Health services management research : an official journal of the Association of University Programs in Health Administration
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Health Serv Manage Res · May 2006
The costs and service implications of substituting intermediate care for acute hospital care.
Intermediate care is part of a package of initiatives introduced by the UK Government mainly to relieve pressure on acute hospital beds and reduce delayed discharge (bed blocking). Intermediate care involves caring for patients in a range of settings, such as in the home or community or in nursing and residential homes. ⋯ It does this by providing a model for evaluating the costs of intermediate care services provided by different agencies and techniques for calibrating the model locally. It finds that consistent application of the techniques over a period of time, coupled with sound planning and accounting, should result in savings to the health economy.
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Health Serv Manage Res · Nov 2005
ReviewEnd-of-life care volunteers: a systematic review of the literature.
This report presents a review of 1988 and onwards research and other literature on end-of-life (EOL) care volunteers. Only 18 research or case studies articles were identified for an integrative review through a search of nine library databases. A review of this literature revealed three themes: (1) the roles of EOL volunteers, (2) volunteer training and other organizational needs or requirements, and (3) outcomes, particularly the impact of volunteering on volunteers and the impact of volunteers on EOL care. ⋯ Volunteers often augment and enhance the range of EOL care services provided to terminally ill individuals and their families. Volunteers should also be recognized as increasing the accessibility of EOL care. The role of the volunteer is not without challenge, however, both for the individuals who volunteer and the organizations that must orient them and provide a meaningful role for them.
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Health Serv Manage Res · Aug 2005
Multicenter StudyRing fencing of elective surgery: does it affect hospital efficiency?
Ring fencing (RF) is defined as separating elective from emergency operations in parallel hospital production lines. This study examines the effects of RF of elective surgery on hospital efficiency. The analysis is performed on two levels. ⋯ The intensive study indicates that RF could have positive effects both on cost and technical efficiency under certain conditions of case-mix and the demand for elective surgery, while the panel analyses of the effects of RF in the hospital population do not produce stable results. We cannot conclude that RF has unconditional positive effects on hospitals' efficiency. However, in certain situations of case-mix and demand for services, RF could be a valuable tool for managers to increase hospitals' efficiency.
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Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. ⋯ It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better.
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Health Serv Manage Res · Nov 2003
Comparative StudyCyclic fluctuations in hospital bed occupancy in Roma (Italy): supply or demand driven?
The objective of this study was to assess hospital bed occupancy both by planned and unplanned cases, and to assess how supply and demand affect bed occupancy. Data was obtained from the Lazio Hospital Information System (HIS) dataset on all hospital discharges from July 1998 to June 2001. Using Diagnosis Related Groups (DRG) as the reason for hospital stay, admissions were classified into four categories: 'planned stay', 'presumed planned stay', 'presumed unplanned stay', and 'unplanned stay'. ⋯ In comparison with unplanned stays, the largest fluctuations were observed for planned stays while presumed planned and unplanned stays showed lesser fluctuations. It is possible to distinguish planned and unplanned hospital stays by using DRG grouping. Cyclic rigidities in the supply of services rather than the availability of beds or demand for beds seem to dictate hospital use in Roma so that restrictions in services hamper any reallocation of beds for 'planned stay' when demand for 'unplanned stay' beds declines.