control Strategy and in an effort to support Capital Health's 100% smoke-free policy, the Addiction Prevention and Treatment Services (APTS) branch of Capital District Health Authority researched, designed and implemented an innovative tobacco intervention program. The success of the Capital approach, combining peer support, adult education concepts, addictions treatment knowledge, and free pharmacological aids, has sparked interest and dialogue among Canadian and American addictions professionals. The following article describes the rationale, guiding principles, key components and future directions of APTS's "To Be Tobacco Free" program.

Catchment Area, Health↗

Financial capital and intellectual capital in physician practice management.

Medical groups need financial resources yet most retain no earnings and have no reserves. Physician practice management (PPM) companies have recognized the need for investment and the scarcity of indigenous capital in the physician sector and are rushing to fill the void. Resources are being contributed by venture capitalists, bond underwriters, private investors, pharmaceutical manufacturers, health plans, hospital systems, and public equity markets. The potential contribution of PPM firms is to nurture the intellectual capital of leading physician organizations and diffuse it throughout the health care system. The risk is that short-term financial imperatives will impede necessary long-term investments.

Capital Financing↗

Biomechanical analysis of capitate shortening with capitate hamate fusion in the treatment of Kienböck's disease.

The biomechanical effects of surgical treatment options for Kienböck's disease have been compared. However, no study has included a direct analysis of capitate shortening along with capitate-hamate fusion (CSCHF). To investigate the biomechanical effects of CSCHF, a cadaver model of the upper extremity was used to determine radiocarpal articular pressure changes resulting from this procedure using pressure-sensitive film. Ten specimens were tested by placing each in an apparatus that applied load across the radiocarpal joint through the wrist flexor and extensor tendons. Testing was performed in 3 wrist positions (ulnar deviation, radial deviation, and neutral) combined with 3 forearm positions (pronation, supination, and neutral) and neutral flexion/extension. Radioscaphoid, radiolunate, and mean contact pressures in the entire radiocarpal joint were determined for each of the 9 wrist positions, both intact and after surgery. The radioscaphoid mean pressure increased in 6 of 9 positions and was unchanged in 3 positions. The radiolunate mean pressure decreased in 9 of 9 positions. The radiocarpal mean pressure increased in 2 of 9 positions and was unchanged in 7 positions. These data suggests that CSCHF increases radioscaphoid mean pressure, decreases radiolunate mean pressure, and has little effect on radiocarpal mean pressure.

Arthrodesis↗

Human capital, social capital and social exclusion: impacts on the opportunity of households with youth to leave poverty.

Based on a sample survey, this paper, analyzes the impact of human capital, social capital and social exclusion on the opportunity of Hong Kong families with youth members to leave poverty. Educational attainment of the youth members and adult family members, as well as the quantity and quality of social networks were found to have significant positive impacts, while social exclusion from the labor market of the adult members was found to have significant negative impact on their opportunity to leave poverty. Among all factors, quality of social network is the most influential. The author suggests that in order to help families out of poverty and enable positive development of youth members, poverty alleviation policies or programs should be targeted to help the youth in poor families to build up a quality social network.

Adolescent↗

Strong cash flow, balance sheet, management, key to capital needs. Symposium on Healthcare Directions: the capital financing imperative.

For a full day, 10 individuals representing varied health fields and viewpoints within the healthcare industry discussed a number of topics confronting health care and predicted what the environment is likely to be in three years (see accompanying sidebars for symposium participants and purpose). This article focuses on one of the symposium topics, capital availability and financing, and the implications in a time of declining utilization.

Capital Financing↗