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The economics of short-term leasing.

Short-term leasing is an everyday occurrence. Tax savings cannot account for the ubiquity of leasing by temporary users. Monopoly explanations are inconsistent with concurrent leasing and selling markets for perfect substitutes. Leasing economizes upon the costs of detecting, assuring, and maintaining quality, costs of search, and costs of risk-bearing. This view is based on standard economic reasoning and has numerous specific implications.

Costs and Cost Analysis↗

Purchasing medical imaging equipment.

This report presents a summary of the steps and factors involved in the purchasing of medical imaging equipment. Although the range of variations in this process is broad, some fundamental common factors are useful to consider before initiating the acquisition process.

Capital Expenditures↗

Congregate living for the mentally ill: patients as tenants.

The authors describe an apartment-living project for chronic mental patients released from the Hillside Division of the Long Island Jewish-Hillside Medical Center. The apartments, which are rented by the hospital and sublet to the patients, are located in modern, well-maintained high-rise buildings within commuting distance from the hospital. To avoid creating a psychiatric ghetto, the project rents no more than two apartments in buildings of a hundred or more units. The hospital was able to rent the apartments by assuring the landlords that the hospital would be a financially responsible tenant and that staff would be in continuing contact with the patients, would be available to the landlords if problems arose, and would remove troublesome tenants. Some of the problems encountered by the patients in the program are described, as are guidelines for selecting those who have a reasonable chance of benefiting from such a program.

Adult↗

Radiotherapy equipment--purchase or lease?

Against a background of increasing demand for radiotherapy equipment, this study was undertaken to investigate options for equipment procurement, in particular to compare purchase with lease. The perceived advantages of lease are that equipment can be acquired within budget and cashflow constraints, with relatively low amounts of cash leaving the NHS in the first year, avoiding the necessity of capitalizing the equipment and providing protection against the risk of obsolescence associated with high technology equipment. The perceived disadvantages of leasing are that the Trust does not own the equipment, leasing can be more expensive in revenue terms, the tender process is extended and there may be lease conditions to be met, which may be costly and/or restrictive. There are also a number of technical considerations involved in the leasing of radiotherapy equipment that influence the financial analysis and practical operation of the radiotherapy service. The technical considerations include servicing and planned preventative maintenance, upgrades, spare parts, subsequent purchase of "add ons", modification of equipment, research and development work, commencement of the lease period, return of equipment at the end of the lease period and negotiations at the end of the lease period. A study from Raigmore Hospital, Inverness is described, which involves the procurement of new, state-of-the-art radiotherapy equipment. This provides an overview of the procurement process, including a summary of the advantages and disadvantages of leasing, with the figures from the financial analysis presented and explained. In addition, a detailed description is given of the technical considerations to be taken into account in the financial analysis and negotiation of any lease contract.

Hospital Costs↗

Political and organizational barriers to satisfying low-income U. S. seniors' need for affordable rental housing with supportive services.

A substantial share of the low-income older tenants who occupy U. S. government-subsidized rental housing has physical and cognitive limitations. These older tenants are often women living alone in their 70s and 80s, who need help obtaining community-based services, demand-responsive transportation, help with apartment housekeeping and maintenance, self-care assistance, and design modifications made to their dwellings. Other low-income and frail older persons who have large housing expense burdens or occupy physically deficient dwellings also need affordable rental housing with these supportive services. The unmet supportive service needs of these groups persist even as this country's major political and professional stakeholders are aware of their problems and have solutions. This paper examines five major political and organizational barriers that have restricted the availability of supportive services in affordable rental developments. It offers 12 policy recommendations.

Activities of Daily Living↗

Trend analysis of dental practice rent and mortgage expenses: 1989-1995.

BACKGROUND: The authors analyzed trends for rent and mortgage, as reported by independent active private practitioners, for the period of 1989-1995. Rent and mortgage were analyzed overall and by different characteristics. METHODS: In the ADA's annual "Survey of Dental Practice," dentists reported gross billings and net incomes, as well as itemized practice expenses. The authors tabulated survey responses over time to develop trends and compare rent and mortgage expenses for each year. If trends over time were not exhibited, the authors combined multiple years of data to develop more reliable statistics. RESULTS: Approximately three-fourths of independent active private practitioners reported rent but no mortgage expenses. The percentages of practitioners who reported rent or mortgage was stable over time. The percentage reporting rent only as an expense increased with the number of dentists in the practice, the age of the reporting dentist and the number of office locations. In contrast, the opposite was true for dentists reporting mortgage only as an expense. CONCLUSIONS: The authors found that office rental is more common than is office ownership and that mortgages as a percentage of gross billings and in dollar amounts were similar to rents. They also found that because the cost of office space as a percentage of gross billings decreased as the number of dentists in the practice increased, limited economies of scale may be present in the cost of dental office space. PRACTICE IMPLICATIONS: There is not a large financial advantage to ownership, so renting is likely to remain an important way to acquire office space. As only limited economies of scale exist in office space expenses, many group practices may choose to rent office space.

Capital Expenditures↗