Do prices vary with purchase volumes in healthcare contracts?

2017 ◽  
Vol 3 (4) ◽  
pp. 185-214
Author(s):  
Robert B Handfield ◽  
Jaikishen Venkitaraman ◽  
Shweta Murthy
Keyword(s):  
Economies Of Scale ◽  
Cost Savings ◽  
Price Variation ◽  
Medical Products ◽  
Explanatory Factors ◽  
Number Of Factors ◽  
Dependent Variables ◽  
Common Strategy ◽  
Low Levels ◽  
The Cost

Hospitals are facing severe increases in the cost of clinical supplies, and a common strategy is to drive economies of scale achieved by hospital consolidation. The supply strategy of “volume leveraging” involves sourcing through contracts with Group Purchasing Organizations (GPOs) for commercial distributors and manufacturers of medical products. This study seeks to document the empirical benefits associated with volume leveraging, through analysis of purchasing data from three large hospitals. The dependent variables include a number of factors that are used to justify volume leveraging approaches, yet the study finds no significant explanatory factors that determine price variation related to the volume purchased. Interviews with physicians and clinicians suggest that poor data quality leads to lack of transparency, and an inability to aggregate volumes across inventory SKUs may be preventing volume-based cost savings from materializing. The results also suggest that lack of transparency results in low levels of utilization, which increases costs.

Student Laptop Ownership Requirement and Centralization of Information Technology Services at a Large Public University

2011 ◽  
pp. 201-212 ◽  
Author(s):  
Gregory B. Newby
Keyword(s):  
Information Technology ◽  
Economies Of Scale ◽  
Cost Savings ◽  
Leading Edge ◽  
Chief Information Officer ◽  
Public University ◽  
General Purpose ◽  
Information Technology Services ◽  
Technology Services ◽  
The Cost

A large, highly ranked public university implemented a requirement for all incoming undergraduates to own a laptop computer starting in fall, 2000. To control increased expenditures for information technology, this requirement has shifted some of the cost of technology to students by decreasing the need for centralized general-purpose computing laboratories. At the same time, a shift towards centralized academic computing support occurred. This shift was away from information technology resources, services and support based in individual departments. This shift, engineered by the newly formed office of the Chief Information Officer (CIO), was envisioned to generate cost savings through economies of scale. The educational impact of the laptop requirement is starting to be felt, but adoption is not widespread in daily classroom use. Envisioned cost savings have not yet become apparent. However, laptop ownership has enabled some new classroom activities and helped to reinforce the leading-edge image of the university.

Student Laptop Ownership Requirement and Centralization of Information Technology Services at a Large Public University

2006 ◽  
pp. 163-175
Author(s):  
Gregory B. Newby
Keyword(s):  
Information Technology ◽  
Economies Of Scale ◽  
Cost Savings ◽  
Leading Edge ◽  
Chief Information Officer ◽  
Public University ◽  
General Purpose ◽  
Information Technology Services ◽  
Technology Services ◽  
The Cost

A large, highly ranked public university implemented a requirement for all incoming undergraduates to own a laptop computer starting in fall, 2000. To control increased expenditures for information technology, this requirement has shifted some of the cost of technology to students by decreasing the need for centralized general-purpose computing laboratories. At the same time, a shift towards centralized academic computing support occurred. This shift was away from information technology resources, services and support based in individual departments. This shift, engineered by the newly formed office of the Chief Information Officer (CIO), was envisioned to generate cost savings through economies of scale. The educational impact of the laptop requirement is starting to be felt, but adoption is not widespread in daily classroom use. Envisioned cost savings have not yet become apparent. However, laptop ownership has enabled some new classroom activities and helped to reinforce the leading-edge image of the university.

scholarly journals Productivity growth, economies of scale and scope in the water and sewerage industry: The Chilean case

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251874
Author(s):  
Maria Molinos-Senante ◽  
Alexandros Maziotis
Keyword(s):  
Productivity Growth ◽  
Technical Change ◽  
Economies Of Scale ◽  
New Technologies ◽  
Cost Savings ◽  
Policy Implications ◽  
Scale Efficiency ◽  
Water And Sewerage Industry ◽  
The Cost ◽  
Quadratic Cost Function

Evaluating the performance and analyzing the cost drivers of water utilities is of great interest for water regulators and water sector managers. This study uses a quadratic cost function to investigate the existence of economies of scale and scope in the Chilean water and sewerage industry over the period 2010–2017. We also estimate and decompose productivity growth into technical change and scale efficiency change. Technical change is further broken into pure, non-neutral and scale-augmenting technical change. The results indicate that cost savings can be achieved by increases in the scale of production and the separation of water and sewerage services. Productivity progressed favorably throughout the whole period at an annual rate of 8.4%, which was attributed to the scale effect, the adoption of new technologies and a good allocation of resources. Some policy implications are finally discussed based on our findings.

Application of a New Nonlinear Programming Code with Decomposition to the Regional Wastewater-Collection and Treatment-Location Problem

1976 ◽  
Vol 8 (5) ◽  
pp. 563-571
Author(s):  
L R Padgett ◽  
A H Montgomery ◽  
L Romino
Keyword(s):  
Nonlinear Programming ◽  
Economies Of Scale ◽  
Location Problem ◽  
Sewage Treatment ◽  
Optimal Solution ◽  
Cost Savings ◽  
Regional Model ◽  
Programming Algorithm ◽  
Trade Offs ◽  
The Cost

A new, highly reliable nonlinear programming algorithm is coupled with decomposition to find the optimal solution to a regional sewage-treatment system for an area in Monongalia County surrounding Morgantown, West Virginia. A regional model with trade-offs between the cost of transporting wastewater to centrally located plants for treatment and the economies of scale accruing to large centralized treatment plants is developed. Possible cost savings of an optimal system are demonstrated.

The IBM-PC in electron microscopy

1996 ◽  
Vol 54 ◽  
pp. 612-613
Author(s):  
James F. Mancuso
Keyword(s):  
Head Start ◽  
Image Acquisition ◽  
Cost Effective ◽  
Financial Applications ◽  
Number Of Factors ◽  
Instrument Control ◽  
The Cost ◽  
Training And Support ◽  
Control Image ◽  
Ibm Pc

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.

Exploration-Stage Implementation Variation

2014 ◽  
Vol 222 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Stephanie Romney ◽  
Nathaniel Israel ◽  
Danijela Zlatevski
Keyword(s):  
Parent Training ◽  
Average Cost ◽  
Cost Savings ◽  
Training Group ◽  
Group Differences ◽  
Triple P ◽  
Community Based ◽  
Parent Training Program ◽  
A Site ◽  
The Cost

The present study examines the effect of agency-level implementation variation on the cost-effectiveness of an evidence-based parent training program (Positive Parenting Program: “Triple P”). Staff from six community-based agencies participated in a five-day training to prepare them to deliver a 12-week Triple P parent training group to caregivers. Prior to the training, administrators and staff from four of the agencies completed a site readiness process intended to prepare them for the implementation demands of successfully delivering the group, while the other two agencies did not complete the process. Following the delivery of each agency’s first Triple P group, the graduation rate and average cost per class graduate were calculated. The average cost-per-graduate was over seven times higher for the two agencies that had not completed the readiness process than for the four completing agencies ($7,811 vs. $1,052). The contrast in costs was due to high participant attrition in the Triple P groups delivered by the two agencies that did not complete the readiness process. The odds of Triple P participants graduating were 12.2 times greater for those in groups run by sites that had completed the readiness process. This differential attrition was not accounted for by between-group differences in participant characteristics at pretest. While the natural design of this study limits the ability to empirically test all alternative explanations, these findings indicate a striking cost savings for sites completing the readiness process and support the thoughtful application of readiness procedures in the early stages of an implementation initiative.

REKAYASA NILAI HARGA PEMBUATAN TERHADAP EFEKTIFITAS PENGGUNAAN BAHAN PADA PEMBANGUNAN PERUMAHAN TIRTO PENATARAN ASRI TIPE 70/135 KECAMATAN NGLEGOK KABUPATEN BLITAR

2017 ◽  
Vol 7 (1) ◽  
pp. 43-52
Author(s):  
Mochamad Tamim Ma’ruf
Keyword(s):  
Engineering Application ◽  
Cost Savings ◽  
Comparison Method ◽  
Value Engineering ◽  
Design Work ◽  
Housing Projects ◽  
Initial Design ◽  
A Value ◽  
The Cost ◽  
Design Proposal

One-solving methods and techniques necessary to avoid inefficiencies and not economic costs as well as reduce the cost of housing construction is the method of Value Engineering. Value engineering is a method and cost control techniques to analyze a function to its value at the lowest cost alternative (most economical) without reducing the quality desired.At the writing of this study used a comparison method by comparing the initial design to the design proposal of the author. In the housing projects Upgrading Tirto Penataran Asri type 70, the application of Value Engineering conducted on the job a couple walls and roofs pair by replacing some work items with a more economical alternative but does not change the original function and high aesthetic level and still qualify safe. For that performed the step of determining a work item, the alternative stage, the analysis stage, and the stage of recommendations to get a Value Engineering application and cost savings against the wall a couple of work items and partner roof.The proposed design as compared to the initial design. Work items discussed was the work of a couple wall having analyzed obtained savings of Rp. 2,747,643.56 and the work of the roof pair obtained savings of Rp. 2,363,446.80. Thus the total overall savings gained is Rp 5,111,090.36 or savings of 0048%.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia

2021 ◽  
pp. 1357633X2098277
Author(s):  
Molly Jacobs ◽  
Patrick M Briley ◽  
Heather Harris Wright ◽  
Charles Ellis
Keyword(s):  
Cost Effectiveness ◽  
Economies Of Scale ◽  
Reference Group ◽  
Unit Cost ◽  
Community Based ◽  
Face To Face ◽  
Conduction Aphasia ◽  
Aphasia Treatment ◽  
The Cost ◽  
The Relationship

Introduction Few studies have reported information related to the cost-effectiveness of traditional face-to-face treatments for aphasia. The emergence and demand for telepractice approaches to aphasia treatment has resulted in an urgent need to understand the costs and cost-benefits of this approach. Methods Eighteen stroke survivors with aphasia completed community-based aphasia telerehabilitation treatment, utilizing the Language-Oriented Treatment (LOT) delivered via Webex videoconferencing program. Marginal benefits to treatment were calculated as the change in Western Aphasia Battery-Revised (WAB-R) score pre- and post-treatment and marginal cost of treatment was calculated as the relationship between change in WAB-R aphasia quotient (AQ) and the average cost per treatment. Controlling for demographic variables, Bayesian estimation evaluated the primary contributors to WAB-R change and assessed cost-effectiveness of treatment by aphasia type. Results Thirteen out of 18 participants experienced significant improvement in WAB-R AQ following telerehabilitation delivered therapy. Compared to anomic aphasia (reference group), those with conduction aphasia had relatively similar levels of improvement whereas those with Broca’s aphasia had smaller improvement. Those with global aphasia had the largest improvement. Each one-point of improvement cost between US$89 and US$864 for those who improved (mean = US$200) depending on aphasia type/severity. Discussion Individuals with severe aphasia may have the greatest gains per unit cost from treatment. Both improvement magnitude and the cost per unit of improvement were driven by aphasia type, severity and race. Economies of scale to aphasia treatment–cost may be minimized by treating a variety of types of aphasia at various levels of severity.

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