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At least 667 records · Page 37Linked to original sources
PubMed1982

Budgeting and controllable cost variances. The case of multiple diagnoses, multiple services, and multiple resources.

This paper examines an unfavorable cost variance in an institution which employs multiple resources to provide stay specific and ancillary services to patients presenting multiple diagnoses. It partitions the difference between actual and expected costs into components that are the responsibility of an identifiable individual or group of individuals. The analysis demonstrates that the components comprising an unfavorable cost variance are attributable to factor prices, the use of real resources, the mix of patients, and the composition of care provided by the institution. In addition, the interactive effects of these factors are also identified.

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PubMed1996

[Budget analysis in a burn center for severely burned patients].

The treatment of patients with severe burn injuries is expensive and belongs in the hands of specialized burn centres. In our burn centre 257 patients were treated from 1991 to June 1995 (between 50 and 60 patients per year except for 1993 with 77 patients). Patients were evaluated according to the ABSI score (mean 7) and had mortality of around 15%. The costs range between 3.7 and 4.8 million DM per year, the profit lies in the same range. The costs are divided into staff costs (1.4-1.8 million DM per year), costs for medical treatment (1.5-1.9 million DM per year) and costs for internal services (600,000-900,000 DM per year) such as laboratory examinations (247,000-386,000 DM per year) and blood bank (100,000-215,000 DM per year), the main factors in this category. The different fields of costs and profit are compared in this analysis. Possible ways of reducing costs are pointed out, and the question of effectiveness of therapy is discussed. Conclusions from this analysis are limited by the individuality of each case with different clinical courses, the great number of influencing factors and the comparably small numbers of patients.

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PubMed1999

[Computer-assisted performance documentation. Effects in orthopedics and trauma surgery on budgets and reimbursement].

Since 1995 German health maintenance laws require hospitals to document and code all referrals, admissions and discharges using the 4-digit ICD. Operative procedures are documented and coded using the ICPM. Beginning in January 1996, reimbursement for health services requires a diagnosis-related billing and payment for special procedures. The decision for billing is based on documented diagnosis and therapy. This extended request for documentation makes an online access to diagnosis and therapy with a computer-assisted coding system advisable. In 1996 in our hospital each diagnosis and operation was manually documented and coded on a form. Since the beginning of 1997, documentation and coding has been exclusively computer-assisted. On the basis of documented diagnosis and therapy the computer provides the route of reimbursement. Retrospectively we evaluated the number of charged diagnosis-related billings and payments for special procedures from January to April of 1996 and 1997. It became evident that with computer-assisted documentation and coding the number of detected and charged diagnosis-related billings and payments for special procedures was significantly increased in comparison with the previous year.

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PubMed1991

Capital budgeting in hospital management using the analytic hierarchy process.

In recent years, the health care industry has been experiencing change to a degree unprecedented since the inception of the Medicare program. With traditional in-hospital care on the decline, hospitals are being forced to compete for business. They must identify within their own systems feasible alternatives for dealing with these changes and then determine which ones will best accomplish the goals of the organization. This paper offers a procedure that utilizes the analytic hierarchy process--a multicriteria decision-making tool that helps arrange the possible alternatives in hierarchical order given the priorities of relevant decision makers. An application of the method to a mid-sized hospital is presented. Although the procedure is structured, it is flexible enough to be updated for the realities of any health care institution.

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PubMed1995

PBMA (programme budgeting marginal analysis)--its role in the future purchasing arrangements for health care services.

The movement of the purchasing process in health care from a central to local level has to be accompanied by an accountability process which makes local purchasers accountable within an agreed national and area framework for their decisions and implementation of change. This paper focuses on PBMA and its applicability to health boards and general practitioner fundholders in future purchasing arrangements. It is argued that it is a useful tool which may provide a basis for more rational discussion about use of resources, both at a micro and macro level, than the current arrangements.

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