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PubMed1998

Laboratory cost control and financial management software.

Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

Cost Control↗
PubMed1993

Markets, budgets, and health care cost control.

Health care cost control is often debated in terms of markets versus bureaucracies. Market restraints are limited in practice by the goal of providing access to care. Therefore, effective cost control requires budgeting. Experience from budgeting for other services should put health care cost control in perspective: The goal should not be rational and efficient allocations, merely better ones. The important choice is not between markets and bureaucracy, but rather which decisions should be made by physicians and which by budgeters, and how to ensure that professional judgment is applied where most important.

Budgets↗
PubMed2000

[Cost control in anesthesiology--regulating net costs exemplified by anesthetics].

German hospitals are beginning to feel more and more pressure due to rising costs in health care. These are due to continuous increase in health care expenditure and decrease in state insurance contributions. A change in the state insurance system (GKV) is well and truly overdue; the source of income needs to be increased by either raising the compulsory insurance wage base or making other forms of income liable for insurance contributions. Unfortunately, the government is still reluctant to take action. The ruling coalition feels that it is better to limit the increase in expenditure on hospital care by introducing a case-related payment system. Unfortunately, they do not recognize that the main reason for the increase in health care expenditure is the growing medical potential and the higher morbidity of an, on average, older population. These cuts in financial means demand an efficient allocation of the available funds. As far as hospital in-patient care is concerned, this means that hospitals need to reconsider their expenditure and that economic success is dependent on their potential to recognize ways of reducing overall costs. This article illustrates that before the "Diagnosis Related Groups" (DRG) become effective in 2003, one needs to establish the cost price of individual hospital cases. The economic principles of cost-benefit ratios and methods to prevent cost inflation are presented. The methods of making a cost-effectiveness analysis of anaesthetic costs are explained in detail. The aim of this paper is to give the clinician a better understanding of cost management and to motivate staff to initiate cost-control studies.

Anesthesiology↗
PubMed1996

[Costs due to osteoporosis-induced fractures in The Netherlands; possibilities for cost control].

OBJECTIVE: Evaluation of the medical costs of osteoporotic fractures in the Netherlands and a discussion of the possibilities of cost control. DESIGN: Cost calculation using published data combined with data from routine hospital and nursing home registration. SETTING: The Netherlands. METHODS: We estimated the total cost of osteoporosis related to fractures of the hip, forearm and vertebrae. Incidence data and data from hospital and nursing home stays were related to information about costs. The analysis was performed for men and women aged 50 and older based on data from 1993. The validity of the assumptions was tested in a sensitivity analysis. RESULTS: The direct medical cost of osteoporosis-related fractures was estimated to be over 400 million builders each year. More than one-third of this cost originated in the group aged 85 and over, while this group only represented 1.3% of the population. About 85% of the costs were caused by hip fractures. Of those costs of hip fractures 80% was due to the hospital admissions. The length of stay in the hospital was associated with discharge status (the length of stay for patients going to a nursing home was almost 8 days longer than for patients leaving for their own homes) and age (the length of stay increased by 0.3 days/year of age). The cost of the stay in a nursing home and of ambulatory care were 20% and 10%, respectively, of the total costs. CONCLUSION: In the short term, cost control is mainly possible by reducing the length of stay in the hospital. This can be done by providing better methods of discharge to suitable care facilities. The cost-effectiveness of prevention of fractures is at present unclear. Due to the duration of the treatment and the frequency of fractures at high ages, the timing of the intervention is of great importance.

Aged↗
PubMed1992

[Naturopathy as a contribution to cost control. Attempt at a cost analysis].

OBJECTIVE: A data analysis has been performed to investigate to what extent naturopathy may contribute to reducing costs of medical care. METHODS: The study included anonymous data from the second quarter of 1988 obtained from the North-Württemberg Kassenärztlichen Vereinigung (insurance company). Physicians practicing in this area at that time were compared to a similarly large collective of those designated additionally as naturopaths and/or homeopaths. RESULTS: Differences between the two groups were significant with respect to drug costs and disability certificates however not with respect to physician fees.

Cost Control↗
PubMed1988

Cost control under the DRG system.

The change in the method of reimbursing hospitals from a retrospective to a prospective payment system known as diagnosis-related group (DRG) caused hospitals to increase control over their costs. This article details a system for cost control that gives timely feedback on the hospital's reimbursement position and allows the hospital to recognize areas that require their attention for proper control over costs. Three variances are discussed: controllable variance, standard variance, and total variance. The system was tested on a hospital found to have enough information for this purpose. The results of this application indicate that the system is as feasible in the hospital industry as it is in other industries.

Cost Control↗
PubMedDate not supplied

Patients' attitudes toward cost control bonuses for managed care physicians.

Physicians' cost containment incentives may create conflicts of interest. To understand how patients view these incentives, we interviewed 1,050 patients regarding a 10 percent cost control bonus and a combined cost control/quality bonus. Seventy-three percent said that the cost control bonus was a bad idea; 49 percent viewed the combined bonus more favorably than the cost control bonus; and 91 percent favored disclosure of bonuses. We conclude that patients find bonuses worrisome and favor their disclosure. A quality component reassures some, but not all, patients. Initiating a dialogue with patients about practicing medicine in an era of limited resources may help health plans and physicians to address patients' concerns.

Attitude to Health↗