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At least 19 recordsLinked to original sources
PubMed1979

Hospital pharmacy purchases and inventories.

The results of the hospital pharmacy purchases and inventories portion of a 1978 national mail survey of pharmaceutical services in short-term hospitals are reported. A sample of 815 hospitals was selected randomly from among 5,200 U.S. short-term hospitals that employ a pharmacist on at least a part-time basis. The inventory question had a response rate of 67.7%, the purchasing question, 62.2%; inventory turnover was calculated based on a response rate of 60.5% to both questions. Inventories were inordinately large in small hospitals. Inventory turnover rates, which increased with hospital size, were somewhat less than optimal in small and medium hospitals. The Pacific region's inventory/bed and purchases/bed values were substantially greater than those of any other region. Large hospitals had a 20% higher annual purchases/bed figure than the smaller hospitals, perhaps because of their relatively greater volume of outpatient services. Based on their respective demand (as measured by adjusted inpatient days), the drug purchases of the New England and Mid-Atlantic regions were less than expected, while the Mountain and Pacific regions' drug purchases were much greater than expected. Total 1979 purchases of pharmaceuticals and related supplies by pharmacies in all short-term hospitals are estimated to reach $2,215 to $2,772 million.

Hospital Bed Capacity↗
PubMed1976

ABC inventory analysis and economic order quantity concept in hospital pharmacy purchasing.

ABC inventory analysis and the economic order quantity (EOQ) concept were studied as alternatives to the cyclical ordering system used by the pharmacy in a 558-bed general hospital. The inventory was divided into A, B or C groups according to the annual dollar value of the items. Two samples were selected to be studied (the first consisting of 10% of the total inventory and the second consisting of 10% of the A, or high cost, items). For each item in both samples the EOQ was calculated to estimate the proposed annual inventory cost as compared to the actual cost as determined from past inventory records. In the first sample, there was a statistically significant mean annual savings of $4.13 +/- $0.36 (S.E.) using the proposed annual cost. In the second sample there was a mean savings of $2.42 +/- $0.60 (S.E.) using the proposed method, which was not statistically significant. Most of the savings with the proposed ABC-EOQ system would occur with the low dollar value items (B and C items) which were being purchased too frequently.

Costs and Cost Analysis↗
PubMedDate not supplied

A computerized purchase order management system.

Order processing and parts issuing are within the scope of an inventory management system and, as such, it was logical to incorporate the Purchase Order Management Menu into the biomedical engineering inventory management system. The Purchase Order Management function was implemented using the services of a biomedical engineering technician who is a staff member. Software development time (two months) was the only resource that was necessary to incorporate this function into the inventory system. This function, implemented on a PC, provided locally functions that had not been available on the mainframe-based hospital purchasing system. These functions directly addressed the needs of the users, who in this case are the staff members of the department of biomedical engineering at University Hospital, Stony Brook, New York.

Computer Systems↗
PubMed1992

Constant incidence rates of needle-stick injury paradoxically suggest modest preventive effect of sharps disposal system.

Does placement of impenetrable sharps disposal systems in hospitals reduce needle-stick injury? To study this question, annual health questionnaires were distributed on a quarterly basis to all 8000 employees in an academic medical center in a large eastern US metropolitan city asking each employee whether he or she had experienced a needle-stick injury since the last questionnaire. Questionnaires from active floor nurses were separated and hand tallied in 1987, 1989, and 1990, the latter 2 years being after impenetrable sharps disposal systems had been placed at nursing stations and in individual patients rooms. Total needle sticks in staff nurses reported during the 3 years (20.5%, 23.2%, 21.8%, not significant) did not decrease in the last 2 years. Simultaneously, hospital purchases of needle-containing devices increased 13.5%. Thus a constant reported needle-stick incidence rate may paradoxically represent a modest preventive effect of a hospital sharps-disposal system.

Equipment Safety↗
PubMed1990

Practice guidelines and professional autonomy in a universal health insurance system: the case of tissue plasminogen activator in Ontario.

Ontario's universal health insurance system has placed few constraints on the clinical and economic autonomy of medical doctors. Although fees are standardized, most physicians remain in private fee-for-service practice and thereby retain control of the mix and volume of services. Utilization review is minimal. While organized medicine has argued that health care is 'under-funded', the government is pressing for better use of extant resources through firmer management of the medical services sector. The Ontario Medical Association (OMA), the major bargaining agent for doctors in the province, has accordingly sought to protect professional autonomy by developing voluntary self-regulatory approaches that obviate the need for external controls over physician practice patterns. Part of this strategy is promulgation of practice guidelines. Tissue plasminogen activator (t-PA), a clot-lysing drug for myocardial infarction, was released in late 1987, and, at C$2950 per treatment, constituted an unforeseen add-on cost for hospitals. The OMA subsequently convened an expert panel to develop guidelines for thrombolysis in myocardial infarction. Among the unanticipated results was the conclusion that insufficient evidence had accumulated to recommend routine use of t-PA instead of streptokinase, an older drug costing C$290. The OMA panel's guidelines were approved by the OMA executive, and led the government to reject special add-on funding for hospitals purchasing t-PA. The OMA's position and government decision provoked negative reactions from the OMA's own cardiology section. Indicative of clinicians' feelings, a follow-up survey of cardiologists and internists showed that only 28% of respondents were indifferent between t-PA and streptokinase, while 64% preferred t-PA. On the other hand, 74% supported clinical policy development by the OMA, while 94% opposed direct government involvement in guideline-setting. The case of the OMA thrombolysis guidelines illustrates a strategic conundrum facing Canadian organized medicine. Professional activism in guideline-setting may in theory protect the individual practitioner's autonomy by offering a voluntary alternative to utilization management by government, and is likely to strengthen the collective influence of organized medicine. However, among the risks are alienation of practitioners who see professional guidelines and government control as two sides of the same regulatory coin, and the transmogrification of voluntary guidelines into parameters for cost control and utilization management by government or hospitals. Future initiatives will depend on how these benefits and risks are weighed.

Cost Control↗
PubMedDate not supplied

The direct costs of universal precautions in a teaching hospital.

An analysis of the increase in expenditures for barrier isolation materials before and after the institution of universal precautions at our 900-bed university hospital was used to generate a national estimate of the cost of implementation of the new Centers for Disease Control guidelines. Following the institution of universal precautions, use of rubber gloves at our hospital increased from 1.64 million pairs of 2.81 million pairs annually. A 5-year review of hospital purchasing and supply records in both inpatient and outpatient areas indicated that the total annual costs for isolation materials increased by $350,900. This represented an increase from $13.70 to $22.89 per admission (60%) after adjustment for inflation. The cost of isolation materials increased from $98 to $215 per 1000 outpatient visits, an adjusted increase of 92%. Two thirds of the increase (64%) was due to rubber gloves and an additional 25% was due to disposable isolation gowns. Universal precautions are estimated to have cost at least $336 million in the United States in fiscal year 1989 after adjustment for inflation. If expenditures for isolation materials at our medical center are representative, previous estimates may have significantly underestimated costs nationwide.

Centers for Disease Control and Prevention, U.S.↗
PubMed1975

The biomedical engineer in the hospital.

The role of the hospital biomedical engineer is described with reference to design and development of equipment and its maintenance, provision of a technical advisory service, and teaching.

Australia↗