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51.
All district health authorities are obliged to use resources most efficiently. One approach to increasing efficiency is to identify measures which allow service levels, in terms of patients treated and standards of care, to be maintained at a lower cost. This could be achieved by maintaining service levels with fewer hospital beds. Reducing lengths of stay by removing organizational delays and expansions of day-case care, are policies which can increase patient caseload per bed. This paper puts forward an approach for estimating the resources released by such policies and assesses the savings achieved by realizing efficiency gains identified in a previous study by Beech et al. (1987). That study identified significant potential for maintaining services with fewer beds, with the expansion of day-case care being a key mechanism. However this paper concludes that when services are maintained with fewer beds, the vast majority of hospital costs remain fixed. It also reaches the alarming conclusion that as a vehicle for reducing costs, day-case care is much less effective than previous studies have implied. However, increasing hospital throughput per bed does release capacity to treat more patients. The proposed reforms of the NHS (Secretaries of State, 1989) envisage an internal market for health care, allowing hospitals to enter into contracts with purchasers of health care. The approach to costing described in this paper is applicable to assessing the increased costs associated with such developments. These extra costs can then be compared with expected income. 相似文献
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54.
D. A. Stewart D. Guo J. A. Sutherland B. A. Ruether A. R. Jones M.-C. Poon C. deMetz J. Klassen A. Chaudhry C. B. Brown J. A. Russell 《Annals of oncology》1997,8(12):1277-1279
Background: Few data are available on the cost, safety, and long-termefficacy of single agent high-dose melphalan (HDM) followed by autologousbone marrow (ABMT) or blood stem cell (ABSCT) transplantation in the salvagetherapy of Hodgkins disease (HD).Patients and methods: From February 1981 to September 1996, 23 patientswith relapsed (n = 15) or refractory (n = 8) HD received salvage therapywith HDM 140–200 mg/m2 followed by non-cryopreservedABMT (n = 18) or cryopreserved ABSCT (n = 5). The cost of HDM/ABSCT in 1996,from initial consultation until transfer back to referring physician, wasdetermined and compared to the estimated costs of two multi-agent regimenscommonly used for HD.Results: HDM was well tolerated with no early transplant-relatedmortality. The five-year overall and progression-free survival rates were52% and 50%, respectively. The average total cost in Canadianfunds of HDM/ABSCT in 1996 was $34,400/patient. This cost wasestimated to be $4,700–6,800 cheaper per patient than themulti-agent high-dose regimens.Conclusion: These data suggest that HDM is safe, feasible, active, andreasonably inexpensive salvage therapy for patients with relapsed/refractoryHD. 相似文献
55.
Graves HA 《Obesity surgery》1994,4(3):232-237
To help answer the call to cut costs of surgical care, hospitals and physicians have joined to compare methods of care for
the more common Diagnosis Related Group (DRG) diagnoses to form a Benchmark. Since many bariatric surgeons are the only ones
performing this surgery in their primary hospitals, they do not have two or more surgical routines for comparison. This presentation
compares data for the preoperative work-up, operating-room, and methods of postoperative care used by 29 members of the American
Society for Bariatric Surgery (ASBS). There was representation of both academic and private surgeons and hospitals. To target
areas for possible savings, the hospital bills of 16 patients without complication were compared. The synthesis of this information
revealed significant differences in the extent and cost of preoperative work-up, antibiotic coverage, other postoperative
care, and length of stay. These differences are examined under the assumption that patient outcome was the same. 相似文献
56.
M. C. Montero M. L. Valdivia E. Carvajal A. Montaño C. Buenestado A. Lluch M. Atienza 《Pharmacy World & Science》1994,16(4):187-192
This article describes the economic and social impact of nutropenia induced by myelotoxic chemotherapy in patients with cancer during the period 1 January–31 December 1991. Neutropenia is a life-threatening complication of chemotherapy in patients with cancer. The episodes of (ever and infections originating from neutropenia require hospitalization of the patient until the granulocyte levels are restored. The calculation of the economic cost was based on the following parameters: length of stay in hospital, analytical tests performed on the patient, type and cost of drug therapy administered, blood transfusions performed, health assistance received, cost of isolation and absence from work. The overall economic cost of neutropenia in patients with cancer reached 329,775 pesetas ($2,893). Cost of the health-care staff was the largest budget item in relation to the total health resources estimated. 相似文献
57.
58.
部分手术类项目标准成本分析 总被引:3,自引:0,他引:3
对6个手术类医疗服务项目进行了标准成本测算,分析了其成本构成,并与全国的实际成本平均水平进行了比较。建议政府以标准成本作为调整医疗服务价格的依据,同时,建议医院在加强手术室成本管理时应着重加强医用材料的管理。 相似文献
59.
K S Bin Saeed 《International journal for quality in health care》1999,11(1):59-65
OBJECTIVE: To determine (i) the cost issues which Saudi health care managers perceive to influence overall quality improvement initiatives, and (ii) the relationship between health care managers' satisfaction with such initiatives and their perceptions regarding the influence of different cost issues on the overall quality improvement initiatives. DESIGN: Data were collected through a self-administered questionnaire in August and September 1996 in the Western Region of the Kingdom of Saudi Arabia. The participants were 236 health care managers of private hospitals. Data was analysed using the chi2 test. RESULTS: Less than one-half of the health care managers surveyed were satisfied with their hospitals' overall quality improvement initiatives. The issue that was rated to have the most influence on such initiatives was the 'cost of malpractice lawsuits' followed by the budget for the quality assurance programme'. The issue that was perceived to have the least influence on overall quality improvement initiatives was 'data on cost allocation'. Of the 17 cost issues included in the study, eight had statistically significant influence on the health care managers' satisfaction with their hospitals' overall quality improvement initiatives. The most statistically significant was the 'measurement of the costs of quality-related actions'. 相似文献
60.
儿童接种肾综合征出血热Ⅰ型灭活疫苗的成本效益和效果分析 总被引:5,自引:1,他引:4
采用建德市肾综合征出血热Ⅰ型灭活疫苗效果考核现场资料,计算5~9岁和10~14岁各年龄组的效益费用比(BCR)和效果费用比(CER)。结果各年龄组BCR和CER均小于1或大于0;5~9岁年龄组儿童接种疫苗后的CER和预防一个病人的费用是10~14岁年龄组的一倍左右。结论:可在高发区10~14岁儿童中开展HFRS疫苗预防接种。 相似文献