There are some new progresses including patient care, active change of attitude for patients, enhanced hospital regulation, strengthened medical equipment, elimination and eradication of serious and/or social diseases. The hospital network have had some limitations including complications in the treatment, attitude for patients, hospital management, overload of higher level hospitals, sewage disposal and income of health staffs. From which the study introduced 10 major solutions including organization, medical equipment, health economic management, drug supply and delivery, profession guidance, patient care and health staff's life.
Hospitals ; Economics, Hospital

Medical equipment procurement authority provides sunshine supervisory channel for hospital staff by power operation monitoring software, which could operate in the open. The exercise of purchase rights should upload the content in accordance with the provisions of "internal control point". It could strengthen the procurement process control and ensure the orderly supervision links to further regulate bidding and purchasing behavior, which can prevent the exercise of uncontrolled power.
Purchasing, Hospital ; Surgical Equipment ; economics

Expounding the status of the current domestic medical equipment maintenance management, and puting forward the strategic thinking of medical maintenance for the challenges of equipment maintenance management in the hospital. This discussion can be performed to control the maintenance costs of hospital effectively, increase the income and social benefits of the hospital.
Costs and Cost Analysis ; Equipment and Supplies, Hospital ; Maintenance and Engineering, Hospital ; economics ; Materials Management, Hospital ; economics

OBJECTIVEStudy the current quality management situation of enterprises marketing corneal contact lens via systemic investigations and explore effective administration countermeasures in the future.

METHODSThe quality management indicators of sixty-two corneal contact lens marketing enterprises in Xuhui district of Shanghai were systematically investigated and enterprises of different operation models was compared and analyzed.

RESULTSWholesale enterprises and retail chain enterprises are apparently better than independent enterprises almost in all facets.

CONCLUSIONFacilitate market accession of corneal contact lens marketing enterprises, encourage the business model of retail chain, enhance supervision of corneal contact lens marketing enterprises, especially independent franchisors.

Contact Lenses ; economics ; Marketing ; Materials Management, Hospital

China ; Computer Communication Networks ; economics ; Hospital Information Systems ; economics ; standards ; Radiology Information Systems ; economics ; standards

BACKGROUNDThe new medical insurance policy (JRSYF(2010) No.255) was released by the Beijing Municipal Government and became effective on January 1, 2011. Medical expenses incurred during a stay in an emergency department (ED) observation unit can be reimbursed as a hospital admission. The aim of this study was to evaluate the impact of a new charging scheme during stays in ED observation unit under Beijing's Basic Medical Insurance.

METHODSData for those patients who had stayed in ED observation unit in 2010 (before the implementation of a new charging scheme) and 2012 (after the implementation of this policy) were retrospectively analyzed in terms of length of stay, patients who were observed (PO), and median medical costs.

RESULTSAfter the implementation of a new charging scheme, compared with the year of 2010, in year of 2012, there were statistically significant longer lengths of stay at the observation unit (6 (4-9) vs. 5 (4-7) days; P < 0.001), more PO (2 257 vs. 1 783; P < 0.001), and more median medical costs (RMB 6 026 vs. 3 650 Yuan; P < 0.01). The proportion of elderly patients (≥ 60 years of age) in 2012 was larger than that in 2010 (70.22% vs. 63.71%; P < 0.01). It was performed on those patients who were admitted after the implementation of a new charging scheme. Compared with patients who were not admitted had stayed in ED observation units, the patients who were admitted had stayed in ED observation units that had a higher proportion for >15 days (36.22% vs. 5.61%; P < 0.01); they had higher median medical costs RMB (9 186 vs. 5 668 Yuan; P < 0.001) and they were more elderly (≥ 60 years of age) (86.10% vs. 66.39%; P < 0.01).

CONCLUSIONSThe new charging scheme under Beijing's Basic Medical Insurance allows patients to get access to inpatient admission more easily. It lowers patients' financial burden in ED observation unit. Since more people stay at ED observation unit, it increases ED payments by the insurance system. However, it slows the turnover rate of ED observation unit and causes overcrowding in ED. Hence, the advantages and disadvantages of the new policy are obvious.

Adult ; Aged ; Emergency Service, Hospital ; economics ; Female ; Hospitalization ; economics ; Humans ; Insurance, Health ; economics ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. METHOD: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. RESULT: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 33,269,925.0. The expense of a surgical nursing ward was 28,325,134.2. Therefore, the net income of a surgical nursing ward was won 4,944,790.8. CONCLUSION: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.
Costs and Cost Analysis ; General Surgery/*economics ; Hospitals, General/*economics ; Humans ; Nursing Service, Hospital/*economics ; Task Performance and Analysis

PURPOSE: Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. METHODS: Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. RESULTS: The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. CONCLUSION: These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.
Costs and Cost Analysis ; Hospitals, General/economics ; Humans ; Internal Medicine/*economics ; Nursing Service, Hospital/*economics ; Task Performance and Analysis ; Time Factors

BACKGROUND: A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. METHODS: Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. RESULTS: Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. CONCLUSIONS: For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.
Clinical Laboratory Techniques/*economics ; Female ; Humans ; *Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital/economics ; Male ; Questionnaires

BACKGROUNDTaiwan has implemented a National Health Insurance (NHI) program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the original payment system in Taiwan's NHI. Under global budgeting system, the total budget is distributed to six geographical regions in Taiwan. There is no pre-determined budget for each hospital. In order to investigate the longitudinal trend of how global budgeting influences health care resource, it is essential to estimate the efficiency of resource allocation in Taiwan's NHI.

METHODSData Envelopment Analysis (DEA) and Malmquist index (MI) are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health, Taiwan, China. A value of MI greater than 1 indicates that total factor productivity progress has occurred, while a value of MI less than 1 indicates productivity loss.

RESULTSAs a result, 37 of the 184 DMUs in the analysis were found to be relatively efficient during the period, in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting. A trend of MI declines between 2002 and 2009 implies the volume of health care services decrease after adopting global budgeting system. Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level.

CONCLUSIONSThe regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system. Hence, a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.

Budgets ; Hospital Administration ; economics ; National Health Programs ; economics ; Resource Allocation ; methods ; Taiwan