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At least 19 recordsLinked to original sources
PubMed1983

National health expenditure growth in the 1980's: an aging population, new technologies, and increasing competition.

Health care spending in the United States more than tripled between 1971 and 1981, increasing from $83 billion to $287 billion. This growth in health sector spending substantially outpaced overall growth in the economy, averaging 13.2 percent per year compared to 10.5 percent for the gross national product (GNP). By 1981, one out of every ten dollars of GNP was spent on health care, compared to one out of every thirteen dollars of GNP in 1971. If current trends continue and if present health care financing arrangements remain basically unchanged, national health expenditures are projected to reach approximately $756 billion in 1990 and consume roughly 12 percent of GNP. The focal issue in health care today is cost and cost increases. The outlook for the 1980's is for continued rapid growth but at a diminished rate. The primary force behind this moderating growth is projected lower inflation. However, real growth rates are also expected to moderate slightly. The chief factors influencing the growth of health expenditures in the eighties are expected to be aging of the population, new medical technologies, increasing competition, restrained public funding, growth in real income, increased health manpower, and a deceleration in economy-wide inflation. Managers, policy makers and providers in the health sector, as in all sectors, must include in today's decisions probable future trends. Inflation, economic shocks, and unanticipated outcomes of policies over the last decade have intensified the need for periodic assessments of individual industries and their relationship to the macro economy. This article provides such an assessment for the health care industry. Baseline current-law projections of national health expenditures are made to 1990.

Costs and Cost Analysis↗
PubMed2003

A decision tree for selecting the most cost-effective waste disposal strategy in foodservice operations.

The purposes of this study were to determine costs of disposal strategies for wastes generated in foodservice operations and to develop a decision tree to determine the most cost-effective disposal strategy for foodservice operations. Four cases, including the central food processing center (CFPC) in a school district, a continuing-care retirement center (CCRC), a university dining center (UDC), and a commercial chain restaurant (CCR), were studied to determine the most cost-effective disposal strategy. Annual costs for the current and projected strategies were determined for each case. Results of waste characterization studies and stopwatch studies, interviews with foodservice directors, and water flow and electrical requirements from manufacturers' specifications were used to determine cost incurred. The annual percentage increases for labor, fees, and services were used to reflect an inflated economic condition for the ensuing 10 years of the study period. The Net Present Worth method was used to compare costs of strategies, and the multiparameter sensitivity analysis was conducted to examine the tolerance of the chosen strategy. The most cost-effective strategy differed among foodservice operations because of the composition of food and packaging wastes, the quantity of recyclable materials, the waste-hauling charges, labor costs, start-up costs, and inflation rate. For example, the use of a garbage disposal for food waste and landfills and recycling for packaging waste were the most cost-effective strategies for the CCRC. A decision tree was developed to illustrate the decision-making process that occurs when conducting cost analysis and subsequent decisions. Dietetics practitioners can use the decision tree when evaluating the results of the cost analysis.

Cost-Benefit Analysis↗
PubMed1989

A profile of sickle cell disease in Nigeria.

Nigeria has a population of 112 million with an annual growth rate of 3.2%. About 25% of adults throughout the country have the sickle cell trait, AS, while the Hb C trait is largely confined to the Yoruba people of southwestern Nigeria in whom it occurs in about 6%. Other variant hemoglobins including beta thalassemia are rare, but alpha thalassemia occurs in 39% (32% with 3 alpha-globin genes; 7% with 2 alpha-globin genes). Of a total of 5.4 million expected live births in 1988, about 90,000 will have SCD and 1.1 million the trait, AS. The clinical phenotype of sickle cell anemia is severe with manifestations occurring very early in childhood and mean Hb level 7.6 g/dl with HbF 5.9%. A very high infant mortality due to infections occurs especially in rural areas. Gallstones, leg ulcerations, and stroke appear less common than in American sicklers, and aplastic crises have not been described. Poor availability of resources to the public health and welfare sectors and economic inflation are severely curtailing access to appropriate medical and social services. This situation is frustrating to the families of a growing number of surviving patients in urban or middle to upper income groups. Efforts to create more awareness of SCD are paradoxically increasing frustration and stigmatization in the absence of a commensurate improvement of services. Any measures aimed at enhancing the sensitization of health professionals, policy makers, and resource allocators to the pertinent issues in the control of SCD would seem to be at this stage an important step in the right direction.

Adolescent↗
PubMed1994

Cost containment: the Americas. Argentina.

For many years, the evolution of Argentina's healthcare system has been influenced by political and economic instability. Inflation and hyperinflation have led to anarchic development of both health administration systems and hospitals. Critical care grew in a similar manner, resulting in a mix of > 500 critical care units with very different levels of technology and trained personnel. Cost-containment policies have been implemented mainly by health administration systems. Public institutions (university and large provincial and county hospitals) have suffered hard budget cuts that have resulted in a decrease in the quality of care and the loss of trained human resources. Union organizations, which cover the healthcare costs of > 60% of the population, implemented a low reimbursement policy that resulted in low standards of care for critically ill patients. The country's private hospital system is extremely heterogenous, ranging from little, simple institutions with a 20- to 30-bed capacity to great private institutions with international standards of care. Cost-containment efforts have been sporadic and isolated, and statistical data to analyze the results are lacking. In order to formulate a strategy of cost-containment in the near future, accreditation and categorization of critical care units and human resources training are being implemented by health authorities and the Argentine Society of Critical Care Medicine.

Accreditation↗
PubMed1997

Service use and cost outcomes for persons with Alzheimer disease.

Use of formal services and the associated costs of caring for people with Alzheimer disease and related disorders are expected increase into the next century. This will be driven primarily by general economic inflation, annual increases in health care costs exceeding the inflation rate, increasing numbers of people 85 years of age and older, increases in the expected life span of people at 65 years of age, increasing numbers of people in the nonelderly disabled population receiving Medicare benefits, and changes in the employment structure of the economy. Two sources of data that have been used to estimate formal health and social service utilization and costs are self-report and Medicare claims data. Self-report data are problematic in studies of people with Alzheimer disease because of the demented person's general inability to reliably report on service utilization and the necessary use of proxies to obtain information. Medicare claims are a source for both service utilization and cost data, but limitations in these data result from their use to document reimbursement claims as opposed to accurately reflecting service use histories. Given the lack of reliable and comprehensive service utilization and cost reporting systems, a variety of methods will be required to estimate service use and cost outcome data for people with dementia. These include self-reports of service use and cost, examination of claims records, and service use document abstraction, when feasible.

Aged↗