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This research aims to explore the fine-grained relationships between nurse staffing and hospital operational performance with respect to care quality and operating costs. The authors also investigate the moderation effect of competition in local hospital markets on these relationships.

A six-year panel data is assembled from five separate sources to obtain information of 2,524 USA hospitals. Fixed-effect (FE) models are used to test the proposed hypotheses.

First, nurse staffing is initially associated with improved care quality until nurse staffing reaches a turning point, beyond which nurse staffing is associated with worse care quality. Second, a similar pattern applies to the relationship between nurse staffing and operating costs, although the turning point is at a much lower nurse staffing level. Third, market competition moderates the relationship between nurse staffing and care quality so that the turning point of nurse staffing will be higher when the degree of competition is higher. This shift of turning point is also observed in the relationship between nurse staffing and operating costs.

The study identifies three ranges of nurse staffing in which hospitals will likely experience simultaneous improvements, a tradeoff or simultaneous decline of care quality and operating costs when investing in more nursing capacity. Hospitals should adjust nurse staffing levels to the right directions to achieve better care or reduce operating costs.

Nurses constitute the largest provider group in hospitals and profoundly impact care quality and operating costs among all health care professionals. Optimizing the level of nurse staffing, therefore, can significantly impact the care quality and operating costs of hospitals.

Benchmarking is a tool for analysing a property or portfolio performance against its peers. This paper outlines some of the central components of benchmarking and demonstrates how benchmarking can bring perspective to operating expenses and ultimately positively affect the valuation of a property. Careful benchmarking of operating expenses can reveal much about the value of investment properties and help to identify opportunities to create value or enhance the value of an asset. Examples illustrate how the value of a given asset can vary dramatically, with even small percentage changes in operating expenses. Such information, in turn, provides the basis for facility and asset management decisions, ranging from estimating budgets to planning capital expenditures for upgrades or improvements. Benchmarking can also enable detailed comparative analysis, which in turn, can assist in identifying areas for improving operations and management by trimming costs or adjusting service levels.

Examines the way in which managers perceive the relative importance of the three costs as applied to professional service firms, financial services firms and retail distribution and manufacturing. Managers′ perceptions may be determined by the nature of the business, the operational focus and the opportunities for the control of costs. Examines the existing literature for indications of the importance attached to each of these costs. Concludes that managers have more discretion of the control of operating costs where they represent a high proportion of the three types and where supply and overhead costs form a high proportion of total costs, managers can exercise discretion by challenging existing industry recipes through restructuring their operations.

Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.

Preface The functions of business divide into several areas and the general focus of this book is on one of the most important although least understood of these—DISTRIBUTION. The particular focus is on reviewing current practice in distribution costing and on attempting to push the frontiers back a little by suggesting some new approaches to overcome previously defined shortcomings.

The purpose of this paper is to apply a numerical simulation of stochastic processes to the problem of real estate investment appraisal.

These uncertain operating costs are integrated into an enhanced dynamic simulation. To model the dynamics in the uncertainty of the cost schedule, a range of different types of stochastic processes is used. The operating costs are classified by cost drivers and an appropriate stochastic process is determined for each of the derived cost clusters. To optimise the capital structure in this application, heuristic optimisation with genetic algorithms is used.

The application of the model to real world investment situations shows that linear and deterministic modelling underestimates the risk‐generating effect of uncertain operating expenses, which often can lead to inefficient investment decisions.

In a further application of the model, the authors demonstrate the effect of uncertain operating costs on the optimal capital structure of real estate investments.

In contrast to models in the literature that are usually focussed on the income side, here the focus is on the uncertain dynamics of real estate operating costs as a key factor affecting return.

The purpose of this paper is the introduction of a best practice tool in order to analyze operating costs in the health care sector. This study presents the findings by using a new innovative benchmarking tool to analyze operating costs, identify cost drivers and highlight the potential savings.

The paper focuses on a survey of operating and maintenance costs from 18 residential homes in Tyrol, Austria. In order to determine the volume and to prioritize the cost drivers, CAREB (Computer‐aided Real Estate Benchmarking) software was used, which was developed by the Institute of Real Estate Benchmarking at the University of Applied Sciences KufsteinTirol, Austria. Statistic analysis was conducted to investigate savings potential, determine the best case of the sample and submit recommendations to the decision‐makers.

Compared to conventional benchmarking methods, this model allows a holistic view on the key factors of cost drivers and reveals the savings potential for each dimension. The key figure which reveals the largest potential gives an indication of whether a residential home has general problems with efficiency (high costs per bed), with occupancy (costs per resident) or with the space efficiency (costs per average space consumption). Furthermore, the study reveals the immense savings potential in the costs of various services.

The paper identifies the volume and structure of the cost drivers of operating costs of buildings in the health care sector by using a new innovative benchmarking tool. This survey is based on the operating costs. Other running costs such as costs for health care personnel as well as quality indicators are not considered in this survey.

The results should help to establish cost benchmarking increasingly and develop it as a strategic planning tool in order to support management in the health care sector in the decision‐making process.

The paper presents a new measuring method which allows a holistic view of the influencing cost factors to investigate weak points in cost efficiency for the health care sector.

The purpose of this paper is to develop a practical economic replacement decision model to identify the economic lifetime of the ventilation system used by Trafikverket in its Stockholm tunnels.

The proposed data-driven optimisation model considers operating and maintenance costs, purchase price and system resale value for a ventilation system consisting of 121 fans. The study identified data quality problems in Trafikverket’s MAXIMO database.

It is found that the absolute economic replacement time (ERT) of the ventilation system is 108 months but for a range of 100–120 months, the total cost remains almost constant. Sensitivity and regression analysis showed that the operating cost has the largest impact on the ERT.

The results are promising; the company has the possibility of significantly reducing the LCC of the ventilation system by optimising its lifetime. In addition, the proposed model can be used for other systems with repairable components, making it applicable, useful and implementable within Trafikverket more generally.

The goal of this study is to perform an economic comparison of alternative service concepts designed to improve the productivity of nursing care in a refurbishment project of selected sheltered housing facility.

Four different service development options were identified for the dining and kitchen facilities: the dining facilities were either decentralised or centralised, and the meals were prepared on site or brought in from outside.

The form of dining model chosen affected the operating costs more than the spatial costs. The biggest differences in operating costs were attributable to the meal price and to the costs of transferring disabled residents to the dining area. The study showed that the option which had the lowest spatial costs surprisingly had the highest total costs. This was the option in which the meals were conveyed to the decentralised dining rooms located on the different floors by the food supplier. The total costs of this option were 50 per cent higher than the total costs of the decentralised option with on‐site cooking facilities. The centralised dining option with externalised food service had considerably lower renovation costs but 15 per cent higher total costs than the lowest cost option (decentralised dining option with own kitchen).

The paper provides a practical model for taking into account not only remodelling costs but also operating costs in total cost calculations of the remodelling process.

While it is true that library building construction and operating costs can be budgeted and controlled independently, they are very interdependent. When initial construction decisions are made without considering that interdependence, they can affect the operating costs of the library every year the facility is in use. Still, for many library managers, state‐of‐the‐art estimation and attribution of costs in library construction is a moving target: pursued but rarely captured. Following a few rules of thumb based on the concept of a building's life cycle can help you determine how construction and operating costs interrelate and impact on the library's financial future.