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At least 775 records · Page 43Linked to original sources
PubMed1997

Programmatic role of the infectious diseases physician in controlling antimicrobial costs in the hospital.

Controlling antimicrobial costs has preoccupied infectious diseases physicians (IDPs). IDPs have controlled antimicrobial costs by the use of eight strategies: education, formulary restriction, pharmacy justification, formulary substitution, computer surveillance, laboratory item cost listing, purchase plans, and multidisciplinary approaches. Most strategies had input from IDPs and resulted in cost savings (up to $500,000 annually), particularly during the initiation periods. Educational efforts were successful in reducing costs but needed continual intervention. Formulary restriction was the most straightforward cost-control mechanism. Restriction of "target antimicrobials" has given way to "switch" therapy between expensive and less costly agents or between parenteral and oral regimens. Switch therapy is facilitated through the use of innovative order forms and on-line computer interaction. Computer surveillance has a capacity for interactive controls. Purchase plans may give way to centralized pharmacy monitoring, a strategy that is attractive to managed care organizations. Multidisciplinary antimicrobial management programs (AMPs) offer the best potential for sustaining savings in antimicrobial costs. Ten recommendations lay a groundwork for IDPs to translate their expertise into leadership of AMPs.

Anti-Bacterial Agents↗
PubMed1987

Analysis and control of costs associated with answering drug information requests.

A strategy is proposed for estimating the average cost of answering drug information requests, comparing the factors that influence cost and controlling that cost. The cost for answering a request is based on the time it takes to answer the request, the salary of the person who answers the request, the cost of the information sources used to find the answer, and, indirectly, the frequency of requests of the same type. Request types have been defined by scope of search and formal of answer required, as textbook search/verbal answer, literature search/verbal answer, and literature search/written answer request. An empirical formula was used to calculate average costs for each request type at the Oregon Poison Control and Drug Information Center. A simple computer program was then used to generate costs over a range of changes that could be considered reasonable for each factor. The effect of modifying any of the factors in this formula demonstrated that a low volume of requests brings about the most critical change. Cost changes abruptly and may become unjustifiably high. If, for example, the volume of requests requiring literature search and verbal answer is 30 per month, the average cost for a request is $29.13; at a volume of 10 per month, the cost is $35.93; and at a volume of one per month the cost is $127.65. It is suggested that hospital pharmacy departments experiencing small frequencies of certain types of request analyze the cost in this manner and, if necessary, adopt a method for controlling the cost.

Costs and Cost Analysis↗
PubMed1979

Maximum allowable cost: can the government control drug costs?

In 1973 the federal government moved to limit drug reimbursement to providers in federally sponsored or supported programs, to the lowest cost at which the drug is generally and consistently available unless a difference in therapeutic effect can be demonstrated between the brand name and generic drug. This paper examines the political evolution and rationale for this program and explores the issues surrounding the ongoing controversy regarding publicly financed programs offering drug benefits. The authors speculate that the government's first attempt to control prices of pharmaceuticals, prior to enactment of some form of national health insurance, if successful, will call forth pharmaceutical industry strategies which could negate program benefits.

Cost Control↗
PubMed1997

What is the cost of controlling quality? Activity-based cost accounting offers an answer.

Achieving high-quality outcomes in healthcare organizations requires effective systems of control. Such systems consist of formal and informal transactions between patients, providers, payors, and policymakers, among others (Shortell 1972; Stiles and Mick 1997). One method for evaluating the suitability of control-oriented transactions to tasks is to compare the costs of controlling the quality of the good or service produced to the cost of its material and labor inputs. Activity-based cost (ABC) accounting provides the methodology for explicating the causal relationship between healthcare organizations' control-oriented transactions, the services whose quality they ensure, and the costs of both control activities and services delivered. Understanding these relationships is of vital importance to those charged with evaluating the feasibility of proposed managed care contracts, new product lines, and existing service configurations. In this article, we explain why traditional accounting practices are poorly suited to accomplishing the control function in today's healthcare arena, highlight activity-based costing's potential to redress the shortcomings of conventional practice, and elaborate the strategic importance of adopting the new methodology.

Accounting↗
PubMedDate not supplied

Competition and prospective payment: a new way to control health costs.

Health care costs must be controlled to finance the expanded eligibility and coverage promised during the Presidential campaign. As a practical reality, reforming the existing fee-for-service system is the only way that significant cost control can be achieved during the next four years. The expansion of the basic Medicare prospective payment system to all health care settings and to all payers, combined with price discounting and consumer incentives to use providers that discount, can form the basis of a competitive prospective payment system (PPS). A competitive PPS can bring down costs and complement managed competition and other ongoing cost-containment initiatives.

Cost Control↗
PubMed1989

The long-term value of the selected list as a method of controlling drug costs in a district general hospital.

The results of a study aimed at evaluating the long-term effects of the Limited List (now officially referred to as the Selected List Scheme) on inpatient drug costs in a district general hospital (DGH) are presented. Study periods of six months duration were examined before, shortly after, and a further year after implementation of the List on 1 April 1985. Eight therapeutic classes affected by the regulations were examined; in four of these (antacids, expectorants, mucolytics and anxiolytics, hypnotics and sedatives) statistically significant reductions in costs were demonstrated over the study periods. There was no significant change in the costs of the other four classes (vitamins, laxatives, nasal preparations and analgesics). Overall, inpatient expenditure for the hospital showed no significant change. The changes in cost demonstrated can be attributed to the Selected List and occurred despite the prior existence of a local formulary.

Cost Control↗
PubMed1998

Hospitals' vertical integration into skilled nursing: a rational approach to controlling transaction costs.

Using 1985 and 1988 American Hospital Association data, this study examines 1,523 hospitals nationwide and concludes that hospitals' ownership of skilled nursing facilities helps minimize the transaction costs associated with post-acute patient transfers while productively using empty hospital beds. Unfortunately, such ownership creates complex cost, quality, and accessibility trade-offs in terms of the skilled nursing care provided.

American Hospital Association↗
PubMed1989

Continuity of care and the control of costs: can case management assure both?

Case management is increasingly extolled as a mechanism to improve services in both health and mental health settings. However, in mental health service systems, case coordination of services is at the client level, while in health services it is applied mainly as a means to manage care and control costs. This paper discusses the background of case management, the policy and management conflict that is arising between the goals of cost control and continuity of care, and a number of steps to reduce the negative effects of these competing policies and goals.

Community Mental Health Services↗
PubMed1976

Demographic differences in support for government measures to control health care costs.

This paper uses longitudinal data from representative samples of national and southern California populations in an analysis of public opinion regarding proposals for health care cost controls. After examining ethnicity in conjunction with sex, socioeconomic status, age and party identification, it appears that this variable has significant explanatory power. This suggests that community may be a more useful concept than class in assessing public support for various forms of national health insurance and regulatory policies.

Black or African American↗