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PubMed1982

Is deregulation likely to affect hospital design and construction?

Is the deregulatory thrust of this administration having an effect on hospital design and construction? does it threaten to create an expansion and construction free-for-all in the industry? A number of architects and construction industry professionals comment on what effect, if any, they expect deregulation to have on health care construction, as well as the expected effect of financing and management in an increasingly competitive environment.

Facility Regulation and Control↗
PubMed1991

Measuring geographic variations in hospitals' capital costs.

The Health Care Financing Administration (HCFA) has proposed incorporating hospital capital payments into the Medicare prospective payment system. HCFA's proposal includes an adjustment to capital payments for geographic differences in capital costs, derived from the prospective payment system area hospital wage index. Alternatively, the geographic adjustment could be based on an area construction cost index. Geographic construction cost indexes calculated from the cost per square foot of finished structures or from construction labor and materials input prices are evaluated in this article.

Abstracting and Indexing↗
PubMed1987

Socioeconomic status, sunlight exposure, and risk of malignant melanoma: the Western Canada Melanoma Study.

In a study of 261 male melanoma patients and age-and sex-matched controls, a strong positive univariate association between socioeconomic status, as determined by usual occupation, and risk of melanoma was detected. This association, however, was substantially explained by host constitutional factors and occupational, recreational, and vacation sunlight exposure. The study demonstrated an increased risk of melanoma in draftsmen and surveyors and a reduced risk of melanoma in construction workers and individuals employed in the finance, insurance, and real estate industry even after control for the effect of host factors and sunlight exposure.

Canada↗
PubMed1983

Planning tips for ambulatory care construction projects.

The growing ambulatory care market has attracted the attention of many hospitals. This article details the ownership, organizational, financing, marketing, and design considerations that must be addressed as part of the planning for construction of ambulatory care programs.

Ambulatory Care Facilities↗
PubMed1983

Planning for progress, productivity, and performance.

A project is described for the interim renovation of a labor intensive existing foodservice facility. The renovated area will provide effective food management during the hospital's redevelopment period, including a new foodservice. Objectives of the interim project were to conserve labor while emphasizing control and centralization, provide economic foodservices with improved quality, and incorporate one tray distribution system throughout the hospital complex. Immediate measures were necessary in order to generate funds to proceed. Renovations had to occur without disrupting food-service to patients. The project was planned over a three year period and included an ingredient control area, two patient tray service centres, a renewed production kitchen and test kitchen facility. Each phase has been financed on the understanding that the costs of construction and equipment will be repaid within one fiscal year of operating the renovated facility. Positive results are being achieved, attributable to the support and encouragement received from staff during the change process.

British Columbia↗
PubMed2004

Room for improvement.

First announced in 1992 by the then Conservative Government, the Private Finance Initiative is a contract whereby private companies finance, design, build and manage public buildings, such as hospitals and schools, and lease them to the public sector for a set period--typically 30 years. In healthcare, the scheme has been particularly prolific, with 34 hospitals and 119 other PFI health schemes built to date. PFI projects are also expected to account for the majority of the 15 NHS hospital developments worth over pound 4 billion, that were recently announced by Health Secretary John Reid. Arguments aside, few could deny that PFI has been instrumental in facilitating the biggest NHS hospital building programme ever seen.

Building Codes↗
PubMed1988

Decree No. 2006 partially amending Decree No. 1906 of 30 December 1987, published in La Gaceta Oficial of the same date, 18 February 1988.

This Decree and Decree 1906, which it amends, mandate the formation of a Special Commission charged with reviewing all loan applications in Venezuela for the acquisition or construction of low-income housing filed in mortgage banks, financing institutions, or savings and loan institutions. Under the Decrees, builders of low-income housing complexes can receive up to 60% of the cost as a loan and buyers up to 75%. Loans will be granted to individual buyers only if they lack housing or their current housing does not meet minimum standards; they can make an initial payment of 15% of the selling price, and monthly payments on the loan do not exceed 30% of their salary. Loans are, in general, to be made at a 9% yearly interest rate. Repayment for loans made for the construction of rental units or the individual purchase of units is set at 20 years. Repayment for loans for the construction of units for sale is set between 18 and 36 months.

Americas↗
PubMed1983

The construction manager can be the hospital trustee's ally.

The construction manager's expertise in accurate cost estimating can help trustees engaged in the process of securing a certificate-of-need authorization and seeking bond market financing for the project. The application of these skills to two recent hospital construction projects is detailed here.

Certificate of Need↗
PubMed2000

Israel's long-term care insurance law after a decade of implementation.

Israel's Long-Term Care Insurance (LTCI) law has been in effect for a decade. It is timely to review the effects of this legislation with a view to identifying possible directions for reform and lessons for other countries considering the introduction of a similar social insurance scheme. The paper considers the law's effects in terms of the size and characteristics of the beneficiary population, the coverage of the scheme, its financial standing, the rate of institutionalization of the elderly, the caregiving burden, the service delivery system, and the overall scope of long-term care services for the aged. Israel's experience has lessons for financing arrangements, target efficiency, service delivery arrangements, and the construction of the burden of care.

Aged↗