Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cost Allocation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,117 records · Page 62Linked to original sources
PubMed1991

'Profit' variability in for-profit and not-for-profit hospitals.

This paper proposes two tests of the hypothesis that not-for-profit hospitals (NFPs) behave differently than for-profit hospitals. The profit variability test states that the profits of an NFP will be less variable over time than profits of a for-profit hospital if the NFP maximizes utility subject to a profit constraint. The second test examines whether NFP profits respond less to change in exogenous factors, such as Medicare reimbursement rates, than profits of for-profit hospitals. Both tests, performed on panel data from 1983 to 1988, support the hypothesis that NFPs behave differently than for-profit hospitals.

Cost Allocation↗
PubMed1992

Estimating the indirect costs of teaching.

Medicare's Prospective Payment System pays teaching hospitals using a regression coefficient in a log-log cost function. Previous literature showed that this coefficient is sensitive to the covariates included in the function, but specified teaching intensity as the logarithm of one plus the intern and resident-to-bed ratio. Provided the true relationship is log-log, adding one biases the coefficient substantially but not predicted cost. In a re-specified equation that makes this bias negligible, the coefficient is not nearly as sensitive to the inclusion of other covariates. Because further issues remain to be explored, it is premature to use our results for policy purposes.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1986

Economic appraisal in the National Health Service: a survey.

Considerable emphasis is currently being placed on the pursuit of efficiency in health service provision. This paper reports the results of a survey of the use of economic appraisal to assist decision makers in choosing efficient courses of action. The survey group comprised National Health Service staff who had undertaken a correspondence course in health economics. The respondents were asked to identify issues arising locally where economic appraisal could have been applied but was not, and to suggest reasons why economic appraisal had not been used. They were then asked to give local examples of attempts to use economic appraisal and to indicate whether they were successful or what problems had been encountered. The results suggest that there is greater use of economic appraisal than is apparent from published sources but there is still not very much. The paper also summarises comments from the respondents on the decision making process in the National Health Service.

Cost Allocation↗
PubMedDate not supplied

Shopping for health: purchasing health services through contracts.

The 1993 New Zealand health service reforms were based on the purported efficiencies of the purchaser/provider split. Purchasers are required to contract for services that will maintain, improve and restore the health of the populations they serve. The purchasing role, which requires the development of contracting skills as well as the setting of strategic directions and priorities, is new and as yet poorly developed. This paper describes the role of purchasing agents in setting priorities, the different approaches that are being taken to contracting for services and some of the problems that have arisen in the first year of contracting. It explores the trade-off that is evident between the potential for improving efficiency through contestable contracting and the need to minimise transaction costs associated with the contracting process. The purchasers' accountability to the public and the Minister is analysed in the broader political context of the purchasers' role in shaping a public health service and improving the health of the population.

Budgets↗
PubMed1994

Health care expenditure in the Nordic countries.

International comparisons of health care expenditure are associated with many different kinds of problems. One type of problem is due to heterogenous definitions and to difficulties with conversion to common prices. Such problems are present also if one selects homogeneous countries as, for example, the Nordic countries, which have a similar GDP per capita and social system. In this paper we compare the health care expenditure in the Nordic countries to illustrate the significance of these problems in international comparisons. We also correct the latest available OECD statistics for local nursing homes, which are not included in health care expenditure for Denmark but are included for the other Nordic countries, and also for the care of the mentally retarded, which is not included in health care expenditure for Denmark or, after 1985, for Sweden. In addition, comparisons of health care expenditure are presented with different currency conversion factors. The comparisons show, for example, that Sweden has a higher expenditure share of gross domestic product (GDP) than Denmark, even after corrections have been made, but that the difference between the countries becomes considerably smaller, from 37% higher expenditure for Sweden without correction to 12-15% after correction.

Commerce↗
PubMed1996

Group living for elderly patients with dementia--a cost analysis.

The average labour cost of group living for elderly people suffering from senile dementia amounted to just over SEK 230,000 per patient and year, or SEK 639 per patient and day (24h), in 1992 prices. These figures emerge from our study of 106 group-living units in 46 municipalities in southern Sweden. The average staff density, that is the number of full-time employees on a yearly basis, was 1.06 per patient. The study also shows that the labour cost per patient decreases when the number of patients in a unit increases. Units that form part of other types of residence for the elderly have lower labour costs than detached group-living units (everything else being equal). If individual flats or apartments are large (at least two rooms), a higher staff density was observed. A high degree of functional disability in the individual entails higher staff density and consequently higher labour costs as well. However, in comparison with other forms of caring for the elderly, such disabilities have a less marked effect on labour costs. Everything else being equal, comparatively young residents entail higher labour costs than older ones. The average cost per patient in group-living units amounted to SEK 986 per day. This cost includes the cost of care (labour cost adjusted for flexible salary increments), as well as of capital, operation and maintenance, and food (raw materials). The cost of care amounts to approx. 80% of the estimated cost per patient. The average cost per patient is higher in group-living units than in old people's homes; but as regards dementia sufferers with some degree of functional disability, the cost of care is probably about the same in both types of accommodation.

Activities of Daily Living↗
PubMed1984

Planning for emergency ambulance service systems.

The application of a computer model to evaluate ambulance deployment configurations in an urban ambulance service is described. A planned expansion of the Boston Emergency Ambulance Service was accomplished using computer projections. The use of analytic models in the planning and implementation of an Emergency Medical Services (EMS) system allows for greater understanding of the interactions between various performance measures, facilitating the effective and cost-efficient allocation of resources.

Ambulances↗
PubMed2007

Invited commentary.

Explore the source record for details and available documents.

Coronary Artery Bypass↗
PubMed2004

The impact of echography on evaluation and management of posterior segment disorders.

PURPOSE: To investigate the impact on patient management of posterior segment echographic evaluation at an academic institution. DESIGN: Retrospective, noncomparative, consecutive case series. METHODS: Records were reviewed of all patients evaluated for the first time with ocular echography for posterior segment evaluation at Bascom Palmer Eye Institute between September 2000 and August 2001. Patients with prior posterior segment echography, intraocular tumors, or suspected optic nerve or orbital disease were excluded. An "impactful" echographic evaluation was defined as an evaluation that confirmed the diagnosis and management plan. A "pivotal" evaluation was defined as an evaluation that either (1) made or subclassified the diagnosis or (2) established or changed the management plan or both. Main outcome measures include proportions of impactful and pivotal echographic evaluations and factors associated with pivotal evaluations. RESULTS: The study included 154 eyes of 143 patients. The requesting physician was a retina fellowship-trained faculty member in 55 cases (36%), a nonretina faculty member in 22 (14%), a fellow in 9 (6%), and a resident in 68 (44%). Reasons for obtaining echography included evaluation for retinal tear or detachment in 83 eyes (54%), evaluation for posterior segment disease (for example, before cataract extraction) in 40 (26%), evaluation for endophthalmitis in 10 (7%), evaluation for intraocular foreign body in 8 (5%), characterization of choroidal detachment in 4 (2%), and other in 9 (6%). Echography confirmed the suspected diagnosis and pre-echography management plan in 128 eyes (83%). Echography made or subclassified the diagnosis in 20 eyes (13%) and established or changed the management plan in 12 eyes (8%). Accounting for definitional overlaps, echography was pivotal in 22 eyes (14%). Significant predictors of a pivotal evaluation or an evaluation that affected the management plan include a retina faculty member as the requesting physician (P =.003), lack of a management plan before echography (P <.001), and certain reasons for obtaining echography (for example, to rule out retinal tear or detachment and to rule out intraocular foreign body; P =.032). The final clinical or pathologic diagnosis confirmed the echographic diagnosis in 148 eyes (96%). CONCLUSIONS: Posterior segment echography may be a very useful diagnostic tool. Its value may be optimized in certain subsets of patients. Considerations such as these may contribute to more cost-effective allocation of resources.

Adolescent↗
PubMed2003

Changes in county hospitals during Sheldon's tenure.

Dramatic changes took place in county hospitals during Dr. Sheldon's tenure, 1964 to 1985. The primary impact came from Medicaid and Medicare legislation in 1965. The secondary impact came as the result of the drug culture entering American cities.

Cost Allocation↗