A note on “Bed allocation techniques based on census data”

Capacity planning and resource allocation are crucial to the cost-effective delivery of health care services. In this paper, we present an analytic approach based on a modified version of the Holt-Winters multiplicative seasonality forecasting model to determine the frequency distribution associated with a hospital care unit's census. This paper is a follow-up to the census frequency distribution simulation model described in Lapierre et al. (Socio Econ. Plan. Sci. 33 (1999) 25). We demonstrate that our model can provide census frequency distributions equivalent to the simulation model of Lapierre et al. [1], but without the computational effort common to simulation models.     

浅议管理会计在医院财务管理中的作用

在计算机迅速发展的今天,以手工操作为主的传统会计模式被计算机逐步取代的情况下,医院会计工作要向管理型会计转化.医院要适应当前的形势,加强财务管理工作是必不可少的一个主要方面,管理会计作为财务管理的一个重要分支,恰恰适应了当前特殊时期医院在财务管理上的需求,文中阐述了管理会计在医院财务管理中的重要作用并提出了几点建议.     

Hospital accounts and accounting systems: a study in the French region of Toulouse from the seventeenth to the nineteenth century

Private charity was the origin of the foundation of hospitals in prerevolutionary France and at the same time their principal source of income; the church played an important role. The Revolution introduced many changes to hospitals. This article has two objectives: to describe hospital organization and accounting practices between the seventeenth and the nineteenth centuries as seen in three hospitals in the Toulouse region, and to show how the accounting model adopted was suited to their structure and aims.     

抓好共青团建设,让医院充满青春与活力

共青团组织作为我党的助手与后备军,在党发展与战斗的各个阶段都发挥了巨大的作用,在社会转型期的新形势下,继续抓好团建工作,发挥团组织的战斗堡垒作用,让医院充满青春与活力,存在其重要性与必要性。     

2010-2011年西藏地区医院业务收入影响因素分析

目的:分析西藏地区医院业务收入的影响因素。方法:对2010-2011年西藏医院门诊、住院收入变动建立因素指数体系,应用多因素分析法分析医院业务收入。结果:2011年较2010年西藏地区医院业务收入增加,以住院日均费用、门诊人次增加为主,住院日均费用中药费涨幅不大。结论:西藏医疗水平在不断进步,服务质量在不断提高,综合经济管理能力在不断提升。     

医院计算机管理系统

本文基于医院计算机系统设计原则，结合医院网络建设的网络配置技术，提出了网络建设的方案，并对其运行环境及日常管理进行了分析。     

关于医院其他物资材料管理的体会

医院其他物资材料占医院流动资金的比例较小,相对于药品等高值、可独立收费的物资,其被关注的程度较低。为降低医院的运行成本,提高医院经济运行管理的效益,以保证医疗活动持续有序地进行,根据其他物资材料的特点,在管理过程中应加强其他物资材料的预算管理、建立物资统计分析制度、重视库存物资清查盘点管理等容易被忽视的几个重要问题。通过科学、规范的管理,使之最大限度地为医院各项业务活动提供必要的物资供应,发挥后勤的保障作用。     

Spatial Interaction,Spatial Multipliers and Hospital Competition

The hospital competition literature shows that estimates of the effect of local market structure (concentration) on pricing (competition) are sensitive to geographic market definition. Our spatial lag model approach effects smoothing of the explanatory variables across the discrete market boundaries, resulting in robust estimates of the impact of market structure on hospital pricing, which can be used to estimate the full effect of changes in prices inclusive of spillovers that cascade through the neighboring hospital markets. The full amount, generated by the spatial multiplier effect, is a robust estimate of the impacts of market factors on hospital competition. We contrast ordinary least squares and spatial lag estimates to demonstrate the importance of robust estimation in analysis of hospital market competition. In markets where concentration is relatively high before a proposed merger, we demonstrate that Ordinary Least Squares (OLS) can lead to the wrong policy conclusion while the more conservative lag estimates do not.     

Performance of French intensive care units: A directional distance function approach at the patient level

By using a novel adaptation of the free-disposable hull analysis of productivity, we assess the medical and technical efficiency of patient care in 25 Parisian intensive care units (ICUs) during 2000. The robust free disposable hull (RFDH) as defined by [Cazals et al., 2002. Nonparametric frontier estimation: a robust approach. Journal of Econometrics 106, 1–25] reduces the impact outliers may have on findings by employing Monte-Carlo techniques and repeated sample selection. Among our key findings, there was no overall significant correlation between medical and technical efficiencies for all the ICUs, therefore performing well in one does not guarantee good performance in the other. We also found that over 80% of inefficiency is concentrated in less than 20% of the sampled patients.     

Hospital economic impact from hemostatic matrix usage in cardiac surgery

Objective:

Improved health outcomes can result in economic savings for hospitals and payers. While effectiveness of topical hemostatic agents in cardiac surgery has been demonstrated, evaluations of their economic benefit are limited. This study quantifies the cost consequences to hospitals, based on clinical outcomes, from using a flowable hemostatic matrix vs non-flowable topical hemostatic agents in cardiac surgery.

Research design and methods:

Applying clinical outcomes from a prospective randomized clinical trial, a cost consequence framework was utilized to model the economic impact of comparator groups. From that study, clinical outcomes were obtained and analyzed for a flowable hemostatic matrix (FLOSEAL, Baxter Healthcare Corporation) vs non-flowable topical hemostats (SURGICEL Nu-Knit, Ethicon–Johnson &; Johnson; GELFOAM, Pfizer). Costing analyses focused on the following outcomes: complications, blood transfusions, surgical revisions, and operating room (OR) time. Cardiac surgery costs were analyzed and expressed in 2012 US dollars based on available literature searches and US data. Comparator group variability in cost consequences (i.e., cost savings) was calculated based on annualized impact and scenario testing.

Results:

Results suggest that if a flowable hemostatic matrix (rather than a non-flowable hemostat) was utilized exclusively in 600 mixed cardiac surgeries annually, a hospital could improve patient outcomes by a reduction of 33 major complications, 76 minor complications, 54 surgical revisions, 194 transfusions, and 242?h of OR time. These outcomes correspond to a net annualized cost consequence savings of $5.38 million, with complication avoidance as the largest contributor.

Conclusions:

This cost consequence framework and supportive modeling was used to evaluate the hospital economic impact of outcomes resulting from the usage of various hemostatic agents. These analyses support that cost savings can be achieved from routine use of a flowable hemostatic matrix, rather than a non-flowable topical hemostat, in cardiac surgery.