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Costs estimation is essential and important to resource allocation and prioritizing different interventions in the health system. The purpose of this paper is to estimate the costs of lung cancer in Iran, in 2017.

This was a prevalence-based cost of illness study with a bottom-up approach costing conducted from October 2016 to April 2017. The sample included 645 patients who referred to Imam Reza hospital, Tabriz, Iran, in 2017. Follow-up interviews were every two months. Hospitalization costs extracted from the patient’s record and outpatient costs, nondirect medical costs and indirect costs collected using questionnaire. SPSS software version 22 was used for the data analysis.

Mean direct medical costs, nondirect medical costs and indirect costs amounted to 36,637.02 ± 23,515.13 PPP (2016) (251,313,217.83 Rials), 2,025.25 ± 3,303.72 PPP (2016) (16,613,202.53 Rials) and 48,348.55 ± 34,371.84 PPP (2016) (396,599,494.56 Rials), respectively. There was a significant and negative correlation between direct medical costs, direct nonmedical costs, indirect costs and age at diagnosis, and there was a significant and positive correlation between the length of hospital stay and direct medical cost.

As the cost of lung cancer is substantial and there have been little studies in this area, the objective of this study is to investigate the cost of lung cancer and present ways to tackle this.

Since the mid‐1980s the major players in US health care have argued that costs and benefits should underlie the allocation of health care resources. Looks at 30 cost benefit studies taken from the medical literature and examines five of them in depth, using the “depth hermeneutical” approach advocated by Thompson (1990). Concludes that cost benefit studies are about not only the co‐ordination of interests but also the obscuring and exclusion of other interests.

Public hospitals in China usually rely on revenues from medical services and medications to compensate for major costs given their nonprofit nature. The lack of government subsidies and unreasonable prices of medical services have led to high medical costs and unbalanced reimbursement system for public hospitals. There is a critical need of research on improvement of reimbursement system that will create positive effect on China’s health-care system. This paper aims to focus on four dimensions of stakeholders (government, patients, medical insurance agencies and social organization) and six major expenditures to explore reimbursement scheme for public hospitals in China with the purpose of relieving unbalanced income and expenditure of hospitals, avoiding medication markups and reducing medical expenses from patients.

In this paper, the authors study reimbursement scheme for public hospitals from the perspective of four dimensions of stakeholders and how stakeholders reimburse six major expenditures of hospitals. A total of 128 effective samples were collected from financial data of 32 public hospitals through 2009-2012. This paper analyzes the econometric models of the selected revenue and expenditure. This paper analyzes the econometric models of the selected revenue and expenditure using linear regression. The linear relationship between each cost and different types of incomes (i.e. reimbursements from government, patients, insurance agencies and social organization) is analyzed before and after cancelling the medication markups.

Results from empirical research verify that government reimbursement is insufficient, and using medication markups to compensate for medical service costs has become a serious problem for China’s public hospitals. To avoid the medication markups and improve the reimbursement scheme, government should reimburse labor cost, fixed assets cost and research cost; patients and medical insurance agencies should reimburse the costs of medical service, medication and administration/operations; and social organization should supplement the fixed assets cost.

In this study, the authors defined and classified stakeholders of reimbursement scheme for public hospitals in China, which help understand the roles and effects that different stakeholders can play in compensation. Along with the proposed reimbursement scheme framework, this study will help make effective implementation of new health-care reform program in China.

Hospital costs in the USA are a large part of the national GDP. Medical billing and supplies processes are significant and growing contributors to hospital operations costs in the USA. This article aims to identify cost drivers associated with these processes and to suggest improvements to reduce hospital costs.

A Monte Carlo simulation model that uses @Risk software facilitates cost analysis and captures variability associated with the medical billing process (administrative) and medical supplies process (variable). The model produces estimated savings for implementing new processes.

Significant waste exists across the entire medical supply process that needs to be eliminated. Annual savings, by implementing the improved process, have the potential to save several billion dollars annually in US hospitals. The other analysis in this study is related to hospital billing processes. Increased spending on hospital billing processes is not entirely due to hospital inefficiency.

The study lacks concrete data for accurately measuring cost savings, but there is obviously room for improvement in the two US healthcare processes. This article only looks at two specific costs associated with medical supply and medical billing processes, respectively.

This study facilitates awareness of escalating US hospital expenditures. Cost categories, namely, fixed, variable and administrative, are presented to identify the greatest areas for improvement.

The study will be valuable to US Congress policy makers and US healthcare industry decision makers. Medical billing process, part of a hospital's administrative costs, and hospital supplies management processes are part of variable costs. These are the two major cost drivers of US hospitals' expenditures that were examined and analyzed.

As the rise in expenditures will be even faster when the baby-boom generation soon reaches healthcare-dependent ages, healthcare providers are facing cost management decision of achieving superior performance. Taiwan provides a unique environment that the dialysis service providers face only one medical buyer. The purpose of this paper is to discuss cost factors of dialysis facilities.

This study provides a comprehensive analysis of factors influencing the dialysis costs using the data collected from a large renal clinic chain at Taiwan. The multiple linear regression analysis is employed to examine the factors influencing dialysis costs. The research sample composed of 1,255 patients is collected from 16 dialysis centers in Taiwan.

The results indicate that the treatment costs of dialysis are influenced by managerial factors including capacity utilization rate (CUR), the percentage of shares held by the owners and the geographical location of clinics (LC). The findings assist renal clinics to identify the parts critical to the cost control. Our results indicate that medical variable costs for performing the dialysis treatments are significantly influenced by such managerial factors as CUR, the percentage of owners’ shares holding and LC.

By identifying a comprehensive set of costs drivers for dialysis services, this study provides useful information for both health providers and policy makers. In specific, the result assists these providers to consider the utilization of better mechanisms/instruments to control costs by increasing the operational efficiency and achieving the economies of scale.

This paper contributes to exploring costs drivers that are generally absent from the extant literature. The result suggests that the regulators should be aware that the dialysis providers may reject costly patients. Hence, to establish the appropriate monitoring mechanisms to prevent such incidence is important. Finally, many other countries in addition to Taiwan also have a similar practice as national health insurances or services (e.g. Medicare in the USA or National Health Service in the UK). Those health systems may all face a similar cost control issues for handling end-stage renal disease patients. The analysis can help health systems worldwide to better design the reimbursement rates to account for the differences existed in dealing with the dialysis treatment costs.

The cost of medical monitoring is a relatively new category of compensatory damages in the United States. It emerged in the late 1980s, received increasing attention by the courts through the 1990s, and remains a highly controversial area of economic damages.

The purpose of this paper is to document the total return on investment (ROI) of a comprehensive worksite health program from 1999 to 2007 through two different analytic approaches.

Two analytical techniques were used: time period analysis and historical trend analysis of the entire study period. The time‐period analysis of ROI was performed among employees in four time periods: 1999‐2001; 2002‐2003, 2004‐2005; and 2006‐2007. The historical trend analysis on participation‐related savings was used to compare the financial trend differences between participants and non‐participants as well as the three different participation levels of continuous, sporadic, and non‐participants since the year 2000 among 2,753 employees who worked for and were covered by the company‐sponsored health plans for the entire study period.

The ROI from health care costs and time away from work ranged from 1.29 to 2.07 for the four time periods with a cumulative ROI of 1.66 over nine years. The historical trend analysis of 2,753 long‐term employees resulted in a 1.57 ROI for 2,036 program participants (t‐test: p<0.005) with statistically significant annual saving of $180 per participant per year.

The returns on comprehensive worksite health program were greater than the program investment as documented by both time‐period and historical trend analyses. Organizations seeking ways to manage the increases in health care and absenteeism costs of employees will be encouraged to see that positive returns can be generated by investments in employee health and wellness and steady or consistent participation is one key to generating success.

Gastric cancer is the fourth most common cancer and the leading cause of death after lung cancer in the world. Considering the economic burden of cancers and their impact on household welfare, this study aims to estimate the cost of gastric cancer in Tabriz (Northwest city of Iran) in 2017.

This was an incidence-based cost of illness study which was conducted from the perspective of society with a bottom-up costing approach. The inclusion criteria for the study were all patients (n = 118) with gastric cancer at the period of the first six months after diagnosis that 102 patients participated. Data were analyzed using SPSS software version 22.

The mean medical direct cost was US$3288.02, 18.19 per cent paid by the patient and 81.81 per cent paid by insurance organizations and governmental subsidies. The estimated out of pocket rate was 18.19 per cent. The mean non-medical direct cost estimated at US$377.54. The mean total direct cost was US$3665.56, 26.61 per cent paid by the patient. The mean indirect cost estimated at US$505.41 and the mean total cost was US$4170.97, 35.5 per cent which imposed on the patient. The mean total cost of gastric cancer within the first six months after diagnosis was equivalent to 0.81 GDP per capita.

Based on the findings, gastric cancer is a highly costly disease that despite insurance coverage imposes a high economic burden on the patients and their families.

Annual influenza epidemics cause great losses in both human and financial terms. The purpose of this paper is to propose a model for optimizing a large-scale influenza vaccination program (VP). The goal is to minimize the total cost of the vaccination supply chain while guaranteeing a sufficiently high level of population protection. From a practical point of view, the analysis returns the number of shipments and the quantity of vaccines in each periodic shipment that should be delivered from the manufacturers to the distribution center (DC), from the DC to the clinics, and from the clinics to each sub-group of customers during the vaccination season.

A mixed-integer programming optimization model is developed to describe the problem for a supply chain consisting of vaccine manufacturers, the healthcare organization (HCO) (comprising the DC and clinics), and the population being vaccinated (customers). The model suggests a VP that implemented by a nation-wide HCO.

The benefits of the proposed approach are shown to be particularly salient in cases of limited resources, as the model distributes demand backlogs in an efficient manner, prioritizing high-risk sub-groups of the population over lower-risk sub-groups. In particular, the authors show a reduction in direct medical burden of consumers, such as the need for doctors, hospitalization resources, and reduction of indirect, non-medical burden, such as loss of workdays.

Drawing from the extended enterprise paradigm, and, in particular, taking consumer benefits into account, the authors suggest an operational-strategic model that creates impressive added value in a highly constrained supply chain. The model constitutes a powerful decision tool for the deployment of large-scale seasonal products, and its implementation can yield multiple benefits for various consumer segments.

The model proposed herein constitutes a decision support tool comprising operational-tactical and tactical-strategic perspectives, which logistics managers can utilize to create an enterprise-oriented plan that takes into account medical and non-medical costs.

Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical‐error problem in the last two decades and present a closed‐loop mistake‐proof operation system for surgery processes that would likely eliminate preventable medical errors.

The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause‐and‐effect diagrams as well as devising poka‐yokes in order to develop a robust surgery operation process for a typical US hospital.

In the improve phase of the six sigma DMAIC cycle, a number of poka‐yoke techniques are introduced to prevent typical medical errors (identified through cause‐and‐effect diagrams) that may occur in surgery operation processes in US hospitals. It is the authors' assertion that implementing the new service blueprint along with the poka‐yokes, will likely result in the current medical error rate to significantly improve to the six‐sigma level. Additionally, designing as many redundancies as possible in the delivery of care will help reduce medical errors.

Primary healthcare providers should strongly consider investing in adequate doctor and nurse staffing, and improving their education related to the quality of service delivery to minimize clinical errors. This will lead to an increase in higher fixed costs, especially in the shorter time frame.

This paper focuses additional attention needed to make a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.