Search results

1 – 10 of over 43000
To view the access options for this content please click here
Book part
Publication date: 1 January 2006

Nana Bro Folmann, Kristine Skovgaard Bossen, Ingrid Willaing, Jan Sørensen, John Sahl Andersen, Steen Ladelund and Torben Jørgensen

Objective. To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts – number of inpatient admissions, number…

Abstract

Objective. To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts – number of inpatient admissions, number of outpatient visits, and number of emergency department visits – based on anthropometric measurements of waist circumference (WC) and information from The National Patient Registry and The Danish Case-Mix System (DRG).

Participants. The study population consisted of two sub-samples from the Inter99 study at Research Centre for Prevention and Health in 1999–2001. One sub-sample used WC as an indicator for obesity (n=5,151), whereas the other used BMI as an indicator for obesity (n=4,048). Using WC, obesity was defined as WC > 102cm for men and > 88cm for women. Normal weight was defined as circumference < 94cm for men and < 80cm for women. Using BMI, obesity was defined as BMI > 30kg/m2, whereas individuals with BMI=18.5–24.9kg/m2 were defined as normal weight. Individuals with BMI < 18.5kg/m2 were excluded from both sub-samples.

Design. We undertook a 3-year retrospective study of the relationship between obesity and use of hospital resources. Data on hospital contacts and costs were obtained from The National Patient Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts.

Results. This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals. When using WC as an indicator for obesity, mean hospital costs were 33.8% greater among obese women and 45.3% greater among obese men in a 3-year period but the differences were not significant. When using BMI to measure obesity, obese men had significantly greater costs (57.5%) than normal weight men.

Furthermore, obese men and women (indicated byWC) had an increased number of hospital contacts compared with normal weight individuals (rate ratio 1.32, 95% CI 1.21–1.43 for men and 1.20, 95% CI 1.11–1.28 for women) including inpatient admissions, outpatient visits, and emergency department visits. The same trends were seen when obesity was indicated by BMI.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

To view the access options for this content please click here
Book part
Publication date: 25 July 2008

Donde Batten, Gerald Goodman and Susan M. Distefano

Research suggests that improving hospital work environments and solving the nursing shortage are critical to improving patient care. The Houston–Galveston region created…

Abstract

Research suggests that improving hospital work environments and solving the nursing shortage are critical to improving patient care. The Houston–Galveston region created an aggressive approach to this issue by forming an unusual coalition of business, university, and hospital leaders and using a quality improvement approach. Four years later, the project has achieved over 40% participation among hospitals in the 13-county region and includes 50 hospitals employing approximately 15,000 registered nurses. The data that have been collected by this collaborative to date suggests that hospitals are taking action to improve outcomes by modifying their key initiatives to address the attributed causes of poor work environments. From 2004 to 2005, executives of top performing hospitals increasingly attributed successful work environment outcomes to an emphasis on management development and executive-driven initiatives, de-emphasizing specific employee behavior, process, and outcome-based initiatives.

Details

Patient Safety and Health Care Management
Type: Book
ISBN: 978-1-84663-955-5

To view the access options for this content please click here
Book part
Publication date: 6 December 2007

James F. Burgess and Jr.

Research on hospital productivity has progressed over the last few decades considerably from early models where measurements of hospital services simply counted inpatient…

Abstract

Research on hospital productivity has progressed over the last few decades considerably from early models where measurements of hospital services simply counted inpatient days, and perhaps outpatient visits or numbers of surgeries performed. This simplicity represents an extreme of aggregation, focuses the attention of the analysis entirely on the structure of the organization at the highest levels, and provides no insight into the specific services that might be provided to each patient as well as the characteristics of those patients, which might lead to specialization of their care. This process is fundamentally complex, which makes it especially difficult to model. This table-setting chapter will characterize some of the key contextual choices that must be made by researchers in this field which are then applied in subsequent chapters. The key point of this chapter will be to argue that there are very few “one size fits all” decisions in this process and thus the context of particular research objectives and questions will determine how modeling choices are made in practice. Some intuition about how these decisions have substantial implications for outcomes of measurement for hospital productivity will be provided; however, no attempt will be made to conduct a literature review of all the choices that have been made. Instead, we will suggest that new careful attention to the choices made can make future studies more effective in communicating to the communities implementing the research.

Details

Evaluating Hospital Policy and Performance: Contributions from Hospital Policy and Productivity Research
Type: Book
ISBN: 978-0-7623-1453-9

To view the access options for this content please click here
Book part
Publication date: 6 December 2007

Jos L.T. Blank and Vivian G. Valdmanis

It is well recognized that hospitals do not operate in a competitive market typically observed in the economics literature, but rather alternative measures of performance…

Abstract

It is well recognized that hospitals do not operate in a competitive market typically observed in the economics literature, but rather alternative measures of performance must be developed. In other words, health policy analysts, managers, and decision-makers cannot rely on determining efficiency via the typical profit maximizing/cost minimizing firm but develop techniques that address the issues germane to hospital productivity. What has been presented in this book demonstrates the research in both productivity and policy that must attend to this anomaly. In this introductory section, we briefly summarize the theoretical underpinnings of this book.

Details

Evaluating Hospital Policy and Performance: Contributions from Hospital Policy and Productivity Research
Type: Book
ISBN: 978-0-7623-1453-9

To view the access options for this content please click here
Book part
Publication date: 6 December 2007

Jos L.T. Blank and Vivian G. Valdmanis

Hospitals worldwide command the majority of any countries’ health care budget. Reasons for these higher costs include the aging of the population requiring more intensive…

Abstract

Hospitals worldwide command the majority of any countries’ health care budget. Reasons for these higher costs include the aging of the population requiring more intensive health care treatments provided in hospitals, the relatively high costs of labor in this labor intensive industry and payment systems that may encourage inefficient behavior on the part of hospital managers and physicians, that have not been fully mitigated via reforms and regulations.

Details

Evaluating Hospital Policy and Performance: Contributions from Hospital Policy and Productivity Research
Type: Book
ISBN: 978-0-7623-1453-9

Content available
Article
Publication date: 19 November 2021

Lakshya Arora and Feroz Ikbal

Mumbai needs to be transformed into a world-class city as stated in the 2005–2025 development plan of Municipal Corporation. For this initiative, hospital management…

Abstract

Purpose

Mumbai needs to be transformed into a world-class city as stated in the 2005–2025 development plan of Municipal Corporation. For this initiative, hospital management information system (HMIS) has to be implemented across 400+ health facilities in the city.

Design/methodology/approach

A case study methodology was adopted to study HMIS implementation. Wave 1 of Phase 1 implementation of HMIS is carried out as a pilot project at Film City’s Hospital, Mumbai, which “go-live” on 21st June 2018. The work for hardware and software implementation was awarded to HardSystems and Solutions Limited and SoftSolutions India Private Limited, respectively, through e-tender.

Findings

Provision of inadequate quantity of hardware, slowness of network or system, non-satisfactory training after observation confirmation and sign-off process, lack of data entry operators, mismatch in numbering systems in blood bank and many other challenges concerned with the specific departments had become a major impediment in the efforts to maximize number of patients registered into HMIS.

Practical implications

Even after providing many clinical and managerial benefits, being the first cloud-based centrally located HMIS in any of the hospitals in the city, it imposes a major challenge for the management in terms of resistance of employees toward technology and need for the adoption of theoretical models for implementing change for the overall organizational development.

Originality/value

To the best of the authors’ knowledge, no other teaching case study is conducted to study the HMIS implementation in large-scale public health-care services. This is a dummy case study for teaching exercises. The identity of the stakeholders, organizations and events has been masked to maintain confidentiality.

Details

Vilakshan - XIMB Journal of Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0973-1954

Keywords

Content available
Article
Publication date: 11 November 2021

Raja Aishah binti Raja Adnan, Mahazan Abdul Mutalib and Muhammad Ridhwan Ab Aziz

This research paper aims to determine the factors needed to propose a platform where waqf (Islamic endowment) organizations can collaborate with government public hospitals

Abstract

Purpose

This research paper aims to determine the factors needed to propose a platform where waqf (Islamic endowment) organizations can collaborate with government public hospitals to develop corporate waqf hospitals. Consequently, the elements of governance and sustainability are included in the management of corporate waqf hospitals thereby leading to the corporatization of public hospitals.

Design/methodology/approach

This study adopts the qualitative research methodology and undertakes content analysis of data collected from journal articles, magazines and official websites. Data analysis involves open coding with NVivo 12.

Findings

General findings from the literature review have shown that architectural and engineering fundamentals were essential factors in the success of past waqf hospitals of the era between 8th and 14th centuries. In that era, the decentralized waqf-based hospitals employed the mutawalli (the trustee/manager of the waqf assets) to govern the administration of the hospitals. Present corporate waqf hospitals can exploit the elements identified from past waqf-based hospitals and additionally adopt the private-public partnership model in the form of a muḍārabah (profit-sharing contract) agreement to design a sustainable waqf governance model for Malaysian public healthcare services.

Research limitations/implications

The proposed platform is designed for a corporate waqf model developed in collaboration between Malaysian waqf institutions and public healthcare services. It abides by both the Malaysian fatwa (Islamic rulings) on waqf and the laws of the Malaysian Government.

Practical implications

There is potential for developing the Malaysian corporate waqf-governance healthcare model which will enable the hospital to provide better quality healthcare to more patients through upgrading the quality of equipment used in hospitals and/or better facilities at equal or lower costs. Consequently, this will not only improve waqf management and distribution but also result in reduction of government expenditure.

Social implications

This research promotes the concept of a corporate waqf hospital which will provide innumerable beneficial healthcare services in terms of improved healthcare quality at affordable costs to the general public and at no cost to the poor and the underprivileged.

Originality/value

Although waqf has played an important role as a vehicle for Islamic financing in the society for centuries, a model of collaboration or partnership of waqf with public healthcare services has yet to be explored and developed. With proper corporate governance and well-managed sustainability in a corporate waqf model, this newly developed partnership between waqf institutions and public healthcare providers can be a first step in many more interesting collaborative arrangements that can be established between waqf institutions and public services in the future.

Details

ISRA International Journal of Islamic Finance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0128-1976

Keywords

To view the access options for this content please click here
Article
Publication date: 2 November 2021

Firoz Ahmad and Boby John

This study aims to investigate a reliability-level demand-oriented pharmaceutical supply chain design with maximal anticipated demand coverage. Different hospitals with…

Abstract

Purpose

This study aims to investigate a reliability-level demand-oriented pharmaceutical supply chain design with maximal anticipated demand coverage. Different hospitals with the particular reliability value associated with the various pharmaceutical items (PIs) are considered. An inter-connected multi-period supply chain comprising manufacturers, distribution centers, hospitals and patients is assumed for the smooth flow of health-care items, enhancing supply chain reliability. A reliability index for PIs is depicted to highlight product preference and facilitate hospitals’ service levels for patients.

Design/methodology/approach

A mixed-integer multi-objective programming problem that maximizes maximal demand coverage minimizes the total economic costs and pharmaceutical delivery time is depicted under intuitionistic fuzzy uncertainty. Further, a novel interactive neutrosophic programming approach is developed to solve the proposed pharmaceutical supply chain management (PSCM) model. Each objective’s marginal evaluation is elicited by various sorts of membership functions such as linear, exponential and hyperbolic types of membership functions and depicted the truth, indeterminacy and falsity membership degrees under a neutrosophic environment.

Findings

The proposed PSCM model is implemented on a real case study and solved using an interactive neutrosophic programming approach that reveals the proposed methods’ validity and applicability. An ample opportunity to generate the compromise solution is suggested by tuning various parameters. The outcomes are evaluated with practical managerial implications based on the significant findings. Finally, conclusions and future research scope are addressed based on the proposed work.

Research limitations/implications

The propounded study has some limitations that can be addressed in future research. The discussed PSCM model can be merged with and extended by considering environmental factors such as the health-care waste management system, which is not included in this study. Uncertainty among parameters due to randomness can be incorporated and can be tackled with historical data. Besides, proposed interactive neutrosophic programming approach (INPA), various metaheuristic approaches may be applied to solve the proposed PSCM model as a future research scope.

Practical implications

The strategy advised is to provide an opportunity to create supply chains and manufacturing within India by helping existing manufacturers to expand, identifying new manufacturers, hand-holding and facilitating, teams of officers, engineers and scientists deployed and import only if necessary to meet timelines. Thus, any pharmaceutical company or organization can adopt the production and distribution management initiatives amongst hospitals to strengthen and enable the pharmaceutical company while fighting fatal diseases during emergencies. Finally, managers or policy-makers can take advantage of the current study and extract fruitful pieces of information and knowledge regarding the optimal production and distribution strategies while making decisions.

Originality/value

This research work manifests the demand-oriented extension of the integrated PSCM design with maximum expected coverage, where different hospitals with pre-determined reliability values for various PIs are taken into consideration. The practical managerial implications are explored that immensely support the managers or practitioners to adopt the production and distribution policies for the PIs to ensure the sustainability in supply chain design.

To view the access options for this content please click here
Article
Publication date: 26 October 2021

Florian Gebreiter

This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital

Abstract

Purpose

This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital accounting and clinical medicine in Britain between the late 1960s and the early 2000s.

Design/methodology/approach

The paper draws on an analysis of professional journals, government reports and other documentary sources relating to accounting and medical developments. It is informed by Abbott's sociology of professions and Eyal's sociology of expertise.

Findings

The paper shows that not only accountants but also elements within the medical profession sought to make the practice of medicine more visible, calculable and standardized, and that accounting and medical attempts to make medicine calculable interacted in a mutually reinforcing manner. Consequently, it argues that a movement towards clinical forms of quantification within the medical profession made it more open to economic calculation, which underpinned hospital accounting reforms and the accountingization, colonization or hybridization of health services.

Originality/value

The paper demonstrates that a fuller understanding of the relationship between accounting and public sector professions can be developed if we examine their mutual interactions rather than restricting ourselves to analyzing accounting's effects on public sector professions. The paper moreover illustrates instances of intraprofessional conflict and inter-professional cooperation, and draws on the sociology of expertise to suggests that while hospital accounting reforms have curbed the power of medical professionals, they have also enhanced the power of clinical expertise.

Details

Accounting, Auditing & Accountability Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0951-3574

Keywords

To view the access options for this content please click here
Article
Publication date: 3 November 2021

Nicoletta Setola, Eletta Naldi, Maria Vittoria Arnetoli, Luca Marzi and Roberto Bologna

The Covid-19 pandemic has placed health-care systems and their facilities throughout the world under immense pressure. The pandemic has highlighted the crucial role of…

Abstract

Purpose

The Covid-19 pandemic has placed health-care systems and their facilities throughout the world under immense pressure. The pandemic has highlighted the crucial role of health-care facilities design in looking beyond the ongoing crisis and considering how hospitals can better prepare for unexpected future health situations. This study aims to investigate how hospitals reacted to the crisis in terms of their physical spaces, which architectural features permitted the necessary transformations, and how this data can inform hospital design research in the future.

Design/methodology/approach

The research adopted a qualitative and multi-method approach to case studies. Data was collected directly (field survey and interviews) and indirectly (literature, periodicals, specialised websites, webinars, conferences and forums), and a strengths, weaknesses, opportunities, threats analysis supported the data evaluation.

Findings

Hospitals’ responses to the crisis were guided by a host of variables depending on the specific intervention context and risk scenario. Some key issues emerged as particularly meaningful to drive future research in hospital design, namely, architectural typology, layout and spatial proximities, technological systems, the quality of care spaces, the role of public spaces, facility management tools to drive the transformation, territorial health care networks and new technologies.

Originality/value

The paper suggests that the current crisis can be transformed into an opportunity, in terms of research and innovation, to rethink and improve the quality and efficiency of health-care spaces, restoring their crucial role of promoting health by design.

Details

Facilities , vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0263-2772

Keywords

1 – 10 of over 43000