The Cost of Burn Care and Implications for the Future on Quality of Care

1986 ◽  
Vol 26 (3) ◽  
pp. 260-265 ◽  
Author(s):  
ALAN R. DIMICK ◽  
LINDA H. POTTS ◽  
EDGAR D. CHARLES ◽  
JOHN WAYNE ◽  
IDA MARTHA REED
Keyword(s):  
Quality Of Care ◽  
Burn Care ◽  
The Future ◽  
The Cost

Value-based dentistry: Putting the patient first

2016 ◽  
Vol 7 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Sreenivas Koka ◽  
Galya Raz
Keyword(s):  
Risk Management ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Dental Care ◽  
Time Cost ◽  
Safety Risk ◽  
The Cost ◽  
Over Time

What does ‘value’ mean? In the context of dental care, it can be defined as the quality of care received by a patient divided by the cost to the patient of receiving that care. In other words: V =Q/C, where Q equals the quality improvement over time, which most patients view in the context of the outcome, the service provided and safety/risk management, and C equals the financial, biological and time cost to the patient. Here, the need for, and implications of, value-based density for clinicians and patients alike are explored.

scholarly journals The cost-effectiveness of physician assistants/associates: A systematic review of international evidence

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259183
Author(s):  
G. T. W. J. van den Brink ◽  
R. S. Hooker ◽  
A. J. Van Vught ◽  
H. Vermeulen ◽  
M. G. H. Laurant
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Cost Effectiveness ◽  
Physician Assistants ◽  
Labor Cost ◽  
Cost Of Care ◽  
Complementary Role ◽  
Care Outcomes ◽  
The Cost

Background The global utilization of the physician assistant/associate (PA) is growing. Their increasing presence is in response to the rising demands of demographic changes, new developments in healthcare, and physician shortages. While PAs are present on four continents, the evidence of whether their employment contributes to more efficient healthcare has not been assessed in the aggregate. We undertook a systematic review of the literature on PA cost-effectiveness as compared to physicians. Cost-effectiveness was operationalized as quality, accessibility, and the cost of care. Methods and findings Literature to June 2021 was searched across five biomedical databases and filtered for eligibility. Publications that met the inclusion criteria were categorized by date, country, design, and results by three researchers independently. All studies were screened with the Risk of Bias in Non-randomised Studies—of Interventions (ROBIN-I) tool. The literature search produced 4,855 titles, and after applying criteria, 39 studies met inclusion (34 North America, 4 Europe, 1 Africa). Ten studies had a prospective design, and 29 were retrospective. Four studies were assessed as biased in results reporting. While most studies included a small number of PAs, five studies were national in origin and assessed the employment of a few hundred PAs and their care of thousands of patients. In 34 studies, the PA was employed as a substitute for traditional physician services, and in five studies, the PA was employed in a complementary role. The quality of care delivered by a PA was comparable to a physician’s care in 15 studies, and in 18 studies, the quality of care exceeded that of a physician. In total, 29 studies showed that both labor and resource costs were lower when the PA delivered the care than when the physician delivered the care. Conclusions Most of the studies were of good methodological quality, and the results point in the same direction; PAs delivered the same or better care outcomes as physicians with the same or less cost of care. Sometimes this efficiency was due to their reduced labor cost and sometimes because they were more effective as producers of care and activity.

scholarly journals Costs and consequences of using average demand to plan baseline nurse staffing levels: a computer simulation study

2020 ◽  
Vol 30 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Christina Saville ◽  
Thomas Monks ◽  
Peter Griffiths ◽  
Jane Elisabeth Ball
Keyword(s):  
Computer Simulation ◽  
Patient Safety ◽  
Quality Of Care ◽  
Nurse Staffing ◽  
Staffing Levels ◽  
Modelling Studies ◽  
Permanent Staff ◽  
Temporary Staffing ◽  
The Cost

BackgroundPlanning numbers of nursing staff allocated to each hospital ward (the ‘staffing establishment’) is challenging because both demand for and supply of staff vary. Having low numbers of registered nurses working on a shift is associated with worse quality of care and adverse patient outcomes, including higher risk of patient safety incidents. Most nurse staffing tools recommend setting staffing levels at the average needed but modelling studies suggest that this may not lead to optimal levels.ObjectiveUsing computer simulation to estimate the costs and understaffing/overstaffing rates delivered/caused by different approaches to setting staffing establishments.MethodsWe used patient and roster data from 81 inpatient wards in four English hospital Trusts to develop a simulation of nurse staffing. Outcome measures were understaffed/overstaffed patient shifts and the cost per patient-day. We compared staffing establishments based on average demand with higher and lower baseline levels, using an evidence-based tool to assess daily demand and to guide flexible staff redeployments and temporary staffing hires to make up any shortfalls.ResultsWhen baseline staffing was set to meet the average demand, 32% of patient shifts were understaffed by more than 15% after redeployment and hiring from a limited pool of temporary staff. Higher baseline staffing reduced understaffing rates to 21% of patient shifts. Flexible staffing reduced both overstaffing and understaffing but when used with low staffing establishments, the risk of critical understaffing was high, unless temporary staff were unlimited, which was associated with high costs.ConclusionWhile it is common practice to base staffing establishments on average demand, our results suggest that this may lead to more understaffing than setting establishments at higher levels. Flexible staffing, while an important adjunct to the baseline staffing, was most effective at avoiding understaffing when high numbers of permanent staff were employed. Low staffing establishments with flexible staffing saved money because shifts were unfilled rather than due to efficiencies. Thus, employing low numbers of permanent staff (and relying on temporary staff and redeployments) risks quality of care and patient safety.

Future of Visual Arts and Their Social Role

2017 ◽  
pp. 73-87
Keyword(s):  
Visual Arts ◽  
Visual Art ◽  
Social Role ◽  
Art Market ◽  
Future Trends ◽  
Moving Images ◽  
The Future ◽  
The Cost

Here we contemplate the future and look also back to see where we have arrived. Art has responded to the ever-increasing presence of images available to people everywhere by maintaining its authenticity and originality. The proliferation of images in newspapers, magazines, books, posters and postcards has deeply influenced people and increased the number of images around them. Next the television, videos and movies introduced moving images and further accelerated this process. This whole phase has taken roughly two hundred years. More recently, the digitizing and Internet together have further made the spreading of images much easier and the quality of copying and receiving images gets all the time better. Meanwhile, the cost of reproducing images has drastically decreased. After this I will cover the present and future trends in art market and new ways of creating visual art and marketing it. There are some people who early on started to wonder whether authenticity really matters any more. My answer is that it matters more than ever and that art is still going strong.

Commissioning healthcare

2020 ◽  
pp. 424-433
Author(s):  
Richard Richards
Keyword(s):  
Quality Of Care ◽  
Cost Effectiveness ◽  
Full Range ◽  
Minimum Cost ◽  
Social Medicine ◽  
The Cost

This chapter is concerned with the use of contracts and payments as a means of ensuring that care maximizes health at minimum cost. The chapter aims to cover the full range of healthcare commissioning from the simplest form, an individual patient making a private payment to an individual practitioner, through to the most complex, tax-funded, social medicine ‘free at the point of delivery’. In all healthcare commissioning, a common set of concerns arise: The nature of the need, including an assessment of the (cost-) effectiveness of the relevant interventions; Examination of the services available, including inputs, quality of care, and outcomes; The costs and efficiency of the care on offer; The development of formal commissioning agreements.

The Optimal Provision of Services in National Parks

2002 ◽  
Vol 2 (1) ◽  
Author(s):  
Robert W. Turner
Keyword(s):  
Public Good ◽  
National Parks ◽  
National Park ◽  
Pure Public Good ◽  
The Future ◽  
Provision Of Services ◽  
Park Service ◽  
Good Provision ◽  
The Cost

Abstract A national park provides recreational opportunities and also provides a pure public good. This paper presents an intergenerational model in which a club good and a pure public good are provided jointly. The focus is on optimality conditions for services provided by park managers. At the margin, the cost of providing the services should be balanced by the benefits of services. Services can directly enhance visitor enjoyment, both immediately and in the future; they can also affect congestion currently and in the future; they can affect the quality of park resources; and they can affect the pure public good provision. The framework developed in this paper suggests what information should be used by the National Park Service when deciding on the level and kind of services to provide.

scholarly journals Enforcing Quality Metrics over Equipment Utilization Rates as Means to Reduce Centers for Medicare and Medicaid Services Imaging Costs and Improve Quality of Care

2011 ◽  
Vol 1 ◽  
pp. 28 ◽  
Author(s):  
Amit Sura ◽  
Alexander Ho
Keyword(s):  
Quality Of Care ◽  
Quality Metrics ◽  
Utilization Rate ◽  
Improve Quality ◽  
Appropriateness Criteria ◽  
Cost Cutting ◽  
Equipment Utilization ◽  
The Cost ◽  
Fee Schedule

Radiology has been the focus of efforts to reduce inefficiencies while attempting to lower medical costs. The 2010 Medicare Physician Fee Schedule has reduced Centers for Medicare and Medicaid Services’ (CMS) reimbursements related to the technical component of imaging services. By increasing the utilization rate, the cost of equipment spreads over more studies, thus lowering the payments per procedure. Is it beneficial for CMS to focus on equipment utilization as a cost-cutting measure? Can greater financial and quality of care rewards be made by improving metrics like appropriateness criteria and pre-authorization? On examining quality metrics, such as appropriateness criteria and pre-authorization, promising results have ensued. The development and enforcement of appropriateness criteria lowers overutilization of studies without requiring unattainable fixed rates. Pre-authorization educates ordering physicians as to when imaging is indicated.

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