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PubMed2005

States of emergency. As fiscal challenges increasingly overwhelm their budgets, states brace for the Bush administration's Medicaid plan.

With a host of other expensive issues leading President Bush's agenda, officials fear Medicaid could suffer some hard blows. States are already carving out efficiencies, even as enrollment swells. New HHS Secretary Mike Leavitt, left, last week said he saw an opportunity to revamp coverage for some Medicaid recipients. "Wouldn't it be better to give Chevys to everyone, rather than Cadillacs to a few?" he asked.

Budgets↗
PubMedDate not supplied

Prices and healthcare.

Explore the source record for details and available documents.

Cost Allocation↗
PubMed1991

[Economic evaluation of interventions in public health: potentials and limitations].

One of the main principles of economic evaluation refers to the scarcity of resources. So, choices must and will be made concerning the commitment of these resources to one use instead another. Economic evaluation can assume different methodological forms regarding the kind and complexity of programme to be assessed and the issue of outcome valuation, but each analytic technique compares the resources consumed by different relevant alternatives with the health improvements and other consequences arising from them. From a pragmatic point of view, four types of economic evaluation can be distinguished associated with different measurement and valuation of consequences: cost-minimization, cost-effectiveness, cost-utility and cost-benefit analysis. A first step of economic appraisal is definition and description of each competing alternative. Then, there are difficulties associated with measurement and valuation of both costs and effectiveness of alternatives. The assessment of public health interventions poses some special problems in terms of time profiles of cost and consequences. Most of the costs of a health programme incurred in the present while benefits will come later in the future. Therefore, cost and consequences must be discounted to reflect the existence of time preference. The last important point concerns the assessment of health consequences. Ideally, evaluation of efficacy takes the form of a well controlled randomized trial designed for this purpose. But, in many situations, this approach is not relevant, appropriate or feasible and efficacy appraisal must be developed on the basis of available data and "realistic" assumptions. So, every evaluation will contain some degree of uncertainty or imprecision and a sensibility analysis must be performed in order to test sensitivity of the results to alternative assumptions and uncertainty.

Cost Allocation↗
PubMed1991

Myths of competitive reform.

During the 1980s, private economists and government policy-makers promoted market competition as a means of controlling costs and improving quality in the health services industry. However, inflation-adjusted costs rose faster during the 1980s than during the 1970s, and most of the expected benefits were not realized. Competitive reform failed because government and private payors were unwilling or unable to force providers to compete primarily on price and quality. Despite its failure to control costs, competitive reform has created a "mythology" that continues to influence health policy to the detriment of effective reform.

Cost Allocation↗
PubMed1990

Managing operating room budget variances.

Credibility, power, and the ability to obtain greater departmental resources are three benefits of managing the operating room (OR) department's operating budget effectively. Still, few resources exist to help novice as well as seasoned OR directors grapple with the practicalities of maintaining their budget after the annual budget process is completed. The authors examine how astutely controlling personnel, materials, and services budget variances will result in hospital administrators "hearing" and approving an OR director's requests for resources more readily, staff and physicians who enjoy the benefits of better-staffed services and new technology, and an OR director with a reputation as an effective department head among peers in the hospital.

Administrative Personnel↗
PubMed1990

Quality of life--economic aspects.

The interest for quality of life assessments in health care has grown during recent years. From the economist's point of view, quality of life is an appropriate outcome measure in economic assessments of health care as a tool in priority settings. In quality adjusted life-years (QALYs) improvements in the length of life and in its quality are amalgamated into one single index. Different types of medical interventions can be compared by calculations of costs per gained QALY. Unsolved problems still remain with QALYs but with scarce resources within the health care sector measures like QALYs provide a powerful guidance in priority settings.

Cost Allocation↗
PubMed1990

Journal pricing issues: an economic perspective.

Scientific journal prices have increased markedly in the past two decades, outpacing inflation by severalfold. Such increases challenge the librarian's ability to manage acquisitions resources effectively and threaten the mission of the health sciences library as a resource for present and future scientific information needs. Explanations for serial price increases vary with the point of view considered. Publishers, librarians, faculty, and consumers of scientific information perceive the situation differently. This paper provides an economic analysis of each group's views. Particular emphasis is given to the aspects of journal publishing and pricing that foster price increases. In addition, the paper examines the problems of dual-pricing structures and narrowly focused journals that cater to subspecialties of medicine. Suggested responses to subscription rate increases are offered to curtail further increases and to avoid the potential detrimental effects of reduced library collections. Since one of the underpinnings of education is threatened by reductions in library collections, actions must be taken by publishers, librarians, faculty, and professional associations to ameliorate the present situation and to limit additional increases in serial prices.

Cost Allocation↗