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Cost control, primary care initiatives challenge teaching hospitals.

Pressures currently affecting medical schools and teaching hospitals are detailed. Although cost containment poses special problems for teaching hospitals, physicians can help hold down cost. Primary care initiatives and specialty redistribution, as well as the classification of "staff" and "private" patients, and planning agencies also are exerting pressures.

Costs and Cost Analysis↗

The medical mall design as an answer to hospital cost control.

Reorganizing the hospital's inpatient and outpatient services for the convenience of patients and to decrease acute care costs is becoming a necessary strategy under prospective pricing. Two architectural planners discuss the health care mall concept and the benefits of segregating ambulatory and ancillary services.

Facility Design and Construction↗

Labor analytics software can help control labor costs.

One of the largest costs in healthcare organizations is labor. As volume of activity fluctuates, the labor supply needs to be adjusted appropriately. Having an appropriate quantity and skill mix of full- and part-time employees affects labor costs per hour and labor efficiency, two labor-cost control points that department managers need to monitor to make effective hiring decisions. Managers can use software applications for operating budgets, productivity monitoring, position control, and staffing/scheduling to manage labor expenses. Knowing the type of information each of these cost-control tools provides is critical to making effective decisions related to labor expenses. Because of their unique expertise, healthcare financial managers can serve as a resource to help the organization's department managers manage labor costs.

Cost Control↗

Tailoring the optimal control cost function to a desired output: application to minimizing phase errors in short broadband excitation pulses.

The de facto standard cost function has been used heretofore to characterize the performance of pulses designed using optimal control theory. The freedom to choose new, creative quality factors designed for specific purposes is demonstrated. While the methodology has more general applicability, its utility is illustrated by comparison to a consistently chosen example--broadband excitation. The resulting pulses are limited to the same maximum RF amplitude used previously and tolerate the same variation in RF homogeneity deemed relevant for standard high-resolution NMR probes. Design criteria are unchanged: transformation of I(z)--> I(x) over resonance offsets of +/-20 kHz and RF variability of +/-5%, with a peak RF amplitude equal to 17.5 kHz. However, the new cost effectively trades a small increase in residual z magnetization for improved phase in the transverse plane. Compared to previous broadband excitation by optimized pulses (BEBOP), significantly shorter pulses are achievable, with only marginally reduced performance. Simulations transform I(z) to greater than 0.98 I(x), with phase deviations of the final magnetization less than 2 degrees, over the targeted ranges of resonance offset and RF variability. Experimental performance is in excellent agreement with the simulations.

Algorithms↗

A study of consumer attitudes about health care: the control, cost, and financing of health services.

The delivery of health care had emerged as one of the most important political issues of the 1970's, yet public attitudes about health issues remains a relatively unexplored subject. Little is known about the public's opinion of who should control the delivery of health care, about how the costs of health care are perceived, or about how the delivery of care should be financed. This paper relates respondent attitudes on these subjects to attitudes about criteria that determine the respondent's choice of ambulatory care facility and to socioeconomic, political, and other demographic characteristics. The data are derived from a survey (N=521) of households representative of the area of Rochester, New York.

Adolescent↗