No abstract available.
Cost Savings*

BACKGROUND: Studies addressing the appropriateness of laboratory testing have revealed approximately 20% overutilization. We conducted a narrative review to (1) describe current interventions aimed at reducing unnecessary laboratory testing, specifically in hospital settings, and (2) provide estimates of their efficacy in reducing test order volume and improving patient-related clinical outcomes. METHODS: The PubMed, Embase, Scopus, Web of Science, and Canadian Agency for Drugs and Technologies in Health-Health Technology Assessment databases were searched for studies describing the effects of interventions aimed at reducing unnecessary laboratory tests. Data on test order volume and clinical outcomes were extracted by one reviewer, while uncertainties were discussed with two other reviewers. Because of the heterogeneity of interventions and outcomes, no meta-analysis was performed. RESULTS: Eighty-four studies were included. Interventions were categorized into educational, (computerized) provider order entry [(C)POE], audit and feedback, or other interventions. Nearly all studies reported a reduction in test order volume. Only 15 assessed sustainability up to two years. Patient-related clinical outcomes were reported in 45 studies, two of which found negative effects. CONCLUSIONS: Interventions from all categories have the potential to reduce unnecessary laboratory testing, although long-term sustainability is questionable. Owing to the heterogeneity of the interventions studied, it is difficult to conclude which approach was most successful, and for which tests. Most studies had methodological limitations, such as the absence of a control arm. Therefore, well-designed, controlled trials using clearly described interventions and relevant clinical outcomes are needed.
Arm ; Cost Savings ; Hospitals ; Laboratories

BACKGROUND: Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed. METHODS: Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money. RESULTS: The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL. CONCLUSION: Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.
Cost Savings ; Efficiency ; Health Promotion

The purpose of this study is to investigate an efficient use of labor in personnel scheduling for the restaurant industry. More specifically, this study attends to reduce overall labor cost while not sacrificing both full-time and part-time employees' schedules. The customers' demands were measured by sales in this analysis. Historically, server scheduling in the restaurant has been practiced by manager's experience and intuition; however, those practices provided drawbacks because managers often fail to consider external factors such as a employees' working conditions and change in a restaurant's size. The result of a new method in personnel scheduling provided significant cost saving compared to a previous scheduling technique. This study found that a new method in personnel scheduling allowed the restaurant to save labor cost. The outcome of this study should offer important strategic implication for the restaurant managers.
Appointments and Schedules ; Commerce ; Cost Savings ; Intuition ; Restaurants*

Optical diagnosis of polyp histology can potentially result in enormous cost savings by way of the "resect and discard" strategy for diminutive polyps and the "do not resect" strategy for diminutive hyperplastic polyps in the distal colon. Narrow Band Imaging (NBI) highlights the surface mucosal and vascular pattern on polyps and has been shown to accurately characterize adenomatous and hyperplastic polyps by experts. However, the results have been a little discouraging amongst lesser experienced endoscopists. Studies have also shown that using the NBI diagnosis of diminutive polyp histology, experts can accurately define the future surveillance colonoscopy intervals. However nonexperts in academic or community setting have as yet failed to achieve the recommended thresholds. The subjectivity in assessment by endoscopists leads to the variable accuracy rates and can be circumvented by computer based automated tools. Although initial experience with a few computer based algorithms have shown accuracies comparable to experts, further refinement and validation will be required before these can be implemented in clinical practice. Incorporation of optical diagnosis of diminutive polyps into clinical practice is bound to face several hurdles. But the potential for enormous cost saving makes it an attractive strategy that can make colonoscopy more cost effective.
Colon ; Colonoscopy ; Cost Savings ; Narrow Band Imaging ; Polyps

Recent progress in advanced endoscopic imaging and electronic chromoendoscopy allows the real-time endoscopic estimation of the histologic type of polyps, mainly for the differentiation of adenomas from hyperplastic polyps. Accordingly, a "resect-and-discard" strategy applied to diminutive colorectal polyps is now one of the emerging issues among gastroenterologists. The strategy has a practical advantage in terms of the potential cost savings. However, it has a number of limitations in the medical, academic, and legal aspects. The major pitfalls include the endoscopic investigation of colorectal polyps with a wide variety of histogenetic origins, including serrated polyps, and the lack of a standardized method for polyp size measurement. Another issue is the importance of the pathologic diagnosis for legal purposes and medical research. Moreover, it is not certain whether the implementation of the strategy has economic benefit in countries with an undervalued reimbursement system for pathologic examination. There is no doubt that a highly confident optical diagnosis of polyp type is a novel valuable tool. It can provide a more steady symbiosis between gastroenterologists and pathologists to allow a more evident diagnosis and management of patients with colorectal polyps.
Adenoma ; Cost Savings ; Diagnosis ; Humans ; Jurisprudence ; Polyps* ; Symbiosis

The rapid technological progress in the fields of computer and engineering has accelerated the medical society to introduce a new advanced paradigm in handling medical information. This paper describes a fully integrated Computer Aided Diagnosis, Speech Recognition/PACS system running on a single platform. We feel that the combination of Computer Aided Diagnosis, Speech Recognition and PACS in a fully integrated single platform has created a tremendous synergy, with process improvements that maximize the advantage s of three systems. The Computer Aided Diagnosis and the Speech Recognition included marked improvement in experiments turnaround time and cost saving for departments because of decreased transcription costs. Proposed system should help others complete the task of digitalizing a hospital information system and may be adaptable to other systems as well.
Cost Savings ; Diagnosis* ; Hospital Information Systems ; Nonoxynol ; Running ; Societies, Medical

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

On September 26-27, 2015, the 8th European Congress for Integrative Medicine convened the Global Summit on Integrative Medicine and Healthcare in Greater Copenhagen and Helsingør, Denmark at the Culture Yard just across from Kronborg Castle, which is home to William Shakespeare's Hamlet. This article is a summary of the author's presentation about integrative medicine within the Nordic region, driving factors that determine value in healthcare, key tenets of integrative medicine that lead to healthcare cost savings and the potential for a Nordic healthcare renaissance.
Cost Savings ; Delivery of Health Care ; economics ; Homeostasis ; Humans ; Integrative Medicine

In 2000, Korea Health Industry Development Institute(KHIDI) made a plan for sharing electronic patient records between health care institutions which reflects the advance of information technology. The implementation of the plan is believed to have a number of desirable effects such as direct and indirect medical cost savings, the increase in patient satisfaction, the rationalization of health care institution management, and the improvement of health care delivery system. At the same time, however, it requires a great amount of resources for building the system at first and maintaining it since then nationwide. Therefore, the economic evaluation is required for the plan to be undertaken. This paper assessed the plan from economic perspective. In particular, cost-benefit analysis was performed and the result showed that the present value of net benefit, or the social profit is 3,046.3 billion won over the period of 2000-2030. Also, the benefit-cost ratio turned out to be 1.25. The results of cost-benefit analysis confirmed that the benefits of the plan justify the costs.
Cost Savings ; Cost-Benefit Analysis* ; Delivery of Health Care* ; Humans ; Information Dissemination ; Korea ; Patient Satisfaction ; Rationalization