A filmless radiology department in a full digital regional hospital: quantitative evaluation of the increased quality and efficiency.
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Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went "filmless" in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a "high level" and a "detailed" business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must. (+info)
An evaluation of a micro-credit system to promote health knowledge among poor women in Bangladesh.
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A Micro-credit system (MCS) is a financial system to support the economic needs of the poor. It is thought of as a community-based method to solve various problems, including the lack of health-related knowledge. Participants are organized in groups that assemble in regular meetings. Hadi (Hadi in Health Promotion International 16, 219-227, 2001) investigated the MCS as a method to solve the lack of health-related knowledge among the poor in Bangladesh. His result among rural MCS participants shows a positive relationship between the duration of membership in a micro-credit group and health knowledge. Further, more knowledge was ascertained among participants than among non-participants. The present research investigated the effectiveness of the MCS in increasing health-related knowledge. Comparisons were made between rural and urban groups on the basis of three different durations of membership and the influence of TV. This three-factorial design shows a significant increase in knowledge in a very short period in rural areas, whereas in urban areas, no systematic increase was found. TV plays a significant roll in increasing knowledge. Different theoretical conclusions are discussed on the basis of the results. (+info)
HIV/AIDS drugs for Sub-Saharan Africa: how do brand and generic supply compare?
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BACKGROUND: Significant quantities of antiretroviral drugs (ARVs) to treat HIV/AIDS have been procured for Sub-Saharan Africa for the first time in their 20-year history. This presents a novel opportunity to empirically study the roles of brand and generic suppliers in providing access to ARVs. METHODOLOGY/PRINCIPAL FINDINGS: An observational study of brand and generic supply based on a dataset of 2,162 orders of AIDS drugs for Sub-Saharan Africa reported to the Global Price Reporting Mechanism at the World Health Organization from January 2004-March 2006 was performed. Generic companies supplied 63% of the drugs studied, at prices that were on average about a third of the prices charged by brand companies. 96% of the procurement was of first line drugs, which were provided mostly by generic firms, while the remaining 4%, of second line drugs, was sourced primarily from brand companies. 85% of the generic drugs in the sample were manufactured in India, where the majority of the drugs procured were ineligible for patent protection. The remaining 15% was manufactured in South Africa, mostly under voluntary licenses provided by brand companies to a single generic company. In Sub-Saharan African countries, four first line drugs in the dataset were widely patented, however no general deterrent to generic purchasing based on a patent was detected. CONCLUSIONS/SIGNIFICANCE: Generic and brand companies have played distinct roles in increasing the availability of ARVs in Sub-Saharan Africa. Generic companies provided most of the drugs studied, at prices below those charged by brand companies, and until now, almost exclusively supplied several fixed-dose combination drugs. Brand companies have supplied almost all second line drugs, signed voluntary licenses with generic companies, and are not strictly enforcing patents in certain countries. Further investigation into how price reductions in second line drugs can be achieved and the cheapest drugs can actually be procured is warranted. (+info)
Financing clinical dental education.
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Many reports have documented the growing financial challenges faced by dental schools. This article examines the financial implications of two new models of dental education: 1) seniors spend 70 percent of their time in community clinics and practices, providing general dental care to underserved patients, and 2) schools develop patient-centered clinics where teams of faculty, residents, and senior students provide care to patients. We estimate that the average dental school will generate new net revenues of about $2.7 million per year from the community-based educational programs for senior students and about $14 million per year from patient-centered care clinics. These are upper boundary estimates and vary greatly by school. The organizational and financial challenges of moving to these new educational models are discussed. (+info)
Learning-related human brain activations reflecting individual finances.
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A basic tenet of microeconomics suggests that the subjective value of financial gains decreases with increasing assets of individuals ("marginal utility"). Using concepts from learning theory and microeconomics, we assessed the capacity of financial rewards to elicit behavioral and neuronal changes during reward-predictive learning in participants with different financial backgrounds. Behavioral learning speed during both acquisition and extinction correlated negatively with the assets of the participants, irrespective of education and age. Correspondingly, response changes in midbrain and striatum measured with functional magnetic resonance imaging were slower during both acquisition and extinction with increasing assets and income of the participants. By contrast, asymptotic magnitudes of behavioral and neuronal responses after learning were unrelated to personal finances. The inverse relationship of behavioral and neuronal learning speed with personal finances is compatible with the general concept of decreasing marginal utility with increasing wealth. (+info)
Doing better to do good: the impact of strategic adaptation on nursing home performance.
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OBJECTIVE: To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance. DATA SOURCES: Online Survey, Certification, and Reporting (OSCAR) data from 1997 to 2004, and the area resource file (ARF). STUDY DESIGN: The extent of strategic adaptation was measured by an aggregate weighted implementation score. Nursing home performance was measured by occupancy rate and two measures of payer mix. We conducted multivariate regression analyses using a cross-sectional time series generalized estimating equation (GEE) model to examine the effect of nursing home strategic implementation on each of the three performance measures, controlling for market and organizational characteristics that could influence nursing home performance. DATA COLLECTION/ABSTRACTION METHODS: OSCAR data was merged with relevant ARF data. PRINCIPAL FINDINGS: The results of our analysis provide strong support for the hypothesis. CONCLUSIONS: From a theoretical perspective, our findings confirm that organizations that adjust strategies and structures to better fit environmental demands achieve superior performance. From a managerial perspective, these results support the importance of proactive strategic leadership in the nursing home industry. (+info)
Dental insurance: will it help or hinder adoption of caries management practices?
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Whether public or private dental insurance will provide benefits for caries management practices is a business decision. The foundation for this decision is multifactorial and continually changing as the values of the purchasers and health care consumers evolve. Understanding the dynamics involved in allocating finite health care resources will help those who advocate for caries management inform decision makers about the potential benefits of these strategies. (+info)
Tuberculosis and HIV infection: the global setting.
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Tuberculosis (TB) and human immunodeficiency virus (HIV) infection make each other's control significantly more difficult. Coordination in addressing this "cursed duet" is insufficient at both global and national levels. However, global policy for TB/HIV coordination has been set, and there is consensus around this policy from both the TB and HIV control communities. The policy aims to provide all necessary care for the prevention and management of HIV-associated TB, but its implementation is hindered by real technical difficulties and shortages of resources. All major global-level institutions involved in HIV care and prevention must include TB control as part of their corporate policy. Country-level decision makers need to work together to expand both TB and HIV services, and civil society and community representatives need to hold those responsible accountable for their delivery. The TB and HIV communities should join forces to address the health-sector weaknesses that confront them both. (+info)