The strengthening of medical equipment led the burden for the health sector and national budget. It should consider the cost for the paraclinical services and the mechanism of partial or total collection of hospital bursar
Hospitals ; Hospital Costs ; Diagnosis

A retrospective study on the budget and fee utility for 1000 patients in Thuû nguyªn, Tiªn l·ng district hospital from March 1998 to April 1998 has shown that the state budget allocated for district hospitals mainly were low level (66% and 69% total budget of Thuû nguyªn and Tiªn l·ng, respectively). This did not facilitate to poor people who can receive the health services in district hospitals. There has not been the budget which allocated to poor people. And there has not been the equity in hospital fee between subjects with different income.
Hospitals ; Hospital Costs ; Family Characteristics

PURPOSE: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. METHODS: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in ‘Public Hospitals Alert’, was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. RESULTS: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as ₩29,128 The nursing cost per inpatient per day was calculated as ₩157,970, and the administration cost per patient was calculated as ₩133,710. CONCLUSION: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.
Budgets ; Cost Allocation ; Costs and Cost Analysis ; Health Care Costs ; Hospital Costs ; Hospitals, Public ; Humans ; Inpatients ; Methods ; Nursing Services ; Nursing*

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

BACKGROUND: Recently, reports show that minimally invasive cardiac surgery is effective in shortening the hospital stay. We reviewed the patients who underwent repair of their congenital heart anomalies under ministernotomy approach and were discharged within 5 days. MATERIAL AND METHOD: In this study, we included two groups : Group I were 29 patients who underwent minimally invasive cardiac surgery from November 1998 to July 1999(FT group), and Group II were 29 patients who underwent cardiac surgery via median sternotomy from January 1997 to May 1997(conventional group). We compared these two groups. All patients had similar disease categories and underwent the operation by the same surgeon. RESULT: The mean hospital stay in FT group was significantly shorter than conventional group(4.5 vs. 9.1 days, p<0.05, n=29). No complications were found. However, the total mean hospital cost did not reach statistical difference(7,333,184 vs. 7,486,136 won, p>0.05, n=29). CONCLUSION: Our protocol of fast track hospital discharge could shorten the hospital stay without complications. However, the economic benefit remains to be determined.
Heart* ; Hospital Costs ; Humans ; Length of Stay ; Sternotomy ; Thoracic Surgery*

BACKGROUND: This study investigates association modified category medical specialization (CMS) and hospital charge, length of stay (LOS), and mortality among lumbar spine disease inpatients. METHODS: This study used National Health Insurance Service–cohort sample database from 2002 to 2013, using stratified representative sampling released by the National Health Insurance Service. A total of 56,622 samples were analyzed. The primary analysis was based on generalized estimating equation model accounting for correlation among individuals within each hospital. RESULTS: Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a shorter LOS (estimate, −1.700; 95% confidence interval [CI], −1.886 to −1.514; p < 0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a lower mortality rate (odds ratio, 0.635; 95% CI, 0.521 to 0.775; p < 0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per case (estimate, 192,658 Korean won; 95% CI, 125,701 to 259,614; p < 0.0001). However, inpatients admitted with lumbar spine surgery patients at hospitals with higher modified CMS had lower hospital cost per case (estimate, −152,060 Korean won; 95% CI, −287,236 to −16,884; p=0.028). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per diem (estimate, 55,694 Korean won; 95% CI, 46,205 to 65,183; p < 0.0001). CONCLUSION: Our results showed that increase in hospital specialization had a substantial effect on decrease in hospital cost per case, LOS, and mortality, and on increase in hospital cost per diem among lumbar spine disease surgery patients.
Hospital Charges ; Hospital Costs ; Humans ; Inpatients ; Length of Stay ; Mortality ; National Health Programs ; Spine

OBJECTIVE: A cost comparison of the surgical clipping and endovascular coiling of unruptured intracranial aneurysms (UIAs), and the identification of the principal cost determinants of these treatments. METHODS: This study conducted a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of UIAs between January 2011 and May 2014. The medical records, radiological data, and hospital cost data were all examined. RESULTS: When comparing the total hospital costs for surgical clipping of a single UIA (n=188) and endovascular coiling of a single UIA (n=188), surgical treatment [mean+/-standard deviation (SD) : Won 8,280,000+/-1,490,000] resulted in significantly lower total hospital costs than endovascular treatment (mean+/-SD : Won 11,700,000+/-3,050,000, p<0.001). In a multi regression analysis, the factors significantly associated with the total hospital costs for endovascular treatment were the aneurysm diameter (p<0.001) and patient age (p=0.014). For the endovascular group, a Pearson correlation analysis revealed a strong positive correlation (r=0.77) between the aneurysm diameter and the total hospital costs, while a simple linear regression provided the equation, y (Won)=6,658,630+855,250x (mm), where y represents the total hospital costs and x is the aneurysm diameter. CONCLUSION: In South Korea, the total hospital costs for the surgical clipping of UIAs were found to be lower than those for endovascular coiling when the surgical results were favorable without significant complications. Plus, a strong positive correlation was noted between an increase in the aneurysm diameter and a dramatic increase in the costs of endovascular coiling.
Aneurysm ; Costs and Cost Analysis* ; Endovascular Procedures ; Hospital Costs ; Humans ; Intracranial Aneurysm* ; Korea ; Linear Models ; Medical Records ; Retrospective Studies ; Surgical Instruments

PURPOSE: Under the rising demand of health services, the critical pathway (CP) which standardizes the practice guideline was introduced as a means to provide quality healthcare service. CP may increase the patient's satisfaction rate by providing systematic and consistent service. We aimed to evaluate the significance of CP by development and application of CP to patients undergoing laparoscopic cholecystectomy. METHODS: From June 2010 to July 2011, 148 patients underwent elective laparoscopic cholecystectomy. Patients were divided into two groups, including 57 patients in the CP group and 91 patients in the non-CP group. In a retrospective review, related hospital costs were analyzed and compared for both groups. Survey results on satisfaction for the CP group were also analyzed. RESULTS: The mean age was 22.7 years in the CP group and 37.9 years in the non-CP group. Number of hospitalized days was one day for the CP group and 2.51 days for the Non-CP group with p<0.001. In cost analysis all variables showed a significant reduction in the CP group compared to the Non-CP group. The satisfaction rate in the CP group scored 8 points out of 10. CONCLUSION: Results have shown benefit from the financial point of the view for the CP group. Current inclusion criteria for CP are limited and still in development for a solid protocol. Further efforts with a large-scale comparative study to broaden the indication for CP are desired.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Costs and Cost Analysis ; Critical Pathways* ; Delivery of Health Care ; Health Services ; Hospital Costs ; Humans ; Retrospective Studies

PURPOSE: Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs. METHODS: In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed. RESULTS: The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists > or = 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs. CONCLUSION: Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.
Delivery of Health Care ; Health Care Costs ; Hospital Costs ; Hospital Mortality ; Humans ; Length of Stay ; Mortality ; Multivariate Analysis ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Postoperative Complications* ; Risk Factors

PURPOSE: Consensus for endoscopic retrograde cholangiopancreatography (ERCP) related perforation management is lacking. We aimed to identify candidate patients for conservative management by examining treatment results and to introduce a simple, algorithm-based management guideline. METHODS: A retrospective review of 53 patients with ERCP-related perforation between 2000 and 2010 was conducted. Data on perforation site (duodenum lateral wall or jejunum, type I; para-Vaterian, type II), management method, complication, mortality, hospital stay, and hospital cost were reviewed. Comparative analysis was done according to the injury types and management methods. RESULTS: The outcome was greater in the conservative group than the operative group with shorter hospital stay (20.6 days vs. 29.8 days, P = 0.092), less cost (10.6 thousand United States Dollars [USD] vs. 19.9 thousand USD, P = 0.095), and lower morbidity rate (22.9% vs. 55.6%, P = 0.017). Eighty-one percent (17/21) of type I injuries were operatively managed and 96.9% (31/32) of type II injuries were conservatively managed. Between the types, type II showed better results over type I with shorter hospital stay (19.3 days vs. 30.6 days, P = 0.010), less cost (9.5 thousand USD vs. 20.1 thousand USD, P = 0.028), and lower complication rate (18.8% vs. 57.1%, P = 0.004). There was no difference in mortality. CONCLUSION: Type II injuries were conservatively manageable and demonstrated better outcomes than type I injuries. The management algorithm suggests conservative management in type II injuries without severe peritonitis or unsolved problem requires immediate surgical correction, including operative management in type I injuries unless endoscopic intervention is possible. Conservative management offers socio-medical benefits. Conservative management is recommended in well-selected patients.
Cholangiopancreatography, Endoscopic Retrograde ; Consensus ; Hospital Costs ; Hospital Mortality ; Humans ; Intestinal Perforation ; Jejunum ; Length of Stay ; Peritonitis ; Retrospective Studies ; United States