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PubMed2003

Economic impact of healthcare-associated rotavirus infection in a paediatric hospital.

The aim of this prospective study was to determine the extra-length of stay and the average cost for rotavirus healthcare-associated infection (HAI). Children admitted to the paediatric ward of the Reims University Hospital between the 1 December 2001 and 31 March 2002, were included in a pairwise matched (1:1) case-control study. Cases were defined as patients with rotavirus HAI. Controls were selected according to matching variables in a stepwise fashion. The costs measured in this study included all expenses sustained by the hospital. Information on costs was obtained from medical records and the hospital economic department. The attack rate and the incidence of healthcare-associated acquired rotavirus infection were 6.6% and 15.8 per 1000 hospital days, respectively, during a winter outbreak. Fifteen percent of HAI were identified after discharge. The average cost per case was 1930 and the mean excess length of stay was 4.9 days. Our findings clearly demonstrate the substantial expense incurred as a result of HAI caused by rotavirus in children. To prevent these costly infections, several cost-effective measures such as standard precautions should be reinforced in the education of the healthcare workers.

Case-Control Studies↗
PubMed1976

Abortion and the law: the impact on hospital policy of the Roe and Doe decisions.

The purpose of the article is to analyze the effect of the U.S. Supreme Court's abortion decisions upon the policies of hospitals in Harris County (Houston), Texas. The study attempts to determine the variables associated with the hospitals' policies prior to and following the Roe and Doe decisions and which variables best explain the change (or lack of change) from the first period to the other. The principal data source is a series of in-depth personal interviews with 68 key decision-makers in 36 general hospitals in Harris county. Critical data about the hospitals' economic status were obtained from the American Hospital Association's Hospitals: Guide Issue, 1972. The major findings of the study are as follows: (1) the Roe and Doe decisions did affect hospital policy in that within a year after the High Court's rulings, hospitals evidence a dramatic shift toward more permissive abortion policies; (2) economic variables, while not having much explanatory power for pre-Roe and Doe abortion policies, were important predictors of hospital policy and of the propensity for hospitals to liberalize their abortion standards after the Supreme Court decisions; and (3) the values, attitudes, and attributes of the individual decision-makers had much to do with explaining their respective hospitals' abortion policies before and after the Supreme Court decisions and accounted for changes in abortion policy from the first to the second period.

Abortion, Legal↗
PubMed1963

Medical economics.

Explore the source record for details and available documents.

Economics, Hospital↗
PubMed1995

AIDS scenarios for The Netherlands; the economic impact on hospitals.

OBJECTIVE: To assess the economic impact of HIV/AIDS on the health care system in The Netherlands. DATA AND METHODS: Two types of data are used: (i) routine surveillance data on AIDS incidence and (ii) information on hospital resource utilisation and corresponding monetary costs. Progression of disease is modelled using a multi-stage model, with stages corresponding to clinical classifications and to different phases of health care need. Economic impact is analysed for all stages in three scenarios: the reference and two alternative scenarios. RESULTS: In the year 2000 hospital bed need would reach 220 beds if yearly new HIV infections in the 1990s remain at the level estimated for the end of the 1980s, and if the intensity of hospital care remains constant. A minimum need of 125 beds is projected if no new HIV infections occur in the 1990s. Hospital costs in 1993 are estimated to amount to 33.8 million ECUs. Scenarios indicate a range of 26.7-50.7 million ECUs for the year 2000 (price level: 1993). The proportion of the costs of hospital inpatient care and cure in total hospital costs increases, whereas the proportion for outpatient services decreases. CONCLUSIONS: Projected hospital bed need of 125-220 for HIV/AIDS in the year 2000 is limited compared to the projections for coronary heart disease and stroke, but approaches that for lung cancer, pneumonia and diabetes. We estimate hospital costs to have been 85% of total health care costs for HIV/AIDS in 1993. In 1993, the estimated proportions in hospital costs are 41% for inpatient care, 20% for inpatient cure and 39% for outpatient facilities. Our scenarios indicate a decreasing share of outpatient costs--possibly to 30% of total hospital costs for HIV/AIDS in 2000--illustrating the growing relative importance of the AIDS stage for the hospital costs. We project hospital costs for HIV/AIDS in 2000 to reach up to 0.53% of projected hospital costs for all diseases. A present value of 38 million ECUs (23%) of hospital costs projected in the reference scenario might be avoidable, during the period 1994-2000. However, with unchanged treatment patterns a present value of 127 million ECUs for hospital costs during the same period is projected to represent unavoidable costs (discount rate: 5%). In The Netherlands, data needs in the field of economic impact assessment of HIV/AIDS especially refer to registrations of non-hospital outpatient resource utilisation and costs.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The economic impact of hospitals in rural communities.

This article presents how to assess the economic impact of a hospital on a rural community. The economic impact is identified by assessing the direct, induced, and indirect impacts that result because of the presence of a hospital in a rural community. The methodology utilizes survey data and estimation procedures for four rural hospitals. The economic impact estimates are based on microdata. Income multipliers are estimated for each of the rural communities. The research demonstrates that rural hospitals do make significant economic contributions to the communities they serve. Community leaders can use the model presented to evaluate the economic impact of their local hospital.

Community-Institutional Relations↗
PubMedDate not supplied

Integrated delivery networks: a detour on the road to integrated health care?

This paper reviews the rationales and evidence for horizontal and vertical integration involving hospitals. We find a disjunction between the integration rationales espoused by providers and those cited in the academic literature. We also generally find that integration fails to improve hospitals' economic performance. We offer seven lessons from hospitals' efforts to integrate and then suggest four alternative models for achieving integrated delivery of health care services.

Conflict, Psychological↗