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PubMedDate not supplied

How to increase efficiency, safety and cost control in hospital infectious waste treatment.

An efficient and cost-effective on-site infectious waste management program can be implemented by integrating the decontamination advantages offered by both steam sterilization and incineration. To do so requires the understanding of the interrelationship between the components that comprise the program. The physical and chemical characteristics of the various infectious waste constituents will dictate the mode by which each constituent will be decontaminated. The treatment mode will in turn dictate the packaging and containment necessary to ensure decontamination. An understanding of the operating principles, and design features of each treatment mode will further enhance treatment efficacy.

Cost Control↗
PubMed1993

Antibiotic cost control measures in a hospital pharmacy.

Faced with rising drug costs and an increase in type-1 beta-lactamase resistance, hospitals have been looking for ways to contain antibiotic costs while continuing to provide quality medical care. The hospital pharmacy at Montefiore Medical Center, Moses Division, has developed a number of programs aimed at identifying antibiotic prescribing trends and minimizing costs. An antimicrobial susceptibility cascade reporting (ASCR) system is used to consolidate and target antimicrobial susceptibility information available to the staff physicians. All antibiotics are tested in the microbiology laboratory for susceptibility; however, physicians receive susceptibility reports only for the more cost-effective, conventional antibiotics. Broader-spectrum, more powerful, and usually more expensive antibiotics are not reported with the ASCR system unless resistance to the more cost-effective antibiotics is noted. Two other reforms initiated are expansion of the pharmacy-based intravenous additive program to include antibiotics and the implementation of a drug therapy enhancement program authorizing automatic conversion by the pharmacist of targeted drug regimens to more clinically rational, cost-effective regimens.

Anti-Bacterial Agents↗
PubMedDate not supplied

Case management: a rich history of coordinating care to control costs.

The process of case management has been used to coordinate health and human services in the United States for more than a century. Throughout its history, case management has been practiced by a variety of disciplines, primarily nursing and the social service disciplines. Regardless of the degree of sophistication of the case management model or the discipline practicing case management, historically the goal has been the same--coordination of complex, fragmented services to meet the needs of the client while controlling the costs of services. As the health care industry continues to evolve during the managed care era, case management seems to be pervading all health care delivery systems as a means of dealing with the issues of access and quality while containing costs. The long history of case management provides a strong foundation for the refinement of case management systems to meet the needs of clients in the 1990s.

Case Management↗
PubMed1991

Employers look to hospitals to help control costs.

The high cost of health insurance for employees is forcing employers to take a second look at ways to control their rising costs, and they are looking for help from hospitals, according to a national study conducted by National Research Corp. In addition, four out of 10 employers surveyed said they believe more taxes should be shifted to hospitals and healthcare services.

Attitude to Health↗
PubMed2006

Molecular medicine, the Medicare drug benefit, and the need for cost control.

The implementation of Medicare Part D, although successful in improving access to prescription drugs for millions of beneficiaries, will lead to a marked escalation in the cost of the Medicare program. An important component of the rise in costs will be specialty pharmaceuticals, including a group of drugs that are self-administered and that cost at least 1,000 dollars/month. The rate of growth in expenditures on specialty pharmaceuticals has been 34% per year. Although all these drugs confer benefits, the degree of benefit varies from dramatic (e.g., imatinib for chronic myelogenous leukemia) to cost-effective (e.g., tumor necrosis factor-alpha blockers for rheumatoid arthritis) to more modest (e.g., disease-modifying drugs used in multiple sclerosis). Historically, when costs within the Medicare program have risen, Congress has enacted price controls, as it did with hospitalization, physician services, and outpatient care. The Medicare Modernization Act (MMA) currently prohibits such an approach. Resorting instead to competition from generic drugs will be of little utility, because there is currently no mechanism to allow biogeneric drugs and patents in the biopharmaceutical industry to limit competition. Controlling the cost of the Medicare Part D program, as dramatically illustrated by the case of specialty pharmaceuticals, will require patent reform, giving the Food and Drug Administration jurisdiction over biogenerics, and amending the MMA to allow the Centers for Medicare and Medicaid Services to institute price controls.

Aged↗