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Results for “Cost Allocation”

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Preoperative correlates of the cost of coronary artery bypass graft surgery: comparison of results from three hospitals.

This article furthers our understanding of the cost of coronary artery bypass graft (CABG) surgery by analyzing the extent to which preoperative correlates of cost differ among hospitals. A total of 2828 patient who underwent bypass surgery at 3 hospitals (2 teaching and 1 nonteaching) were analyzed. The preoperative correlates of direct variable cost (marginal cost) were determined by ordinary least squares regression. Age, urgent/emergent surgical priority, previous CABG, and chronic obstructive pulmonary disease (COPD) were significant contributors (P < .05) to cost in all hospitals, but overall, there were many differences. The major contributor to cost was non-white race (31.3%) at teaching hospital A, previous CABG (30.5%) at teaching hospital B, and preop insertion of intra-aortic balloon pump (IABP) (35.9%) at the nonteaching hospital. The number of significant risk factors also differed. Preoperative characteristics that contribute to cost can be quite different among hospitals and therefore results from one hospital cannot be broadly generalized to others.

Age Factors↗

Comparing costs of monitoring glaucoma patients: hospital ophthalmologists versus community optometrists.

OBJECTIVES: To compare the costs of monitoring stable glaucoma patients by community optometrists and hospital ophthalmologists. METHODS: A cost analysis was conducted alongside a randomised controlled trial which compared the accuracy and acceptability of measurement in each form of care. The viewpoints of the health service and of patients were considered. Costs were assessed using a number of different methods. Sensitivity analysis was conducted for key variables. RESULTS: The baseline analysis reflected heavily the different length of time between follow-up in the two arms of the trial (10 months (average) for hospital, 6 months for optometrists). It showed annual cost per patient for hospital ophthalmologists varied from 14.50 pounds to 59.95 pounds, and community optometrist costs varied from 68.98 pounds to 108.98 pounds. Assuming a 6-month follow-up interval for the hospital ophthalmologists, costs varied from 24.16 pounds to 99.92 pounds. CONCLUSIONS: Recommendations about the least costly form of follow-up must depend on the context in which the decision is being taken and the scale of change envisaged. If the aim is to recoup resources from hospitals in order to pay for monitoring in the community, community monitoring is unlikely to be the least costly option.

Community Health Services↗

Shrinking share.

Explore the source record for details and available documents.

Ambulatory Care↗

Components of the costs of controlling quality: a transaction cost economics approach.

This article identifies the components that contribute to a healthcare organization's costs in controlling quality. A central tenet of our argument is that at its core, quality is the result of a series of transactions among members of a diverse network. Transaction cost economics is applied internally to analyze intraorganizational transactions that contribute to quality control, and questions for future research are posed.

Cost Allocation↗

Do your capitation expenses match these benchmarks?

Data Insight: By understanding the percentage of premium dollars allocated to each category of expense, you can determine how much to expect in percent-of-premium contracts and how much to allocate for subcapitation.

Benchmarking↗

Activity-based costing in the operating room at Valley View Hospital.

This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting.

Accounting↗

The implications for information system design of how health care costs are determined.

As the costs of health care assume increasing importance in national health policy, information systems will be required to supply better information about how costs are generated and how resources are distributed. Costs, as determined by accounting systems, often are inadequate for policy analysis because they represent resources consumed (expenditures) to produce given outputs but do not measure forgone alternative uses of the resources (opportunity costs). To accommodate cost studies at the program level and the system level, relational information systems must be developed that allow costs to be summed across individuals to determine an organization's costs, across providers to determine an individual patient's costs, and across both to determine system and population costs. Program level studies require that cost variables be grouped into variable costs that are tied to changes in volume of output and fixed costs that are allocated rationally. Data sources for program-level analyses are organizational financial statements, cost center accounting records, Medicare cost reports, American Hospital Association surveys, and the Department of Veterans Affairs (VA) cost distribution files. System-level studies are performed to predict future costs and to compare costs of alternative modes of treatment. System-level analyses aggregate all costs associated with individuals to produce population-based costs. Data sources for system-level analyses include insurance claims;n Medicare files; hospital billing records; and VA inpatient, outpatient, and management databases. Future cost studies will require the assessment of costs from all providers, regardless of organizational membership status, for all individuals in defined populations.

Accounting↗