Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 101
Filter
2.
J Hosp Infect ; 105(4): 657-658, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32389708

ABSTRACT

This study demonstrated the use of purchase data to determine the incidence of sharps injuries in a major tertiary referral hospital in Australia. The incidence rates of injuries per 100,000 items purchased were 2.65 and 12.60 for syringe needles and scalpel blades, respectively. These figures were lower than those reported previously using this method. The incidence rate for injuries with suture needles, which had not been reported previously, was 31.89/100,000 items purchased. Incidence data calculated in this manner may be used in conjunction with purchase cost estimates to inform policy and practices on institutional staff safety measures.


Subject(s)
Accidents, Occupational/statistics & numerical data , Needles/supply & distribution , Needlestick Injuries/epidemiology , Occupational Health/statistics & numerical data , Purchasing, Hospital/statistics & numerical data , Tertiary Care Centers/statistics & numerical data , Australia , Humans , Incidence , Needles/classification , Surveys and Questionnaires
3.
J Pediatr ; 177: 244-249.e5, 2016 10.
Article in English | MEDLINE | ID: mdl-27453372

ABSTRACT

OBJECTIVE: To evaluate perioperative red blood cell (RBC) ordering and interhospital variability patterns in pediatric patients undergoing surgical interventions at US children's hospitals. STUDY DESIGN: This is a multicenter cross-sectional study of children aged <19 years admitted to 38 pediatric tertiary care hospitals participating in the Pediatric Health Information System in 2009-2014. Only cases performed at all represented hospitals were included in the study, to limit case mix variability. Orders for blood type and crossmatch were included when done on the day before or the day of the surgical procedure. The RBC transfusions included were those given on the day of or the day after surgery. The type and crossmatch-to-transfusion ratio (TCTR) was calculated for each surgical procedure. An adjusted model for interhospital variability was created to account for variation in patient population by age, sex, race/ethnicity, payer type, and presence/number of complex chronic conditions (CCCs) per patient. RESULTS: A total of 357 007 surgical interventions were identified across all participating hospitals. Blood type and crossmatch was performed 55 632 times, and 13 736 transfusions were provided, for a TCTR of 4:1. There was an association between increasing age and TCTR (R(2) = 0.43). Patients with multiple CCCs had lower TCTRs, with a stronger relationship (R(2) = 0.77). There was broad variability in adjusted TCTRs among hospitals (range, 2.5-25). CONCLUSIONS: The average TCTR in US children's hospitals was double that of adult surgical data, and was associated with wide interhospital variability. Age and the presence of CCCs markedly influenced this ratio. Studies to evaluate optimal preoperative RBC ordering and standardization of practices could potentially decrease unnecessary costs and wasted blood.


Subject(s)
Erythrocyte Transfusion/statistics & numerical data , Erythrocytes , Hospitals, Pediatric , Adolescent , Blood Banks , Blood Grouping and Crossmatching , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Perioperative Period , Purchasing, Hospital/statistics & numerical data , United States
8.
Eur J Clin Pharmacol ; 60(3): 149-53, 2004 May.
Article in English | MEDLINE | ID: mdl-15057496

ABSTRACT

INTRODUCTION: There are scarce descriptions of hospital drug procurement in the primary literature. The aim of this study was to analyse the drug tender led by a clinical pharmacologist in a 1200-bed university hospital in Serbia, a developing country in socio-economic transition, and to give recommendations for future steps in hospital drug policy. PROCEDURE AND OUTCOMES: Drug tendering was conducted according to the public procurement law from January to April 2003. Analysis included the method of defined daily doses and anatomical therapeutic chemical classification, as well as minimal tender prices, free market prices, essential drugs and domestic and foreign manufacturers. The drug tender list consisted of 548 products, 1,315,501 pharmaceutical units and 312 drug entities, among which 164 were essential. For purchasing purposes, 479 drug formulations were selected, costing approximately 1.4 million Euros (approximately 10% of hospital budget). Three-quarters of the expenditure consisted of antimicrobials (29.1%), cytotoxics (28.8%) and intravenous infusions (17.7%). The top 20 drugs consumed 62.2% of the total drug expenditure. Competition for the most expensive and/or most used drugs was the key for financial success of applicants, even when they offered a limited number of drugs. The tender achieved 4.6% and 17.2% cost savings in comparison with minimal tender price and free-market price, respectively. The tender did not provide a fair balance between domestic and foreign manufacturers. CONCLUSION: The drug tender is resource-consuming, laborious, and risky job. Aggregation of individual tenders, on a national level and/or regional ones, is probably the best choice for hospitals in transition countries at this time.


Subject(s)
Developing Countries , Hospitals, Teaching/organization & administration , Pharmaceutical Preparations/economics , Pharmaceutical Preparations/supply & distribution , Public Sector/organization & administration , Costs and Cost Analysis/methods , Data Collection/methods , Drug Industry/economics , Drug Industry/methods , Forecasting , Humans , Pharmaceutical Preparations/classification , Pharmaceutical Services/ethics , Pharmacology, Clinical/ethics , Purchasing, Hospital/economics , Purchasing, Hospital/statistics & numerical data , Time Factors , Workforce , Yugoslavia
9.
Mod Healthc ; 31(44): 24-8, 3, 2001 Oct 29.
Article in English | MEDLINE | ID: mdl-11715736

ABSTRACT

In the rapidly changing group purchasing market, GPOs are focusing on customization to draw new customers and satisfy the ones they have. One particularly daunting challenge for GPOs involves coronary stents. These tiny devices can amount to big dollar volume, but price isn't the only issue.


Subject(s)
Angioplasty, Balloon, Coronary/instrumentation , Group Purchasing/trends , Purchasing, Hospital/methods , Stents/standards , Consumer Behavior , Equipment Design , Group Purchasing/statistics & numerical data , Humans , Purchasing, Hospital/statistics & numerical data , United States
10.
J Health Econ ; 20(3): 395-421, 2001 May.
Article in English | MEDLINE | ID: mdl-11373838

ABSTRACT

This paper empirically examines the relationship between HMO market share and the diffusion of magnetic resonance imaging (MRI) equipment. Across markets, increases in HMO market share are associated with slower diffusion of MRI into hospitals between 1983 and 1993, and with substantially lower overall MRI availability in the mid- and later 1990s. High managed care areas also had markedly lower rates of MRI procedure use. These results suggest that technology adoption in health care can respond to changes in financial and other incentives associated with managed care, which may have implications for health care costs and patient welfare.


Subject(s)
Diffusion of Innovation , Health Maintenance Organizations/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Magnetic Resonance Imaging/statistics & numerical data , Purchasing, Hospital/statistics & numerical data , Catchment Area, Health , Data Collection , Health Maintenance Organizations/economics , Health Services Accessibility/economics , Humans , Insurance, Health, Reimbursement , Magnetic Resonance Imaging/economics , Proportional Hazards Models , Purchasing, Hospital/economics , Regression Analysis , Small-Area Analysis , United States
11.
J Healthc Manag ; 45(5): 317-30; discussion 330-1, 2000.
Article in English | MEDLINE | ID: mdl-11067424

ABSTRACT

Healthcare decision makers and researchers have long been interested in the factors behind medical technology acquisition. The rate of environmental change in recent years has dramatically affected technology acquisition decision making in acute care hospitals. This study examines the relative role of decision-maker influence and environmental factors on the timing of MRI acquisition in hospitals operating in three western states with different levels of environmental uncertainty. The results suggest that the relative influence of decision makers and environmental factors on innovation acquisition timing varies depending on environmental turbulence, and that hospitals acquire new technology as one way of controlling the turbulence in their environments.


Subject(s)
Decision Making, Organizational , Diffusion of Innovation , Purchasing, Hospital/statistics & numerical data , Technology Assessment, Biomedical/statistics & numerical data , California , Hospital Bed Capacity , Hospitals, Teaching , Magnetic Resonance Imaging/instrumentation , Oregon , Ownership , Purchasing, Hospital/organization & administration , Surveys and Questionnaires , Technology, High-Cost , Washington
20.
Infect Control Hosp Epidemiol ; 19(9): 629-34, 1998 Sep.
Article in English | MEDLINE | ID: mdl-9778158

ABSTRACT

OBJECTIVE: We studied hospital costs associated with healthcare worker (HCW) respiratory protection and respirator fit-testing programs recommended by the Centers for Disease Control and Prevention (CDC) and mandated by the Occupational Safety and Health Administration to decrease nosocomial or occupational Mycobacterium tuberculosis (TB). DESIGN: The number and cost of high-efficiency particulate air (HEPA)-filter and dust-mist (DM) respirators for 1989 to 1994 were obtained from study hospital purchasing departments, and the costs of HCW fit-testing and education programs for 1994 were estimated from information provided by infection control practitioners. Costs of N-class respirator programs were estimated for study hospitals using retrospective cost analysis and an observational study. SETTING: Four urban hospitals with, and one rural community hospital without, documented nosocomial or occupational transmission of multidrug-resistant TB. RESULTS: During the study period, four of five hospitals introduced HEPA and DM respirators and respirator education and fit-testing programs. Median costs in 1994 were $83,900 (range, $2,000-$223,000) for respirators and $17,187 (range, $8,736-$26,175) for respiratory fit-testing programs. The projected median annual cost of N95 respirators was $62,023 (range, $270-$422,526). CONCLUSIONS: Compliance with CDC TB guidelines may require a substantial investment. However, outlays for respirators and education and fit-testing programs are more reasonable than would be suggested by analyses that estimated the costs of preventing one case of nosocomial TB.


Subject(s)
Hospital Costs/statistics & numerical data , Infection Control/economics , Inservice Training/economics , Occupational Exposure/prevention & control , Personnel, Hospital/education , Purchasing, Hospital/economics , Respiratory Protective Devices/economics , Tuberculosis, Pulmonary/prevention & control , Cross Infection/prevention & control , Disease Outbreaks/economics , Disease Outbreaks/prevention & control , Equipment and Supplies, Hospital/economics , Florida , Hospitals, Rural/economics , Hospitals, Urban/economics , Humans , Infection Control/methods , Nebraska , New York City , Occupational Health Services/economics , Purchasing, Hospital/statistics & numerical data , Retrospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL
...