1,720,961 research outputs found
Managerial control and cost accounting systems in national health care services
No full textMany governments in Europe are struggling with the need to reduce public spending, especially because of the global recession and of the recent sovereign debt crisis. The reduced growth rates (or, in some cases, even recessions) that several European countries are currently experiencing are putting a strain on public spending, and have forced some governments to introduce drastic measures for increasing financial stability. National health care services, which normally constitute an important portion of public spending, are also affected. The compounded effect of an aging population and an increase in health care costs is forcing even more governments to focus on the efficiency in the management of their national health services. However, the critical relevance of health care expenditures in maintaining the welfare of the population advises against indiscriminate and non-focused cost reductions. Instead, it is essential to identify and understand the main health care cost drivers, in order to develop rational cost reduction plans, aimed at the patient or at the medical procedure level. In order for reduction plans to be successful, in fact, it is paramount that the health care administrators know about the costs related to the different therapeutic or diagnostic treatments (see: Francesconi, 1993; Grisi, 1997; Baker, 1998; Cinquini et al., 2009; Kaplan and Porter, 2011). In this paper we describe the theoretical and practical implications of the determination of costs in a hospital context, with a particular emphasis on the implementation of modern costing systems, such as Activity Based Costing (Kaplan and Cooper, 1998; De Rosa, 2000; Kaplan and Anderson, 2004). This paper represents the first step in a research project that aims to develop an international comparison of health care costs in neighbouring countries. Cross-country benchmarking and comparison, in fact, may be a precious tool for defining the most cost-efficient methods for offering therapeutic and diagnostic medical services
64-Slice CT coronary angiography versus conventional coronary angiography: activity-based cost analysis
No full textThis study was done to analyse the costs of 64-slice computed tomography (CT) coronary angiography and conventional coronary angiography and determine the cost-effectiveness of the two modalities. MDCT coronary angiography has far lower costs than conventional coronary angiography, and its cost-effectiveness is better in the large majority of patients
The Role of CEUS in the Characterization of Hepatocellular Nodules Detected During the US Surveillance Program – Current Practices in Europe
No full textThe basic pathological feature for the differential
diagnosis between hepatocellular carcinoma
(HCC) and non-malignant hepatocellular nodules
in cirrhotic patients detected during ultrasound
(US) is the vascular supply to the nodule. Computed
tomography (CT) and magnetic resonance
imaging (MRI) are considered reference imaging
techniques for depicting hepatocellular nodule
vascularity in the noninvasive diagnosis of HCC.
Contrast-enhanced US (CEUS) improves the diagnostic
performance of unenhanced US in the diagnosis
of HCC, giving an overall diagnostic accuracy
that is similar to that of CT, even for nodules smaller
than 2 cm. An additional diagnostic feature of
CEUS relative to CT is the possibility to visualize
contrast wash-in to hepatic nodules during the
arterial phase and contrast washout during the
portal venous and late phases. Sensitivity for the
diagnosis of HCC with combined assessment of
CEUS and CT is higher than for separate assessments
of CEUS and CT due to the reduction of
false-negative findings. CEUS represents a competitive
imaging method from an economic point of
view, and is an effective imaging tool for assessing
the therapeutic outcome after surgery, ablation
therapy, and transarterial chemoembolization
(TACE)
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Linking Cost Control to Cost Management in Healthcare Services: An Analysis of Three Case Studies
No full textThe issue of healthcare costs has become increasingly problematic over the years. This chapter summarizes the problems faced by hospitals when measuring the costs of healthcare treatments, explaining how an Activity Based Costing (ABC) framework can be successfully adopted in healthcare settings. After describing the theoretical foundations of cost control and cost management, the chapter continues with the analysis of three real-life applications of ABC in a hospital, drawn from the process analysis and activity-based costing experience developed at the Azienda Ospedaliero-Universitaria (AOU – University Hospital) “Ospedali Riuniti” (Joint Hospitals) of Trieste, Italy. In particular, the cases are about cost measurement in cardiology, odontostomatology, and radiology, and describe the technical solutions applied for computing the costs of selected therapeutic and diagnostic treatments. A particular emphasis is placed on how these measures have been subsequently used by hospital managers and medical personnel in order to gain insights and to improve the efficiency of the processes developed within the organization
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
MR angiography versus intra-arterial digital subtraction angiography of the lowerextremities: activity-based cost analysis
No full textThe aim of this study was to analyse the costs pertaining to the radiology department of magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) in the evaluation of arterial disease of the lower limbs. Intra-arterial DSA costs more than MRA, mainly because of the higher costs of supplies used during the procedure and higher personnel costs (as a result of the longer duration of intra-arterial DSA)
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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