A Total Cost of Operation (TCOp) Analysis of Electric Vehicles Introduction in Urban Transport in La Havana

Abstract The urban transport electrification is going upward in many countries. However, this electrification faces many hurdles, among them, the limited range and cost that present-day electric vehicles (EV) have. This paper analyzes which Battery Electric Vehicles (BEV) could meet the current car travel needs in different uses. The results from a survey about distance travelled in daily trips in La Havana, allow the assessment of maximum average daily distance travel (MADT) by the private owners, cars in public service, taxis and leasing. The Lognormal distribution adjusts to MADT´s histogram in each group, and yields estimates characterizing its behavior. The use of a database of BEV with more than 60 electric vehicles allows to select an appropriate model for each use. The BEV´s range is normally expressed using several driving cycles, being EPA (Environmental Protection Agency) the most adequate, but the range by EPA is not always available. A regression analysis was made to obtain the EPA range as a function of range by others driving cycles. Finally, a Total Cost of Operation (TCOp) is calculated considering the purchase cost, energy cost, maintenance, etc. The outcomes are that for the private use, only small BEV with a strong subsidy or battery leasing can compete with an Internal Combustion Engine Vehicle (ICEV). In the public, taxis and leasing sector, the BEV are competitive in several years. The daily mileage and electricity cost are decisive. The use of renewable energy to charge batteries can reduce this period to some extent.

Study on the Effects of Total Cost Prospective Payment System on the Consumption of Drugs / 中国药房

OBJECTIVE:To investigate the consumption of drugs after the inplementation of total cost prospective payment sys-tem(PPS),and to provide reference for hospital drug cost control. METHODS:The data of prescriptions collected from 9 hospital during 2007-2014 were divided into group A,B and C according to PPS,and then summarized statistically in respects of increase rate of total consumption sum,consumption sum ratio of major category;the drug cost per time of outpatient department,emergen-cy department and inpatient department were calculated as well as consumption sum ratio of self-paid drugs;the dosage per time of drugs in blood pressure and diabetes prescription were also calculated. RESULTS:The total consumption sum of drug increased slowly after the implementation of total cost PPS;the consumption sum ratio of major category kept stable,while that of anti-infec-tive agent decreased;the emergency drug cost per time achieved a negative growth,and outpatient and inpatient drug cost per time increased slightly. The proportion of self-paid drugs was relatively stable. The dosage per time of drugs in hypertension and diabetes prescriptions was stable,too. CONCLUSIONS:Total cost PPS is useful in controlling the rapid growth of drug costs,and promote the reasonable drug use. The consumption sum of self-paid drugs are well controlled. The increase of drug cost per time in outpa-tient and inpatient should arouse the attention of the relevant departments. In addition,it has no effect on drug dosage for the pa-tients with hypertension and diabetes.

Health care seeking behaviour and expenditure pattern among Scrub Typhus patients attending a tertiary care hospital in Mysore city.

Background: Scrub typhus is one among the re-emerging infectious diseases throughout the world. Various studies conducted across India reveals that its public health importance is increasing. This study was conducted 1) To describe the socio-demographic and epidemiological profile of patients admitted with scrub typhus. 2) To assess the health care seeking behaviour of these patients. 3) To estimate the cost factors incurred in the current episode of illness. Methods: This prospective study was conducted from January to December 2013 among all lab confirmed cases of scrub typhus admitted to department of medicine and pediatrics of JSS Hospital, Mysore. The study subjects were interviewed with a pre-tested and structured questionnaire. Data regarding socio-demographic profile, epidemiological profile, disease outcome, health care seeking behaviour and cost factors incurred with current episode of illness were collected. Data entry and analysis were done with SPSS.v.22.0 using descriptive statistics like mean, standard deviations and inferential statistics like chi-square test. Results: Among 192 patients tested positive by Weil-Felix test and/or Immuno-Chromatographic Test (ICT) for scrub typhus majority 105 (54.7%) were males and were predominantly 135 (70.3 %) from rural areas. Mostly 172(89.6%) were unaware of any mite bite in the past. Majority 167 (87.0%) of them had visited atleast three Health Care Facilities (HCF) for treatment. The mean ± SD total duration of illness was 15.6 ± 4.1 days. Most 104 (54.2 %) of them had suffered from illness for 11-15 days. Majority 175 (91.1%) of them had recovered while 3 (1.6%) of them had succumbed to the condition. The median Total direct cost, total indirect cost and overall total cost were Rs. 7500 (7000-9500), Rs. 3000 (2500-3500) and Rs. 10500 (10000-13000) respectively. Most 104 (54.2%) of them spent from money borrowed from others, followed by 78 (40.6%) spent Out Of Pocket (OOP). Conclusion: People from rural areas, unskilled workers and children were affected predominantly. With timely diagnosis and appropriate treatment, significant morbidity and mortality could be prevented. Promotion of various public and private health insurance schemes among public would minimise the OOP expenditure and prevents debts.

Study on Accounting Unit Profit Margin Profit Entity Based Rate Calculation / 中国卫生经济

Under the serious inadequate circumstances of government’s input on public hospitals, how public hospitals can ensure the public welfare and guarantee a reasonable return is the task for managers. Based on the total cost accounting of the hospitals , the patient costs are solved into the cost structure with the same structure of accounting , combined with average profit rates of accounting units, to calculate single patient profit, to summarize diseases and calculate disease profit rate and related indexes on this basis, to provide references for hospital management from new prospective.

The Application of Time Driven Activity-Based Costing Approach in the Mode of Hospital Total Cost Accounting / 中国卫生经济

Objective: To build total cost allocation model based on Time Driven Activity-based Costing (TDABC) and explore how to use it to improve the hospital cost accounting system. Methods: Take an ultrasonic cardiogram department of public hospital as a cost object to estimate the cost of medical service, as well as the efficiency of service and operating benefit analysis by using TDABC method. Results: Parts of routine services of the ultrasonic cardiogram departments having policy loss in a public hospital, the department’ s capacity are not fully utilized in a certain period. Conclusion: TDABC not only plays positive role in raising the level of hospital cost management, but also provides useful references and scientific basis for the formulation and revision of medical service fee and carring out the DRGs payment.

Application Prospect of EPR System in Total Cost Accounting of Hospitals / 中国卫生经济

The cost accounting plays central role in enhancing financial management in the hospital. With the increasing hospital competition, conventional model of cost accounting is changing, and gradually replaced with a novel model of cost accounting-total cost accounting. With the wide spread of total cost accounting in all hospitals, it is found that the general operation of hospitals is limited by the original HIS information system. EPR system feathered with the advanced data administration and potent function of financial analysis holding promise in adoption and acceptance by hospitals, serving as information collector and analyzer following HIS system.

Estimation of Psychiatric Nursing Costs by Using the Resource-Based Relative Value Scale(RBRVS) / 간호학회지

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

Purchase and Management for Medical Equipment in Total-Cost Accounting / 医疗卫生装备

Objective To introduce a new purchase and management model for medical equipment in total-cost accounting. Methods Through an analysis on corrent status of hospital purchase, some disadvantages were summed up and new suggestions and solution were put forward. Management measures of the equipment were discussed according to the check and accept, the archives management and the application. It were put forward to relative measures for maintenance of equipment and metrology management. Results Purchase and management for medical equipment conform to the standard via scientific and effectual management in the hospital.Conclusion More detailed work should be done to implement the model.