scholarly journals Detailed cost of robotic-assisted surgery in the Australian public health sector: from implementation to a multi-specialty caseload

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

scholarly journals Detailed Cost of Robotic-assisted Surgery in the Australian Public Health Sector: From Implementation to a Multi-specialty Caseload

2020 ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background: A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods: A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs.Results: Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (IQR: $15,445 to $32,199). The RAS specific costs were $8,828 (46%) made up of fixed costs including $4,691 (24%) implementation and $2,290 (12%) maintenance, both of which are volume dependent; and $1,848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions: There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

scholarly journals Knowledge and attitudes of theatre staff prior to the implementation of robotic-assisted surgery in the public sector

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213840 ◽  
Author(s):  
Kate E. McBride ◽  
Daniel Steffens ◽  
Kylie Duncan ◽  
Paul G. Bannon ◽  
Michael J. Solomon
Keyword(s):  
Public Sector ◽  
Robotic Assisted ◽  
The Public ◽  
Knowledge And Attitudes ◽  
Robotic Assisted Surgery ◽  
Theatre Staff

Evolving experience of operating theatre staff with the implementation of robotic-assisted surgery in the public sector

2020 ◽  
Author(s):  
Daniel Steffens ◽  
Kate E. McBride ◽  
Rachael Roberts ◽  
Paul G. Bannon ◽  
Michael J. Solomon
Keyword(s):  
Public Sector ◽  
Operating Theatre ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Theatre Staff

Exodus of Clinicians from Public Sector to Non-Clinical Practice in Private Sector in Dar es Salaam Tanzania; Exploring the Drivers

2020 ◽  
Vol 31 (2) ◽  
pp. 45-58
Author(s):  
Elice Temu ◽  
Gasto Frumence ◽  
Nathanael Sirili
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Public Sector ◽  
Private Sector ◽  
Work Environment ◽  
Health Workforce ◽  
Health Sector ◽  
Dar Es Salaam ◽  
Medical Doctors ◽  
The Public

Background: Globally, shortage of clinicians health workforce is among the major challenges facing the health systems of many countries including Tanzania. Migration of medical doctors from clinical practice to non-clinical practice partly contributes to this challenge. This study aimed to explore factors influencing Medical Doctors’ decision to migrate from clinical practice in the public sector to non-clinical practice in the private sector in Dar es Salaam Tanzania.Methods: An exploratory qualitative study was conducted using 12 in-depth interviews with medical doctors working in the private sector but formerly worked in the public health sector. Interviews were digitally recorded, transcribed verbatim and thematically analyzed.Results: Three main themes emerged; health system-level drivers that has three sub-themes, namely poor work environment, heavy workload due to shortage of clinicians and underfunded public health sector; individual-level drivers, which include four sub-themes: Age, area of specialization, marital status and empathy to patients; and external environment drivers consisting of two sub-themes: peer pressure and community culture.Conclusion: Improving the work environment through increased funding will partly address the main health system drivers underlying migration from the clinical practice. Furthermore, nurturing junior doctors to be enthusiastic and adapting to cultural shocks can partly help to address the individual and external drivers. Keywords: Shortage, Medical Doctors, Clinicians, Physicians, migration, health workforce, Tanzania Clinical Practice, Non-Clinical Practice.

The Role of Management Accounting Systems in Public Hospitals and the Construction of Budgets

2016 ◽  
pp. 366-389
Author(s):  
Carla Marina Pereira de Campos ◽  
Lúcia Lima Rodrigues ◽  
Susana Margarida Faustino Jorge
Keyword(s):  
Management Accounting ◽  
Health Sector ◽  
Public Hospitals ◽  
Public Funds ◽  
Accounting Systems ◽  
The Public ◽  
Management Accounting Systems ◽  
Alternative Approaches ◽  
Traditional Approaches

The role of management accounting systems (MAS) in the construction of budgets in the public health sector has been one of the least studied topics in the international literature. Furthermore, several studies have confirmed the loss of relevance of traditional approaches to budgeting due to the need to implement techniques that are more performance-oriented. Since public hospitals are organisations that depend significantly on public funds, with substantial impacts on governments' budgets, the pressure for reducing expenditures is strong, causing increased difficulties in hospital management. In order to analyse the role of MAS in the preparation of hospital budgets, this chapter presents a literature review on this topic. This review allows to understand the loss of relevance of traditional budgeting techniques and to present alternative approaches. In this process, the implementation of different kinds of budgeting is heavily influenced by governments and professionals. Nevertheless, the research on this topic is still very scarce, evidencing the need to continue studying it.

scholarly journals Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

2006 ◽  
Vol 40 (2) ◽  
pp. 304-309 ◽  
Author(s):  
Raquel Jales Leitão ◽  
Marcos Bosi Ferraz ◽  
Ana Cristina Chaves ◽  
Jair J Mari
Keyword(s):  
Public Sector ◽  
Outpatient Care ◽  
Direct Costs ◽  
Sao Paulo ◽  
The State ◽  
Public Hospitals ◽  
Total Direct Cost ◽  
São Paulo ◽  
Regular Treatment ◽  
The Public

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

PPPs and the Changing Public Sector Ethos: Case-Study Evidence from the Health and Local Authority Sectors

2003 ◽  
Vol 17 (3) ◽  
pp. 481-501 ◽  
Author(s):  
Gail Hebson ◽  
Damian Grimshaw ◽  
Mick Marchington
Keyword(s):  
Public Sector ◽  
Public Services ◽  
Health Sector ◽  
Traditional Values ◽  
Term Survival ◽  
Private Finance Initiative ◽  
The Public ◽  
Government Sector ◽  
Work Intensification ◽  
Contractual Approach

This article explores the extent to which a new contractual approach to delivering public services, through public private partnerships (PPPs), is transforming the traditional values underpinning the public sector ethos among both managers and workers. Drawing on two detailed case studies of PPPs - a Private Finance Initiative in the health sector and the outsourcing of housing benefit claims in the local government sector - we identify a range of new pressures impacting on five key elements of a traditional notion of the public sector ethos. Our findings demonstrate that the contractual relations of PPPs have led to a clear weakening of traditional notions of managerial accountability and bureaucratic behaviour, reflecting both a shift to new lines of accountability (private sector shareholders) and a vicious circle of monitoring and distrust between partner organizations, in place of the old faith in bureaucratic process. Among workers, certain traditional values - especially a concern for working in the public interest - continue to inform the way they identify with, and understand, their work in delivering public services. However, the cost cutting and work intensification associated with PPPs present a significant threat to these values.The article identifies examples of short-term resilience of the traditional public sector ethos, as well as developments that threaten its long-term survival.

scholarly journals Reasons for Ethical Problems in the Health Sector

2012 ◽  
Author(s):  
Filiz Tepecik ◽  
Ayla Yazıcı
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Health Sector ◽  
Efficient Production ◽  
Health Care Market ◽  
Unequal Distribution ◽  
Ethical Problems ◽  
The Public ◽  
Private Entrepreneurs ◽  
Effective Use

There are two main reasons of public interventions in the health market. First, the health care market cannot make efficient production on market conditions because of its attributes such as the unequal distribution of knowledge, being a public good, the presence of positive and negative externalities. Second, the public authority has also the aim to achieve justice. These qualities are also the source of ethical problems in the health sector, whether the service is generated, by the public or the private sector. Almost in all countries the health sector is usually provided by the public sector because of externalities. But because the side effects of the production of health services by the public sector emerged in recent years, the participation of the private sector was ensured to minimize these effects. For developing countries such as Turkey and Eurasian countries, a more effective use of the funds used for the health sector is recommended, and the space these expenditures cover in the budget are said can be scaled down with the opening of some areas for private entrepreneurs. However, the unique characteristics of the health sector seem to cause problems regardless whether it is produced by the public or the private sector. In this study it is attempted to give the attributes of the health sector in detail and to establish a relationship with ethical problems in the light of experiences in Turkey.

scholarly journals A structural equation modeling of supply chain strategies for artemisinin-based combination therapies in Uganda

2021 ◽  
Vol 5 ◽  
pp. 239920262110647
Author(s):  
Oluka Pross Nagitta ◽  
Marcia Mkansi ◽  
Sylvia Desire Nyesiga ◽  
George William Kajjumba
Keyword(s):  
Supply Chain ◽  
Structural Equation Modeling ◽  
Public Sector ◽  
Structural Equation ◽  
Public Hospitals ◽  
Equation Modeling ◽  
Top Management ◽  
Sample Population ◽  
Combination Therapies ◽  
The Public

Introduction: Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals. Aim: This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda. Methodology: The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables. Results: From the SEM analysis, all the hypotheses were significant at p < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs. Conclusion: Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals’ core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.

Sign in / Sign up

Export Citation Format

Share Document