Competition among hospitals and managed care have forced hospital industry to be more efficient. With higher degrees of hospital competition and managed care penetration, hospitals have argued that the rate of increase in hospital cost is greater than the rate of increase in hospital revenue. By developing a payer-specific case mix index (CMI) for third-party patients, this paper examined the effect of hospital case mix on hospital cost and revenue for third-party patients in California using the hospital financial and utilization data covering 1986-1998. This study found that the coefficients for CMIs in the third-party hospital revenue model were greater than those in the hospital cost model until 1995. Since 1995, however, the coefficients for CMIs in the third-party hospital revenue model have been less than those in hospital cost models. Over time, the differences in coefficients for CMIs in hospital revenue and cost models for third-party patients have become smaller and smaller although those
Recent studies indicate that approaching death, rather than age, may be the main demographic driver of health care costs. Using a 29-year longitudinal English dataset, this paper uses more robust methods to examine the effects of age and proximity to death on hospital costs. A random effects panel data two-part model shows that approaching death affects costs up to 15 years prior to death. The large tenfold increase in costs from 5 years prior to death to the last year of life overshadows the 30% increase in costs from age 65 to 85. Hence, expenditure projections must consider remaining life expectancy in the populations.
The bill directs the department to consult with the hospital provider fee oversight and advisory board on the development of the hospital expenditure report. The department may combine the hospital expenditure report with the advisory boards annual report on the hospital provider fee. The advisory board, using staff and analysis from the department, shall provide estimates for the payment-to-cost ratio and the cost-shift analysis portions of its report based on information provided to the department by hospitals.. The hospital expenditure report shall include, but not be limited to:. ...
This study determined that prescription drugs do have a positive effect on hospital expenditures by either preventing hospitalization or resulting in cost savings once patients have been admitted.
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Hospital heterogeneity is a major issue in defining a reimbursement system. If hospitals are heterogeneous, it is difficult to distinguish which part of the differences in costs is due to cost containment efforts and which part cannot be reduced, because it is due to other unobserved sources of hospital heterogeneity. In this paper, we apply an econometric approach to analyse hospital cost variability. We use a nested three-dimensional database (stays-hospitals-years) in order to explore the sources of variation in hospital costs, taking into account unobservable components of hospital cost heterogeneity. The three-dimensional structure of our data makes it possible to identify transitory and permanent components of hospital cost heterogeneity. Econometric estimates are performed on a sample of 7314 stays for acute myocardial infarction (AMI) observed in 36 French public hospitals over the period 1994-1997. Transitory unobservable hospital heterogeneity is far from negligible : its estimated ...
(Bloomberg Opinion) -- The Trump administration believes in the power of transparency, at least when it comes to health care. President Donald Trump signed an executive order on Monday afternoon that calls for hospitals to tell patients how much they charge for surgeries and other services. These expenses
Objectives: A current trend in total hip replacement (THR) is the use of minimally invasive surgery. Little is known, however, about the impact of minimally invasive THR on resource use and length of stay. This study analyzed the effect of minimally invasive surgery on hospital costs and length of stay in German hospitals compared with conventional treatment in THR. Methods: We used patient-level administrative hospital data from three German hospitals participating in the national cost data study. We conducted a propensity score matching to account for baseline differences between minimally invasively and conventionally treated patients. Subsequently, we estimated the treatment effect on costs and length of stay by conducting group comparisons, via paired t tests and Wilcoxon signed-rank tests, and regression analyses. Results: The three hospitals provided data from 2886 THR patients. The propensity score matching led to 812 matched pairs. Length of stay was significantly higher for ...
BACKGROUND: The relationship between processes of early stroke care and hospital costs remains unclear.. AIMS: We therefore examined the association in a population based cohort study.. METHODS: We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010.The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization,early catheterization, and early thromboembolism prophylaxis.Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges.. RESULTS: The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant ...
Rising hospital costs have caused concern to the public, Government, and Members of Parliament ever since the start of the National Health Service. They are at present taxing the minds of those responsible for administering the hospitals as they try to contain hospital expenditure within the limits of funds made available by the Government. Nevertheless the problems are not
Examining two 5-year periods, one when HMO enrollment was increasing and one when it was decreasing, shows that HMOs had an effect on lowering hospital costs and revenues, albeit a diminishing one. This study looked at trends in hospital cost and revenue relative to different levels of HMO market structure.
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Earlier introduction of palliative care for patients hospitalized with advanced cancer is associated with lower hospital costs, according to a recent study.
Introduction: the hospital as the largest health care center of the society allocates a bulk of the sources and credits assigned to the health sector of the country. Several studies carried out by the researchers indicate that the manpower cost of each hospital constitutes over sixty per cent of its resources. Due to the relevance of the personnel in the quality of services provided to the patients and its costs for hospital, determining the number of optimal needed employees of hospital complex departments is a problem; it has not had a specified standard. Therefore, this research has been carried out for reducing the hospital costs to minimum through the optimization of the nursing force allocation using the Linear programming model in the hospital emergency department. This case study was conducted in 2015.. Method: this is a scientific-applied and cross-sectional-descriptive study that has been done in a public health training Centre in 2015; the emergency department was randomly selected as ...
Sinn Féins deputy spokesperson for Public Expenditure & Reform Jonathan OBrien TD has called on DPER officials to come before the Public Accounts Committee.. This comes after yesterdays Public Accounts Committee during which new details of the National Childrens Hospital cost overrun came to light.. Speaking today, the TD for Cork North-Central, Deputy OBrien said:. "Yesterdays meeting of the Public Accounts Committee brought further light to the mismanagement of the National Childrens Hospital and the resulting cost overruns. "We now know that between June and November of 2018, in a period of 5 months, costs rose by up to €450 million; thats €100 million a month. As yet we dont know exactly how those costs rose. Many questions remain.. "Officials before the Public Accounts Committee made clear that the Department of Health assumed overall responsibility for this scandalous mismanagement of taxpayers money, but attention must now turn to the knowledge and involvement of the ...
Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State ...
A strength of the architecture of the web is the central role played by the relationship between names and resources. We propose to leverage that W3C strength, in the public interest. The W3C would create specifications by which information collectors could publish up-to-date lists of the public domain unique identifiers that they bind to entities on which they collect information. The information would include all of the public information that would help users and applications to infer, construct or publish their own relationships among identifiers (experience shows that geographic and postal address information is essential to the mapping process). To take two concrete examples:. ...
Downloadable! This paper provides a simple method to account for heteroskedasticity and cross-sectional dependence in samples with large cross sections and relatively few time-series observations. The method is motivated by cross-sectional regression studies in finance and accounting. Simulation evidence suggests that these estimators are dependable in small samples and may be useful when generalized least squares is infeasible, unreliable, or computationally too burdensome. We also consider efficiency issues and show that, in principle, asymptotic efficiency can be improved using a technique due to Cragg (1983).
With their speed, capacity, intelligence, and security capabilities, mainframes remain a core component of banking data practices.
Credit reporting agency Equifax confirmed that fraudulent and unauthorized access to financial files of four high profile people were recently compromised, but the company declined to identify the individuals.
Most soon to be parents are so excited and busy with the upcoming birth that they dont even think about the price of the hospital. But as all new parents know, the charges from the hospital can be downright shocking. Vox wanted to find out. This is what happened. ...
Insurance companies negotiate in secret with hospitals for big discounts on all services, and line-item veto on individual charges. Now you can save thousands of dollars by learning how to take advantage of these secret contracts and apply them to your own bills.
For hospitals and health systems, theres some good, bad and ugly in legislation that is moving swiftly through Congress to change how Medicare pays physicians.
Want to know how much a hip replacement will cost? Many hospitals wont be able to tell you, at least not right away -- if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.
Want to know how much a hip replacement will cost? Many hospitals wont be able to tell you, at least not right away - if at all. And if you shop...
See how physicians and hospitals can reduce costs and provide the best patient care with longer-lasting devices and fewer CRT-D and ICD device replacements.
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Growth in hospital costs from 1997 2009 for the 20 most common inpatient procedures is presented. Hospital cost growth for nonelderly versus elderly patients is compared.
Too many companies justify raising prices by saying that their own costs, usually for materials, have gone up. (Mark Graban at the Lean Blog recently focused on this practice in the auto industry.) That is a bad attitude, partly because it shows no consideration for the customer, and partly because it ignores the possibility that process improvements can reduce expenses and compensate for higher material costs ...
An integrated cloud offers a more manageable and secure alternative to separate, best-of-breed applications. Sharing HR and financial data provides a deeper view across your business. Your operations will be simplified, streamlined, and better able to react to unforeseen marketplace changes and support sustained growth. By allowing all lines of business to have cross-functional data access, you can get better management and decision-making.. "With HCM and ERP together in the cloud there is no lag time. And you dont need resources to make manual updates to data in both systems to ensure they are in sync." Corey West, EVP, Corporate Controller and Chief Accounting Officer, Oracle. ...
Hackers are attacking databases in large numbers in an effort to swipe personal and financial data, a security vendor said Wednesday.
RE: how to secure the whole process? --- How you do it, how to secure it and the amount of security you need is somewhat dependent on your individual needs. There is minor security built in via the password.. but read up on its vulnerabilities do your own risk assessment. Consideration should be given to what type of data is each system, if a VPN is being used, is the help being given over WAN or LAN, if its a server always on listening for connections from a WAN or just a quick reverse connection to quickly help someone. You may prefer to do one thing on a server with financial data that is always one vs something much simpler to quickly help grandma take a virus off her computer that she only stores cat photos on. Google is your friend with keywords such as secure, uvnc , maybe plugin or how to setup a vpn. Many ways and many entries here and elsewhere on this ...
Dragon Pharmaceutical announced a business update and selected unaudited 2004 pro-forma financial data of the Company combined with Oriental Wave Holding Limited.
Select the appropriate statistical test that allows you to conduct an analysis of the factors affecting hospital costs. You will have to select the correct statistical test and conduct that test in Excel. 1. Analyze your data.
If youre pregnant, or considering it and planning ahead, picking a good obstetrician and hospital may be one of the most important decisions you make.
Estimates of the marginal effect of measures of adiposity such as body mass index (BMI) on healthcare costs are important for the formulation and evaluation of policies targeting adverse weight profiles. Many existing estimates of this association are affected by endogeneity bias caused by simultaneity bias, measurement error and omitted variables. The contribution of this study is to avoid this bias by using a novel identification strategy - random germline genetic variation in an instrumental variable analysis - to identify the presence and magnitude of the causal effect of BMI on inpatient hospital costs. We use genetic variant-level data to undertake much richer testing of the sensitivity of results to potential violations of the instrumental variable assumptions than is possible with existing approaches. Using data on over 300,000 individuals, we found effect sizes for the marginal unit of BMI over 50% as large as multivariable effect sizes. These effects attenuated under sensitivity ...
Background - Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship. Study Design and Methods - A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs. Results - Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence ...
Background and Purpose- It is important to know the costs for hospitalization for endovascular embolectomy patients so that comparisons can be made to payments to hospitals.. Methods- Using the National Inpatient Sample, we evaluated the costs for hospitalization for patients treated with endovascular embolectomy in the United States from 2006-2008. The primary endpoint examined in this study was total hospital costs, and these were correlated with clinical outcome. Hospitalization costs were then compared with Medicare payments for their respective outcomes. MS-DRG 24 was the diagnostic related group code (DRG) for mechanical embolectomy with good outcome and MS-DRG 23 was the DRG code for mechanical embolectomy with major complications. Medicare payments were available at http://www.cms.hhs.gov.. Results- A total of 3864 patients received endovascular embolectomy. 1649 patients were ,65 years old and 2205 patients were ≥65 years old. Median hospital costs in 2008 dollars were $36,999 (IQR ...
BACKGROUND: Laparoscopic inguinal hernia surgery is increasingly seen as the superior technique in hernia repair. Compared to open-mesh hernia repair, laparoscopic approaches are often reported to be more cost-effective but incur higher costs for the provider. The objective of this study was to analyze the effect of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair of nonincarcerated inguinal hernias in men on hospital costs and length of stay (LoS). METHODS: We used routine administrative, highly standardized, patient-level cost data from 15 German hospitals participating in the national cost data study. We compared TEP, TAPP, and open-mesh repair. We conducted propensity score matching to account for baseline differences between treatment groups and subsequently estimated the treatment effect on costs and LoS. RESULTS: Total costs for both TEP and TAPP surgery were significantly lower than those for open-mesh repair (p , 0.0001 and p , 0.05, respectively). TEP repair ...
Global Financial Data divides the past four centuries of the stock market into four eras: Mercantilism (1601-1799), Free Trade (1800-1914), Regulation (1914-1981), and Globalization (1981-). The stock market was fundamentally different during those four eras affecting equity and bond returns, the dividend yield and the equity risk premium.. During the period of Mercantilism, government favored national monopolies that could trade with the rest of the world. The Dutch had the East India Company (Vereenigde Oost-Indische Compagnie) and the West India Company (Geoctroyeerde Westindische Compagnie). The French had its own East India Company (Compagnie des Indes) which traded in all parts of the world. England had three companies which dominated their stock market during the 1700s, the Bank of England, the East India Co. and the South Sea Co. In addition to these three companies, British 3% Consols represented the majority of trading in London as Britain funded its wars in the 1700s through debt and ...
There are many ingredients in our stroke project, including a stroke neurologist medical director, stroke nurse, multidisciplinary team, dedicated stroke unit, standing orders, stroke care plan, and experimental stroke protocols. Application of this entire format to other community or academic hospitals may not be feasible, but portions of it could be used at any hospital. Despite the cost and effort required, the dramatic decline in LOS, hospital charges, and apparent costs of short-term stroke care will result in savings to the hospital. At Mercy General Hospital, our charges to Medicare for stroke patients declined $1 621 296 over 3.5 years. More recently, we monitored cost per patient rather than charges and have found lower costs and shorter LOS for patients with stroke standing orders and critical path plans than for those without such plans (unpublished data, 1995).. Other authors have examined the impact of stroke projects on hospital costs. Bowen and Yaste4 reported a 6-month study of ...
TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents ...
Background: CT-guided radiofrequency ablation (CT-RFA) is presumed to be less morbid and less costly than laparoscopic RFA (L-RFA). CT-RFA, however, has a higher treatment failure rate than L-RFA. This analysis looks at the 30-day morbidity and financial data for CT-RFA versus L-RFA for hepatocellular cancer (HCC) and colorectal liver metastases (CRLM).. Methods: All patients with the diagnosis of CRLM or HCC who underwent CT-RFA or L-RFA at our institution between 2002-2008, were reviewed retrospectively. Demographics, risk stratification and procedural data were analyzed. Hospital financial data was queried for total cost, reimbursement and itemized departmental charges. Patients with CRLM or HCC were evaluated separately.. Results: Twenty-two RFA procedures were performed for the treatment of CRLM (6 CT-RFA; 16 L-RFA) and 15 RFA procedures were performed for the treatment of HCC (5 CT-RFA; 8 L-RFA). For patients with CRLM, there were no significant differences in patient age (p=0.55), ASA ...
Pediatric critical care and hospital costs under reimbursement by diagnosis-related group: Effect of clinical and demographic characteristics Academic Article Article ...
Adult patients on prolonged acute mechanical ventilation (PAMV) comprise 1/3 of all adult MV patients, consume 2/3 of hospital resources allocated to MV population, and are nearly twice as likely to require a discharge to a skilled nursing facility (SNF). Their numbers are projected to double by year 2020. To aid in planning for this growth, we projected their annualized days and costs of hospital use and SNF discharges in year 2020 in the US. We constructed a model estimating the relevant components of hospital utilization. We computed the total days and costs for each component; we also applied the risk for SNF discharge to the total 2020 PAMV population. The underlying assumption was that process of care does not change over the time horizon. We performed Monte Carlo simulations to establish 95% confidence intervals (CI) for the point estimates. Given 2020 projected PAMV volume of 605,898 cases, they will require 3.6 (95% CI 2.7-4.8) million MV, 5.5 (95% CI 4.3-7.0) million ICU and 10.3 (95% CI 8.1
TY - JOUR. T1 - Factors influencing third party payer costs for allogeneic BMT. AU - Griffiths, R. I.. AU - Bass, Eric B. AU - Powe, N. R.. AU - Anderson, Gerard F. AU - Goodman, S.. AU - Wingard, J. R.. PY - 1993. Y1 - 1993. N2 - To assess how payer costs for allogeneic BMT relate to patient characteristics and clinical complications, a retrospective cohort study of 402 persons undergoing allogeneic BMT between 1980 and 1987 at a university-based BMT center was designed to determine total inpatient payer costs, including hospital and physician costs, and number of days hospitalized during the first 180 days following BMT. The average total inpatient payer cost (in 1990 dollars) during the first 180 days following BMT was $208 410. Inflation adjusted inpatient payer costs increased from $227 806 in 1980 to $308 545 in 1983, and then decreased to $156 163 by 1987. In multivariate analysis, inpatient payer costs were strongly associated with occurrence of CMV infection (increase of $53 517; p = ...
Most people assume that if they have to go to the hospital that it will be a costly experience. While this thought process has some merit, it becomes a bit more complicated when you consider the disparity in hospital cost amongst insured vs. uninsured. Hospitals charge the highest fees to those who are uninsured. Fees can range from 2 times to 5 times more than those fees charged to individuals who are insured. In fact, those who are insured or those who are on Medicare typically receive discounted medical services. There are instances where hospitals provide self pay discounts. However, many times these discounts mean little or nothing when you consider the initial rate that a self pay individual is charged. When a person has insurance, the insurance companies will often negotiate bills for the insured (if the charged price seems excessive). That being the case, hospitals will typically charge a reasonable price (initially) for those who are insured. On the other hand, if you are not ...
The Dutch case-mix office (DBC-Onderhoud) has an import role in calculating national tariffs. To do so, DBC-Onderhoud (DBC-O) needs different kinds of information from different sources as building blocks. There are three cost-components for each DBC: a separate cost-component for the total hospital costs of a DBC; a cost for the main medical specialist; and costs for all supporting medical specialists that are involved in treating the patient.. Every medical association estimates the time needed for each DBC to be produced by their specialty. Matched with the total capacity in the Netherlands, this determines the work load per DBC. The Dutch health authority determines the hourly rate for the medical specialists. Medical associations that represent supporting specialties estimate the time needed per care activity to be produced by their specialty. Matched with the total capacity in the Netherlands, the work load per care activity is determined.. Healthcare providers supply production ...