scholarly journals Time-driven activity-based costing for patients with multiple chronic conditions: a mixed-method study to cost care in a multidisciplinary and integrated care delivery centre at a university-affiliated tertiary teaching hospital in Stockholm, Sweden

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e032573
Author(s):  
George Keel ◽  
Rafiq Muhammad ◽  
Carl Savage ◽  
Jonas Spaak ◽  
Ismael Gonzalez ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Mixed Method ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Multiple Chronic Conditions ◽  
Activity Based Costing ◽  
Managerial Accounting ◽  
Process Data ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

ObjectiveThis study can be applied to cost the complex non-standardised processes used to treat patients with multiple chronic conditions.DesignA mixed-method approach to cost analysis, following a modified healthcare-specific version of the seven-step Time-Driven Activity-Based Costing (TDABC) approach.SettingA multidisciplinary integrated and person-centred care delivery centre at a university-affiliated tertiary teaching hospital in Stockholm, Sweden, designed to improve care coordination for patients with multiple chronic conditions, specifically diabetes, cardiovascular disease and kidney disease.Participants314 patients (248 men and 66 women) fit inclusion criteria. Average age was 80 years.ResultsThis modified TDABC analysis costed outpatient care for patients with multiple chronic conditions. The approach accounted for the difficulty of conceptualising care cycles. The estimated total cost, stratified by resources, can be reviewed together with existing managerial accounting statements to inform management decisions regarding the multidisciplinary centre.ConclusionsThis article demonstrates that the healthcare-specific seven-step approach to TDABC can be applied to cost care for patients with multiple chronic conditions, where pathways are not yet discernable. It became clear that there was a need for slight methodological adaptations for this particular patient group to make it possible to cost these pathways, stratified by activity and resource. The value of this approach can be discerned from the way management incorporated the results of this analysis into the development of their hospital strategy. In the absence of integrated data infrastructures that can link patients and resources across financial, clinical and process data sets, the scalability of this method will be difficult.

Factors Impacting CTCA Quality in a Major Tertiary Teaching Hospital

2021 ◽  
Vol 30 ◽  
pp. S189
Author(s):  
I. Button ◽  
J. Bradley ◽  
R. Roberts-Thomson ◽  
B. Lorraine
Keyword(s):  
Teaching Hospital ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

scholarly journals Overdose Rate of Drugs Requiring Renal Dose Adjustment: Data Analysis of 4 Years Prescriptions at a Tertiary Teaching Hospital

2008 ◽  
Vol 23 (4) ◽  
pp. 423-428 ◽  
Author(s):  
Seung Soo Sheen ◽  
Ji Eun Choi ◽  
Rae Woong Park ◽  
Eun Yub Kim ◽  
Young Ho Lee ◽  
...  
Keyword(s):  
Data Analysis ◽  
Teaching Hospital ◽  
Dose Adjustment ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

scholarly journals A rapid clinic-based service for an emergency department of a tertiary teaching hospital during a dengue outbreak

Medicine ◽  
2021 ◽  
Vol 100 (14) ◽  
pp. e25311
Author(s):  
Hsin-I. Shih ◽  
Yi-Ting Huang ◽  
Chih-Chia Hsieh ◽  
Tzu-Ching Sung
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Dengue Outbreak ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

scholarly journals Morbidity Profile and Causes of Mortality in Type 2 Diabetes Patients: Data from a Tertiary Teaching Hospital from Eastern India

2017 ◽  
Vol 07 (03) ◽  
pp. 195-211
Author(s):  
Soumya Ranjan Behera ◽  
Manoranjan Behera ◽  
Sidhartha Das ◽  
Bhabani Prasad Panda ◽  
Saroj Kumar Tripathy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Teaching Hospital ◽  
Eastern India ◽  
Tertiary Teaching ◽  
Causes Of Mortality ◽  
Tertiary Teaching Hospital ◽  
Diabetes Patients

scholarly journals Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria

2021 ◽  
Vol 5 ◽  
pp. 239920262110627
Author(s):  
Roland Nnaemeka Okoro ◽  
Kasim Abdullahi ◽  
Dauda Ayuba Dayar
Keyword(s):  
Proton Pump Inhibitor ◽  
Teaching Hospital ◽  
Proton Pump ◽  
Epigastric Pain ◽  
Factors Associated ◽  
Stewardship Program ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Study Hospital ◽  
Inappropriate Prescriptions

Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients’ Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients’ medical records. Chi-square or Fisher’s exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.

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