Construction activity in U.S. hospitals

Hospital construction activity is increasing, but little information exists on what types of hospital capacity are affected and what is motivating specific efforts. Our analysis of Round Five Community Tracking Study data revealed four general types of activity: new hospital construction or expansion of existing general hospital capacity; new or expanded capacity in specialty services; replacement of aged facilities; and expansion of capacity-constrained services. Some of these actions are responsive to community need, but others resemble a medical-arms-race response. Overall, current construction activity will provide more convenient access for some consumers but at high cost if excess capacity results.     

An evaluation of charity care for tax-exempt hospitals engaging in joint ventures

The study examines whether the level of charity care and financial stability contribute to a nonprofit hospital's motivation for partnering with a for-profit hospital through a joint venture. The Internal Revenue Service (IRS) has heightened its scrutiny of joint ventures within the health care sector. Considering recent calls to investigate the merit of the tax-exempt status of hospitals engaged in joint ventures, this research will assist policy makers in the evaluation of nonprofit hospitals. Constituents will continue to question whether joint ventures contribute to a reduced focus on charitable activities. Results indicate that the propensity to engage in a joint venture significantly increases with increased levels of charity care. Furthermore, nonprofit hospitals with lower profitability are more likely to engage in joint ventures. These results are useful to policy makers when evaluating the level of charity care provided by hospitals seeking alternative strategic alliances. Considering many critics allege hospitals are reducing the provision of charity care to the community, it is imperative for management to be conscious of the impact of joint ventures on the provision of charity care.     

The impact of occupational injury reduction on the U.S. economy

BACKGROUND: Preventing occupational injuries reduces labor and fringe benefit costs to employers. The related savings filter through the economy, impacting its performance. This study is a first attempt to measure the impact of occupational injury reduction on national economic output, gross domestic product, national income, and employment by using an input-output model of the U.S. economy. METHODS: Occupational injury costs by industry for 1993 were used as a baseline for an input-output model, and the impact of the 38% injury rate reduction between 1993 and 2002 was measured. All computations are in year 2000 dollars. RESULTS: Declining occupational injury between 1993 and 2002 increased employment by an estimated 550,000 jobs. The increase in gross domestic product (GDP) was 25.5 billion US dollars or 9% of the average annual GDP increase from 1993 to 2002. CONCLUSIONS: These estimates represent the benefits of injury rate reduction but ignore associated prevention costs.     

Adoption of costing systems by U.S. hospitals

This article re-examines the use of costing information in hospitals. While previous research reports that hospitals are increasingly adopting costing methodologies, survey results indicate that costing systems and cost methodologies have not been widely implemented. A telephone survey of 94 hospital executives revealed only 26 percent routinely collect procedure-level costs and only 12 percent apply basic costing techniques described in prior health care management literature. It appears that despite cost accounting's benefits, immediate cost-control problems are answered with short-term, focused cost-cutting solutions. While these short-term measures allow hospitals to survive in the current environment, health care reform and other pressures to control revenue growth will make sophisticated cost management a necessity for hospitals in the near future.     

美国医院管理体系简介

介绍了美国医院内部管理的框架和各个组成部分，以及现代美国医院的变革，发展趋势，以使读者对美国医院的管理有比较清晰的认识。     

An empirical investigation of for-profit and tax-exempt nonprofit hospitals engaged in joint ventures

Joint ventures between nonprofit and for-profit hospitals offer opportunities for collaboration to increase efficiency. These transactions have attracted the attention of the Internal Revenue Service, which may threaten tax-exempt status. This article analyzes inherent financial characteristics of nonprofit hospitals that joint venture with for-profit hospitals and those that choose not to joint venture.