Consequences of right siting of endocrinology patients--a financial and caseload simulation.
نویسندگان
چکیده
INTRODUCTION Right siting has been actively advocated to mitigate rising healthcare costs as well as to free up tertiary resources for the provision of care to more complex patients, research and education. There are, however, concerns that in a block budget setting right siting will reduce patient volumes, thus impacting on subsequent funding allocations and also patient revenues. We sought to determine through modelling and simulation the financial and volume impacts of right siting of endocrinology outpatients in a large tertiary hospital in Singapore. MATERIALS AND METHODS Data were collected prospectively on patient casemix including complexity (complex defined as requiring specialist care), time required for consultations and revenues garnered. The data were used to simulate 2 scenarios: right siting of all simple cases with freed up resources directed to research and teaching (research scenario) and right siting of all simple cases with replacement by complex cases (service scenario). RESULTS The department sees an estimated 33,000 outpatients per year with a total annual outpatient revenue of $8.6 million. The research scenario would see a decline in patient volume to 11,880 cases per year which would result in a corresponding decrease in revenue of $5 million and freeing up of 2.8 hours/ week for each staff. The service scenario yields a drop in patient volume of 9500 per annum and a drop in revenue of $1.9 million. CONCLUSION Right siting reduces tertiary care patient volumes and revenues and may discourage right siting efforts. A viable business model for the tertiary institutions is needed to facilitate support for right siting.
منابع مشابه
Optimal Siting and Sizing of Hybrid Energy Systems (PV-WT-CHP) and Electric Vehicle Charging Stations Simultaneously based on Game Theory Approach
This paper proposes a methodology for practical siting and sizing of Hybrid energy systems (HESs) consist of: wind turbine (WT), photovoltaic (PV) and combined heat and power (CHP) units. In this method, the interaction of Plug-in Electric Vehicles (PIEVs) in the electric distribution system is considered. Electric Vehicle are seen to have some negative impacts on electric distribution system p...
متن کاملThe Role of Quantitative Risk Assessment in Improving Hazardous Installations Siting: A Case Study
Safety distance has already been a main measurement for the hazard control of chemical installations interpreted to mean providing space between the hazardous installation and different types of targets. But, the problem is how to determine the enough space. This study considers the application of quantitative risk assessment to evaluating a compressed natural gas station site and to identi...
متن کاملBackground: World Health Organization (WHO) defines three goals to assess the performance of a health system: the state of health, fairness in financial contribution and responsiveness. We assessed the responsiveness of health system for patients with diabetes in a defined population cohort in Tehran, Iran. Methods: Total responsiveness and eight domains (prompt attention, dignity, communica...
متن کاملEXPERIENCE WITH ADRENOCORTICAL TUMORS IN CHILDREN: A REPORT OF ELEVEN CASES
During a period of IS years from 1975 to 1989, eleven children with adrenocortical tumors were managed with relatively favorable results in our center. Despite its rarity in the pediatric age group, our series is one of the largest reported in the literature in the given period of time. All of our 11 patients presented with hyperfunction of the adrenal cortex. Virilization alone was the mo...
متن کاملAssessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review
Background Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community’s uncertainty about peaceful purpose of Iran’s nuclear program and inadequacy o...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Annals of the Academy of Medicine, Singapore
دوره 37 2 شماره
صفحات -
تاریخ انتشار 2008