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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

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

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

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

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

Article
Publication date: 21 October 2022

Mohammad Hossein Ronaghi

The fourth industrial revolution and digital transformation have caused paradigm changes in the procedures of goods production and services through disruptive…

Abstract

Purpose

The fourth industrial revolution and digital transformation have caused paradigm changes in the procedures of goods production and services through disruptive technologies, and they have formed new methods for business models. Health and medicine fields have been under the effect of these technology advancements. The concept of smart hospital is formed according to these technological transformations. The aim of this research, other than explanation of smart hospital components, is to present a model for evaluating a hospital readiness for becoming a smart hospital.

Design/methodology/approach

This research is an applied one, and has been carried out in three phases and according to design science research. Based on the previous studies, in the first phase, the components and technologies effecting a smart hospital are recognized. In the second phase, the extracted components are prioritized using type-2 fuzzy analytic hierarchical process based on the opinion of experts; later, the readiness model is designed. In the third phase, the presented model would be tested in a hospital.

Findings

The research results showed that the technologies of internet of things, robotics, artificial intelligence, radio-frequency identification as well as augmented and virtual reality had the most prominence in a smart hospital.

Originality/value

The innovation and originality of the forthcoming research is to explain the concept of smart hospital, to rank its components and to provide a model for evaluating the readiness of smart hospital. Contribution of this research in terms of theory explains the concept of smart hospital and in terms of application presents a model for assessing the readiness of smart hospitals.

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

Keywords

Article
Publication date: 1 July 1966

Ronald Start

THE PATTERN OF LIBRARY PROVISION in hospitals in this country has for over half a century followed the traditional double‐track of one service for medical staff and a…

Abstract

THE PATTERN OF LIBRARY PROVISION in hospitals in this country has for over half a century followed the traditional double‐track of one service for medical staff and a second for patients. Medical libraries range from the great teaching and research collections to the handful of basic works and journals; it is probable that every hospital would claim to have a collection of medical literature: a library. Not all hospitals provide books for patients, possibly three out of four, but many of those that do extend the patients' library service to members of hospital staff.

Details

Library Review, vol. 20 no. 7
Type: Research Article
ISSN: 0024-2535

Article
Publication date: 1 January 1991

Janice L. Dreachslin, Marjorie Zernott, Len Fenwick, Peter Wright and Bernard Canning

Fundamental hospital management reforms, enacted in 1990, focus oncompetition for National Health Service (NHS) contracts between publicand private hospitals and the…

Abstract

Fundamental hospital management reforms, enacted in 1990, focus on competition for National Health Service (NHS) contracts between public and private hospitals and the option of self‐governing trust status for NHS hospitals. The need to challenge the status quo in the NHS is discussed. Initiatives leading to self‐governance are reviewed. The Freeman Hospital′s model for the cultural change which is prerequisite to self‐governance is presented. The Freeman Hospital, Newcastle upon Tyne, a national pilot site selected by the NHS Management Executive to develop new management systems and practices, is among the first self‐governing hospital trusts in the NHS.

Details

Journal of Management in Medicine, vol. 5 no. 1
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 1 February 1998

G.R.M. Scholten and T.E.D. van der Grinten

Analyses the way hospital organisation models handle the relationship between medical specialists and hospital management. All models that have been developed during the…

1758

Abstract

Analyses the way hospital organisation models handle the relationship between medical specialists and hospital management. All models that have been developed during the last ten years seek to integrate the medical specialists in the hospital organisation by formally subordinating them to the hospital management. However, recently a new model has come to the fore ‐ the “co‐makership” ‐ in which the hospital management and the medical specialists are assigned a position alongside each other.

Details

Journal of Management in Medicine, vol. 12 no. 1
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 1 April 1998

Syed Amin Tabish

Hospitals consume the largest share of government health resources, yet, until recently, they have not been a focus of health policy and research in developing countries…

1262

Abstract

Hospitals consume the largest share of government health resources, yet, until recently, they have not been a focus of health policy and research in developing countries, where the resources are in negative proportion to the demands placed on services of health care institutions, and where the possibility of resources being increased in the short run is very remote, the only hope for the increase in the effectiveness of the health care system being the effective management of hospitals. A professional administrator with multidisciplinary training would ensure the optimal use of resources. We live in the age of perfection at all levels. Hence, professional training is the basic requirement for the personnel to function effectively in a hospital. Professional training is required to be imparted by the institutions specialised in professional training. Professional management has an immense scope and a bright future market on account of the increasing demand for specialised and quality health care. Better management or lack of it will determine the future of health service. This paper focuses on development of management and the requirement for professional administrators in India.

Details

Journal of Management in Medicine, vol. 12 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

1 – 10 of over 46000