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HHS accuses infusion companies of overcharging

AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第5期57卷 417-418页

作者： [Anonymous]

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Direct costs associated with a nosocomial outbreak of adenoviral conjunctivitis infection in a long-term care institution

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AMERICAN JOURNAL OF INFECTION CONTROL 2002年第7期30卷 407-410页

作者： Piednoir, E Bureau-Chalot, F Merle, C Gotzamanis, A Wuibout, J Bajolet, O CHU R Debre Lab Bacteriol Virol Hyg F-51092 Reims France CHU R Debre Dept Biostat F-51092 Reims France CHU R Debre Dept Ophthalmol F-51092 Reims France

Background: In October 2000, 41 people were infected during an outbreak of adenoviral keratoconjunctivitis. Such nosocomial outbreaks are frequently reported in long-term care institutions, even though simple measures to prevent or limit such occurrences are well documented. This study describes the significant direct costs incurred as a result of this nosocomial outbreak that involved patients and staff. Methods: The costs measured in this study were grouped into the following 4 categories: medical, investigative, preventive, and lost productivity. Information about costs incurred by the hospital was gathered from a number of sources. Results: The outbreak cost the hospital US $29,527 ($1085 for medical costs, $8210 for investigative costs, $3048 for preventive measures, and $17,184 for lost productivity). Conclusion: This study demonstrates the substantial expense incurred by 1 hospital as a result of an outbreak of a preventable disease. The measures necessary to prevent such a costly outbreak are simple and, therefore, cost-effective.

关键词：腺病毒感染人/药物疗法腺病毒感染人/经济学腺病毒感染人/预防和控制腺病毒人抗病毒药/经济学费用效益分析交叉感染/药物疗法交叉感染/经济学交叉感染/预防和控制交叉感染/病毒学疾病暴发流行/经济学卫生保健费用感染控制/经济学角结膜炎/药物疗法角结膜炎/经济学角结膜炎/预防和控制角结膜炎/病毒学技术性护理设施/经济学女(雌)性人类男(雄)性

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AN ANALYSIS OF THE COST OF PROVIDING ANCILLARY SERVICES TO SKILLED NURSING FACILITY PATIENTS IN NEW-YORK-STATE

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SOCIO-ECONOMIC PLANNING SCIENCES 1985年第6期19卷 417-423页

作者： HANNAN, EL ODONNELL, JF GIMBRONE, CJ NEW YORK STATE DEPT HLTH OFF HLTH SYST MANAGEMENTCORNING TOWEREMPIRE STATE PLAZAALBANYNY 12237 USA

Currently, nursing homes can arrange for the provision of ancillary services either by providing the services directly, purchasing the services through contracts and fees, or by outside billings, in which the services are supplied by other providers who then bill Medicaid directly. Frequently, some combination of these three modes of provision is used for each ancillary service. The purpose of this study is to explore ancillary costs in a sample of nursing homes and to determine, to the extent possible, the most cost-efficient means of providing selected ancillary services (physical therapy, radiology and medical staff services). Prior to examining the impact of the mode of provision on cost levels, other facility and patient characteristics that might justifiably affect costs are identified and adjusted for. The results demonstrate that outside billing or purchasing services can be much less expensive than providing the services directly. It is suggested that all ancillary services (outside billings as well as services provided directly through contracts and fees) be included when facility-to-facility cost comparisons are made. This approach should serve as an incentive for nursing homes to seek the most cost-efficient means of providing ancillary services.

关键词：费用分配/方法成本及成本分析/方法直接服务费用医务人员/经济学模型理论纽约物理治疗技术/经济学放射摄影术/经济学技术性护理设施/经济学人类

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THE MARGINAL COST OF NURSING-HOME CARE - NEW-YORK, 1983

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JOURNAL OF HEALTH ECONOMICS 1988年第4期7卷 393-412页

作者： NYMAN, JA UNIV MINNESOTA MINNEAPOLISMN 55455 USA

Many believe that nursing homes exclude heavy-care Medicaid patients because their costs exceed the Medicaid reimbursement rate. This paper tests whether this was true in New York in 1983 by calculating the marginal costs of a day of nursing home care and comparing them with the per diem Medicaid reimbursement rate. Contrary to popular beliefs, the marginal cost of the most dependent SNF patient was found to be between $9 and $12 less per patient day than the average Medicaid reimbursement rate for SNF patients. This suggests that excess demand, rather than lower-than-cost reimbursement rates, was creating the heavy-care access problem in New York in 1983. Policy solutions differ depending on the cause of the access problem. The strengths and weaknesses of the different policy solutions are compared.

关键词：成本及成本分析/统计学和数值数据数据收集卫生服务易得程度/经济学卫生服务需求/经济学卫生服务研究/经济学保险健康补偿中间诊疗设施/经济学长期医疗/分类 Medicaid/经济学纽约医护疗养所/经济学支付标准制定和审核技术性护理设施/经济学

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THE COSTS OF MEDICARE PATIENTS IN NURSING-HOMES IN THE UNITED-STATES - A MULTIPLE OUTPUT ANALYSIS

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JOURNAL OF HEALTH ECONOMICS 1989年第3期8卷 253-270页

作者： DOR, A URBAN INST WASHINGTONDC 20037 USA

The reluctance of nursing homes to admit Medicare beneficiaries is well recognised. A possible explanation is that under the current Medicare reimbursement policy, nursing homes do not have adequate incentives to increase admissions. This paper examines that hypothesis. Using a national sample of nursing homes, Medicare-specific marginal costs were estimated from a flexible form of the cost function. In most cases, Medicare-specific marginal costs were well above Medicare reimbursement rates. From an investigation of economies of scale and economies of scope, it appears that reimbursements may be sufficient only in nursing homes that specialize in Medicare beneficiaries. Unless Medicare reimbursements are brought in line with costs, access of Medicare beneficiaries to the nursing homes will remain limited.

关键词：成本及成本分析/统计学和数值数据卫生服务易得程度/经济学 Medicaid/经济学 Medicare/经济学模型统计学回归分析偿还途径技术性护理设施/经济学统计学(主题) 美国

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The share of Medicaid for nursing home care.

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Journal of health & social policy 1990年第3期1卷 35-53页

作者： Swan, J.H. Institute for Health and Aging University of California San Francisco 94143.

Over one-third of Medicaid dollars go to nursing homes, a share that is decreasing but that varies widely among the states. This paper examines demand, supply, and policy factors explaining interstate variation over time in the nursing home share of state Medicaid dollars. Nursing home bed stock shows strong effects;Medicaid expenditures for acute hospital and for ICF-MR care are important;and various demand factors also explain nursing home share. In this model, residual nursing home share of Medicaid declines over time, which is interpreted to reflect omitted state policy factors explaining state ability to constrain Medicaid nursing home utilization and expenditures.