A three-way corporate partnership for specialty hospitals

Ultimately, the burden of escalating health care costs will be shared by all. A coalition of hospitals, suppliers, and group purchasing organizations possesses the power to communicate with each other as well as to ensure viability in the 21st century. Creative contracting will hopefully become the wave of the future in the health care industry.     

The high cost of foreign sourcing

Buyers in many industries have, for the past 30 years, sought lower purchased prices of materiel by sourcing with foreign suppliers. Few companies have fully assessed the actual cost of purchasing and using these foreign goods and comparing these costs with those of domestic producers. This is a reexamination of the actual costs, not foreign source "bashing." The results may surprise you.     

试论价值工程在高校食堂采购中的应用

在高校餐饮业采购改革中,合理地选择采购方式是降低采购成本、优化采购管理的重要途径。本文通过将价值工程原理应用在采购方式的科学选择上,探讨了如何在高校食堂采购中应用价值工程方法来提高工作绩效。     

加强物资采购管理 降低综合采购成本

当前,现代物流业飞速发展,在新的形势下如何加强物资采购全过程管理,最大限度地降低综合采购成本,已成为煤炭物资流通企业关心的工作重点。文章从采购计划管理、供应商管理、采购方式和采购渠道管理等方面阐述了降低煤炭企业物资采购综合成本的方式方法,并对降低采购成本的具体措施进行了分析。     

Total quality management and statistical quality control: practical applications to waste stream management

TQM offers a completely new approach to problem solving in health care. The approach requires dedication and persistence in monitoring, understanding, and changing systems at a level that has never been reached before in the United States' health care system. Materiel management, purchasing, nursing, housekeeping, and administration now have the necessary tools to centrally study the medical waste stream flow at their facilities. The intent of this article is to display how TQM techniques can be applied to minimize a hospital's medical waste stream. The approach of studying medical waste as a defect generated during the process of delivering high-quality care enables a hospital to pinpoint causes of these defects, modify the parent system of the defect, and lessen the generation of medical waste defects. Successful implementation of these techniques as a continuous process will enable hospitals to be leaders in the preservation of their host communities' environments.     

紧固件管理模型的建立

目前,全国许多汽车企业尚无法系统、真实地反映紧固件在企业的使用状况,产品工程师只是根据各自零部件的需要而自行设计和选用紧固件,这样易造成工程师查询、选用紧固件困难,造成重复设计,浪费人力、物力,增加采购成本。文章对汽车企业紧固件管理模型的建立进行研究,以有效地实现汽车企业零部件细化和专业化管理,降低成本和提高整车产品质量。     

Using Subjective Risk Adjusting to Prevent Patient Dumping in the Health Care Industry

We examine how to procure health care services at minimum cost while preventing suppliers from refusing to care for high-cost patients. A single risk-adjusted prospective payment is optimal only when it is particularly costly for the supplier to discover likely treatment costs. Cost sharing is optimal when these screening costs are somewhat smaller. When screening costs are sufficiently small, screening is optimally accommodated and subjective risk adjusting is implemented. Under subjective risk adjusting, the supplier classifies patients according to his personal assessment of likely treatment costs, and payments are structured accordingly. Optimal procurement policies are contrasted with prevailing industry policies.     

Developing collaborative professionalism: an investigation of status differentiation in academic organizations in knowledge transfer partnerships

In recent years, there has been a significant growth in knowledge transfer partnerships to improve the quality and timeliness of health care. These activities require an increasing level of interdependence between academic and health care professionals, with important implications for human resource management. To understand these knowledge transfer partnerships, we conducted an in-depth longitudinal study based on 99 interviews and 5 focus group workshops across academic and health care professionals in nine university-based knowledge transfer partnerships in England. We explore how academic professionals of lower and higher status organizations develop a new form of professional work, based on the principles of collaborative professionalism, during their involvement in partnerships with health care professionals. We illuminate how the interdependent work between academic professionals and health care professionals in the development of a new academic specialization is shaped by the status of their organizations.     

Health care reform and the hospital supply chain

With health care reform, hospitals will be differentiated in the marketplace by how well they manage the costs of services. Because products will be market priced, hospital materiel managers will have to minimize all other related acquisition costs. The key opportunities will be in changing processes to eliminate non-value added administrative, supply chain, and process activities and their attendant costs.     

Advanced supplier partnership practices: a case study

This article describes how a supplier partnership was set up to avoid the typical purchasing relationship--price being inversely proportional to quantity and having the purchaser take all the risk of product obsolescence. The case study also describes how rate-based replenishment replaced time-based delivery, and how all these advantages were achieved at reduced administrative costs.     

Public and Private Provision of Health Care

One of the mechanisms that are implemented in the cost containment movement in the health care sectors in western countries is the definition, by the third-party payer, of a set of preferred providers. The insured patients have different access rules to such providers when ill. The rules specify the copayments patients must pay when using an out-of-plan care provider. This paper studies the competitive process among providers in terms of both prices and qualities. Competition is influenced by the status of providers as in-plan or out-of-plan care providers. Also, there is a moral hazard of provider choice related to the trade-off between freedom to choose and the need to hold down costs. It is possible to achieve the first-best allocation by an appropriate definition of the reimbursement scheme when decisions on prices and qualities are taken simultaneously (as in primary health care sectors). In contrast, some type of regulation is needed to achieve the optimal solution when decisions are sequential (as in specialized health care sectors). We also derive normative conclusions on how price controls should be implemented in some European Union member states.     

Analysis of cost and coverage of government financed primary health care services in Tanzania.

A method for cost analysis is presented and applied to Primary Health Care Services in Tanzania. Primary care utilization figures are combined with budget and cost data to arrive at estimates of per capita and per visit cost. Data for analysis of geographical coverage, health care needs, and utilization are most readily available for the MCH sector of Primary Health Care Services, the most important health care sector in LDCs, which is used in this paper as a proxy for estimating health care needs and utilization. The importance of separating appropriately identified investment costs from recurrent costs is illustrated. Speedy implementation of health care for all requires assistance for investment costs, the recurrent costs of appropriately designed Primary Health Care Services being within the reach of developing nations themselves.     

Conservation and laundry: using outside vendors to clean reusable linens

Using outside laundry facilities is a viable and efficient means for hospitals to clean and sanitize soiled linens. Such services also allow hospitals to achieve cost-effective linen systems. All kinds of linen products, including gowns, sheets, blankets, pillowcases, mops, diapers, and surgical textiles, are easily processed through such purveyors. Even newer fabrics with improved barrier protection qualities can be serviced. The three elements that make up the laundry cost equation are purchasing, processing, and usage. Improvements and reductions in any one of these areas positively affect the other two. With this in mind, a hospital and an outside laundry service should work closely together to improve linen management, to control usage, and to remove waste, thus reducing hospitals' per-patient-day costs. Close interaction and teamwork will make the relationship work with dynamic results. Together, both parties will grow and meet the ever-evolving needs of the health care industry.     

Managing competitive software component supplier relationships

This study addresses purchasing challenges faced by companies buying commercial software components. The purpose is to find out how we can understand the purchasing challenges in software component business. First we develop pre-understanding based on knowledge on competitive supplier relationships and competitive bidding. This is elaborated empirically through a qualitative case study. We contribute to prior literature by concluding that the nature of software component supplier relationships is influenced by the object and costs of exchange. We also argue that, in markets like software component business, it is essential to pay attention to the development of the whole supply market.     

The impact of public pension board of trustee composition on state bond ratings

The declining financial health of public pension systems is increasingly becoming a budgetary concern for many state and local governments. While the academic literature has identified several factors behind the growth in unfunded state and local public pension liabilities, there is mixed evidence on how the composition of a pension system’s board of trustees affects a pension’s financial health. This article contributes to this literature by measuring how public pension board composition affects fund financial health as measured by state bond ratings. With a panel dataset of state pensions between 2001 and 2014 our results indicate that elected board members are consistently associated with lower bond ratings (and thus higher borrowing costs) while appointed and ex-officio board members are associated with higher bond ratings. These results are robust to a number of specifications.     

Low cost country sourcing and its effects on the total cost of ownership structure for a medical devices manufacturer

In this paper, we describe a total cost of ownership (TCO) method as an activity-based costing (ABC) application along the value chain to measure and analyse the costs of international sourcing activities. We further describe the method's implementation for a manufacturer of high-tech medical devices. For this case study, we analyse the effects of shifting purchasing volume from traditional procurement market suppliers to low cost country suppliers on the cost structure of purchasing projects. We find that particularly costs at component and supplier level gain importance over traditionally dominating unit level costs. Furthermore, we identify low cost country sourcing as a decision with extensive impact on value chain entities other than purchasing. Finally, a considerable part of costs in low cost country sourcing accrue at the beginning of a purchasing project due to problems stemming from unsatisfactory initial quality, language barriers and intercultural communication.     

Just-in-time and stockless programs for hospitals: fad or trend?

The JIT and stockless approach to provider-supplier relationships has proven to be a win-win proposition for the partners that have implemented it in many manufacturing industries and health care organizations as well. This strategy will fundamentally impact the entire cost structure within the hospital supply distribution chain. rewards have proven attainable and more comprehensive than had been hoped in the health care applications. The sweeping changes the health care industry experienced during the 1980s are leading creative materiel managers to seize the initiative to improve the current operating costs of their hospitals. They do not want to be left behind "holding the inventory."     

Electronic data interchange in hospital materiel management

The survey findings reported here support the continued trend toward increasing application of computer linkages in hospital operations. A majority of the hospitals surveyed already had some sort of computer linkages with their suppliers, possibly an EOE system. There were strong indications of expanding computer linkages to other health care institutions, financial institutions, business partners (i.e., insurance companies), purchasing groups, supporting agencies (i.e., libraries, research laboratories, and counseling agencies), electronic mail, and patient billing. Private hospitals, especially nonprofit hospitals, were more aggressive in the implementation of computer linkages. The initial costs of electronic linkage systems seemed to be affordable, or well justified, as indicated by the relatively large number of medium-size hospitals already linked electronically to other institutions. Top management attention was positively related to the implementation of computer linkages to suppliers but played a lesser role in establishing other types of linkages. The overall optimism concerning future expansion of computer linkages suggests an increasingly important role for electronic linkages in materiel management.     

Electronic decision support for procurement management: evidence on whether computers can make better procurement decisions

We analyse how well purchasing managers are able to judge the likelihood of problems for a given purchasing transaction. The literature on clinical versus statistical prediction suggests that humans in general, including purchasing managers, are often outperformed by relatively simple statistical formulas for such kinds of tasks. Based on a vignette experiment of real purchasing transactions, we compare the performance of purchasing managers with freshmen students and with a statistical formula based on a cross-validated sample. The results show that the formula outperforms the humans, and that experienced purchasing managers do not outperform freshmen students. We conclude that it would make sense to use decision support systems in the daily practice of purchase management so that humans can devote their time to what they are good at, while being guided by statistical software that takes care of multi-dimensional decisions in noisy environments.     

石油物资集中采购模式的分析

实行石油物资的集中采购，能有效降低采购成本,提高油田经济效益，对油田企业至关重要。近年来，我国三大石油公司大力推行集中采购，取得十分明显的经济效果。由于物资种类多,采购规模大，因而相应的供应商数量也非常多。而油田多以传统采购模式为主，采购部门重复，采购效率低下。采购成本增加。在此分析集中采购在石油物资采购中的优势，以期达到降低采购成本，增加油田效率的目的。