Search

OBJECTIVES Lung volume reduction surgery (LVRS) is a clinically effective palliation procedure for patients with chronic obstructive pulmonary disease. LVRS has recently been commissioned by the NHS England. In this study, a costing model was developed to analyse cost and resource implications of different LVRS procedures. METHODS Three pathways were defined by their surgical procedures: bronchoscopic endobronchial valve insertion (EBV-LVRS), video-assisted thoracic surgery LVRS and robotic-assisted thoracic surgery LVRS. The costing model considered use of hospital resources from the LVRS decision until 90 days after hospital admission. The model was calibrated with data obtained from an observational study, electronic health records and expert opinion. Unit costs were obtained from the hospital finance department and reported in 2021 Euros. RESULTS Video-assisted thoracic surgery LVRS was associated with the lowest cost at €12 896 per patient. This compares to the costs of EBV-LVRS at €15 598 per patient and €13 305 per patient for robotic-assisted thoracic surgery LVRS. A large component of EBV-LVRS costs were accrued secondary to complications, including revision EBV-LVRS. CONCLUSIONS This study presents a comprehensive model framework for the analysis of hospital-related resource use and costs for the 3 surgical modalities. In the future, service commissioning agencies, hospital management and clinicians can use this framework to determine their modifiable resource use (composition of surgical teams, use of staff and consumables, planned length of stay and revision rates for EBV-LVRS) and to assess the potential cost implications of changes in these parameters. [ABSTRACT FROM AUTHOR]

Before 1948, approximately one‐third of the United Kingdom (UK)'s hospital beds were located in voluntary hospitals, many of which continued to benefit from the funds generated by their historic endowments. When the National Health Service (NHS) was created, the vast majority of these hospitals were taken over by the State. This paper examines the neglected question of what happened to these endowments and the role which charity continued to play in the funding of NHS hospitals more generally. It makes an explicit attempt to examine the development of hospital services in each of the UK's constituent nations and shows how the treatment of endowments and the role of charity differed between them. It also highlights the continuing importance of arguments over the 'boundaries' between 'essential' and 'non‐essential' forms of health service expenditure, and between the roles of the statutory and voluntary sectors more generally. [ABSTRACT FROM AUTHOR]

To examine whether hospital closure is associated with high levels of area socioeconomic disadvantage and racial/ethnic minority composition. Pooled cross-sectional analysis (2007–2018) of 6467 U.S. hospitals from the American Hospital Association's Annual Survey, comparing hospital population characteristics of closed hospitals to all remaining open hospitals. We used multilevel mixed-effects logistic regression models to assess closure as a function of population characteristics, including area deprivation index ([ADI], a composite measure of socioeconomic disadvantage), racial/ethnic composition, and rural classification, nesting hospitals within hospital service areas (HSAs) and hospital referral regions. Secondary analyses examined public or private hospital type. Overall, 326 (5.0%) of 6467 U.S. hospitals closed during the study period. In multivariable models, hospitals in HSAs with a higher burden of socioeconomic disadvantage (per 10% above median ADI ZIP codes, AOR 1.05; 95% CI, 1.01–1.09) and Black Non-Hispanic composition (highest quartile, AOR 4.03; 95% CI, 2.62–6.21) had higher odds of closure. We did not observe disparities in closure by Hispanic/Latino composition or rurality. Disparities persisted for Black Non-Hispanic communities, even among HSAs with the lowest burden of disadvantage. Disproportionate hospital closure in communities with higher socioeconomic disadvantage and Black racial composition raises concerns about unequal loss of healthcare resources in the U.S. [ABSTRACT FROM AUTHOR]

The article describes a legal dispute regarding the classification of a hospital in the emergency care level in the hospital plan. The clinic, the operator of the hospital, demands the designation as a hospital for specialized care within the framework of emergency care. The hospital offers, among other things, palliative medicine, internal medicine, and geriatrics, and has a department for palliative medicine as well as a dementia ward. The Joint Federal Committee has discretionary power in deciding whether a hospital is designated as a hospital for specialized care. The case was heard before the Administrative Court of Schleswig-Holstein. The X-Hospital in A-City has filed a lawsuit against the decision of the Joint Federal Committee regarding structured emergency care. The lawsuit was partially successful. The hospital has subjective rights according to the provisions of § 26 paragraph 2 NFS-R. According to the Hospital Structure Act, the Joint Federal Committee has decided on a tiered system of emergency structures in hospitals. The specialized care module allows certain facilities to participate in emergency care, even if they do not meet all the requirements of the tiered emergency care. The judgment of the Federal Administrative Court of October 21, 1986 deals with the provisions of § 26 paragraph 2 NFS-R, which grant the hospital planning authority discretionary power. These provisions serve both the public interest in a functioning emergency care system and the economic interest of the hospitals. The claim for a new decision according to § 26 paragraph 2 NFS-R is justified, but there is no entitlement to the designation of the hospital as a hospital for specialized care. The decision on special facilities and their remuneration lies with the GKV-Spitzenverband, the Association of Private Health Insurance, and the German Hospital Association. The present text deals with the interpretation of § 26 paragraph 2 No. 2 and No. 3 Alt. 1 NFS-R with regard to the discretionary power of the hospital planning authority. It is stated that the wording of the provision does not contain precise requirements for the designation of a facility as a "special facility for emergency care" and thus leaves the authority with a broad scope for decision-making. It is also pointed out that the courts only review the hospital target planning to determine whether it has been carried out within the framework of the laws and regulations of the Hospital Financing Act. The judicial review is limited to whether the authority has complied with the valid procedural provisions and has fully and correctly determined the facts. The article deals with the legal situation regarding the designation of hospitals as special facilities for emergency care. It is noted that the hospital planning authority has the final decision-making authority and discretionary power. It is argued that the authority's decision must not be arbitrary and that judicial review is limited in cases where there are no standardized requirements and there is room for decision-making. It is stated that the authority's decision not to designate a hospital's palliative facility as a special facility for emergency care was not sufficiently justified and is therefore unlawful. The plaintiff is therefore entitled to a new decision. [Extracted from the article]

Background: Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals in Morocco and craft this database as a resource for further use in a strategic purchasing system. It also aims at estimating the funding gap and the budget that should be secured for public hospitals in Morocco to fully play their roles in the current ambitious reform. Method: A costing study was implemented in 39 hospitals in 12 regions of Morocco (10 provincial hospitals, 11 regional hospitals, and 18 teaching hospitals). Using the hospital costing approach, we adapted and validated nationally our methodology to generate a database of unit costs based on data from 2019. All perspectives on cost were considered. Data collection was performed by cadres from MoH and facilitated by the WHO country office in Morocco. The production of the cost database allowed the development of a bottom-up estimation of the financing size for public health hospitals. Results: The study showed the feasibility of large-scale costing in the context of Morocco. The ownership of MoH and adherence to the process ensured the high quality of the collected data. There are many differences in unit costs for the same services moving from one hospital to another, which indicates existing inefficiencies. The database will contribute to shaping the strategic purchasing mechanism within the generalized health insurance schemes. The studied hospitals could be used as references to systematically update the billing system for health insurance. [ABSTRACT FROM AUTHOR]

Does financial reform improve public good provision? We examine state-level adoption of municipal bankruptcy law. After reform, municipalities' borrowing costs decrease and bonds' issuance increase, particularly for bonds financing hospitals; hospitals' investments increase, particularly when using such bonds; local firms' investment and performance increase, particularly in the construction sector. Ex ante, reform occurs earlier in states with weaker unions, stronger bondholders' interests, and better courts. Similar factors explain congressional voting on municipal bankruptcy law. These results support the hypothesis that financial reform destroys labor union rents and expands investment, highlighting a novel spillover channel from public finance to the real economy. This paper was accepted by Victoria Ivashina, finance. Funding: This work was supported by the Baffi-CAREFIN Research Center at Bocconi. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4800. [ABSTRACT FROM AUTHOR]

Introduction: The sustainability of public hospital financing in Spain is a recurring issue, given its representativeness in annual public healthcare budgets which must adapt to the macroeconomic challenges that influence the evolution of spending. Knowing whether the responsiveness of hospital expenditure to its determinants (need, utilisation, and quasi-prices) varies according to the type of hospital could help better design strategies aimed at optimising performance. Methods: Using SARIMAX models, we dynamically assess unique nationwide monthly activity data over a 14-year period from 274 acute-care hospitals in the Spanish National Health Service network, clustering these providers according to the average severity of the episodes treated. Results: All groups showed seasonal patterns and increasing trends in the evolution of expenditure. The fourth quartile of hospitals, treating the most severe episodes and accounting for more than 50% of expenditure, is the most sensitive to quasi-price factors, particularly the number of beds per hospital. Meanwhile, the first quartile of hospitals, which treat the least severe episodes and account for 10% of expenditure, is most sensitive to quantity factors, for which expenditure showed an elasticity above one, while factors of production were not affected. Conclusions: Belonging to one or another cluster of hospitals means that the determinants of expenditure have a different impact and intensity. The system should focus on these differences in order to optimally modulate expenditure not only according to the needs of the population, but also according to the macroeconomic situation, while leaving hospitals room for manoeuvre in case of unforeseen events. The findings suggest strengthening a network of smaller hospitals (Group 1)–closer to their reference population, focused on managing and responding to chronicity and stabilising acute events–prior to transfer to tertiary hospitals (Group 4)–larger but appropriately sized, specialising in solving acute and complex health problems–when needed. [ABSTRACT FROM AUTHOR]

The Supreme Court (OGH) in Austria has ruled that a plaintiff who is denied medically necessary treatment in a hospital financed by the National Health Fund cannot transfer his claims for damages to the social insurance carrier. The OGH argues that the social insurance carrier must provide benefits regardless of the harmful event and therefore there is no congruence with the plaintiff's claims for damages. The decision is based on the wording of § 332 para. 1 ASVG and the finding that the insurance event of illness did not occur due to the defendant's liability. The OGH emphasizes that the legal assignment only includes claims that cover the damage that the social insurance benefit is also intended to cover. [Extracted from the article]

The purpose of the article. The study aims to analyze how these special rules of financing during the pandemic affected the financial situation of hospitals in Poland. Methodology. We analyzed a sample of 86 Polish hospitals from 2019 to 2021. The financial condition is assessed based on financial ratios and the synthetic measure M1. We employ the Kruskall-Wallis test to confirm the differences between the values of financial ratios in the analyzed period. Results of the research. We confirm that due to the special rules and financing, combined with underperformance, the financial condition of Polish hospitals has slightly improved - especially in the case of operating margin, EAT to debt ratio and ROA. [ABSTRACT FROM AUTHOR]

The National Health Insurance Program (JKN) through the Social Security Administering Body has been running since January 1 2014, the Tenriawaru Regional General Hospital in Bone Regency is one of the hospitals under the auspices of the local government that works closely with BPJS Kesehatan. The Bone Regency Government has registered 237,381 people into the National Health Insurance (JKN) program. In general, this study aims to analyze the economic impact of the implementation of the National Health Insurance (JKN) on hospital income, hospital financing and financial compensation for hospital employees at Tenriawaru Hospital, Kab, Bone. This study uses a qualitative descriptive research method that aims to obtain an in-depth evaluation study on evaluating the economic impact of the implementation of the National Health Insurance (JKN) program on hospitals. The informants in this study totaled 5 people consisting of the Head of Finance Subdivision, the JKN case mix officer, the Head of Service Subdivision, the Head of HR Subdivision and the Head of Public Relations Subsection. The results of the study show that the implementation of the National Health Insurance (JKN) program has an impact on hospital income. The implementation of JKN provides great benefits for the hospital. the implementation of the National Health Insurance (JKN) program also has an impact on hospital financing, JKN covers hospital operational costs, JKN claims have their respective portions for hospital human resources, drug resources and BHP in hospitals. The implementation of the National Health Insurance (JKN) program has no impact on the financial compensation of employees in hospitals, salaries, bonuses and semi-annual incentives that employees get have no effect on the implementation of JKN in service hospitals that get a portion each for the operational needs of the hospital not for employee financial compensation. [ABSTRACT FROM AUTHOR]

We study public versus private provision of health care for veterans aged 65 and older who may receive care provided by the US Department of Veterans Affairs (VA) and in private hospitals financed by Medicare. Utilizing the ambulance design of Doyle et al. (2015), we find that the VA reduces 28-day mortality by 46 percent (4.5 per centage points) and that these survival gains are persistent. The VA also reduces 28-day spending by 21 percent and delivers strikingly different reported services relative to private hospitals. We find suggestive evidence of complementarities between continuity of care, health IT, and integrated care. (JEL H51, I11, I12, I18, J14) [ABSTRACT FROM AUTHOR]

The article deals with a legal dispute regarding the payment of special Corona benefits to healthcare workers in hospitals according to § 26e paragraph 2 sentence 1 of the Hospital Financing Act (KHG). A nurse is suing for the payment of a special benefit, while the hospital she is employed at has received a payment. The State Labor Court has referred the legal dispute to the Administrative Court in Braunschweig. The law serves the economic security of hospitals in order to ensure a high-quality healthcare provision for the population. The jurisdiction for disputes regarding Corona special payments lies with the social courts. [Extracted from the article]

In 2005, Ukraine embarked on hospital financing reforms that included the introduction of a Diagnosis Related Group (DRG) based payment system for acute inpatient care. The primary purpose of introducing activity-based funding was to provide incentives for hospitals to use their limited resources more efficiently.Following an extended period of preparation and planning during which technical assistance was provided by various development agencies, Ukraine took action to implement the DRG system at a national level in April 2018, through a World Bank project. While some progress was made, the execution of the reform faced challenges with the organisation and administration of the implementation process, and duplication of effort. The consequence of these shortcomings was that the newly introduced system was not capable of measuring inpatient DRG activity at a level of accuracy necessary for the determination of hospital performance and the subsequent calculation of payments.If the expected outcomes of DRG implementation in Ukraine are to be realised, stakeholders including both beneficiary agencies and development organisations, will need to improve program governance through better coordination of their activities towards a common goal.

Background: Affordability and accessibility of hospital care are under pressure. Research on hospital care financing focuses primarily on incentives in the financial system outside the hospital. It is notable that little is known about (incentives in) internal funding in hospitals. Therefore, our study focuses on the budget allocation in hospitals: the distribution model. Based on our hypothesis that the reimbursement and distribution models in hospitals might interact, we gain knowledge about-, and insight into, the interaction of different reimbursement and distribution models used in Dutch hospitals, and how they affect the financial output of hospital care. Methods: An online survey with 22 questions was conducted among financial senior management as an expert group in 49 Dutch hospitals. Results: Ultimately, 38 of 49 approached experts fully completed the survey, which amounts to 78% of the hospitals we approached and 60% of all Dutch hospitals. The results on the reimbursement model indicate price * volume with adjusted prices above a maximum cap as the most common dominant contract type. On the internal distribution model, 75–80% of the experts reported incremental budgeting as the dominant budgeting method. Results on the interaction between the reimbursement and the distribution model show that both general and specific changes in contract agreements are only partially incorporated in hospital budgets. In 28 out of 31 hospitals with self-employed medical specialists, a relation is reported between the reimbursement model and the contracts with the Medical Consultant Group(s) in which the medical specialists are united. Conclusions: Our results in Dutch setting indicate a limited interaction between the reimbursement model and the distribution model. This lack of congruence between both models might limit the desired effects of incentives in contractual agreements aimed at the financial output. This applies to different reimbursement and distribution models. Further research into the various interactions and incentives, as visualized in our conceptual framework, could result in evidence-based advice for achieving affordable and accessible hospital care. [ABSTRACT FROM AUTHOR]

Health systems are continuously subjected to challenges of different natures, from the ageing of the population, namely the increase in the number of associated diseases, high costs of financing new technologies to the emergence of pandemics, with a major impact on budgets allocated for health. In 2020, 48% of the funds allocated for health in Romania were spent in hospital units, 25% by retailers and other providers of medical goods, and 14% of the amounts were allocated to outpatient medical service providers. According to the OECD, up to 20% of health expenditure contributes little or no to improving the health status of patients, including unnecessary admissions or average outdated hospitalizations, sets of unnecessary or duplicated analyzes, overstated drug treatments to the detriment of generics, continuous hospitalizations for conditions that can be treated in outpatient settings, etc. Considering the fact that the budget allocated to health in Romania is among the smallest at the level of the Member States of the European Union, it is very important that the allocated amounts are spent as efficiently as possible. This paper carries out a qualitative and quantitative research on the use of funds allocated for health, for the period 2012 - 2022, in six hospital units in the west of the country, in order to verify the level of efficiency of the use of these funds. The results of the research show us the existence of avoidable expenses, which do not bring benefits regarding the health of the patients but put pressure on the budgets of the hospital units. By highlighting these expenses, there are the necessary premises for optimizing the expenses, the amounts thus saved can be used to increase the quality of the medical act and the development necessary to ensure the patients' treatments. [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic had an enormous effect on the health of millions of individuals worldwide and the global economy. A shortage of doctors, nurses, personal protective equipment, and medicines was seen globally. The pandemic drew attention to limitations in the healthcare sector of the United States of America. The massive rise in the daily number of cases, more usage of ICU facilities and all the treatment modalities, and increased overtime compensation for the staff negatively impacted the hospital’s finances. This also affected the mental and physical health of all the healthcare workers. Through additional funding from federal relief legislation and the relaxation of many regulatory requirements, the federal, state, and local governments took significant steps to address the need for prevention and treatment services that arose from COVID-19 and the disruptions in healthcare delivery and finances resulting from the pandemic. Congress enacted the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, on March 27th, 2020. This measure appropriated $2.2 trillion to offer immediate and direct economic assistance to Americans affected by the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

Background: Length of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH. Method: A clinical scoring was developed based on retrospectively collected data from the cerebral aneurysm registry of the National Brain Center Hospital, Jakarta, from January 2019 to June 2022. Multivariate logistic regression was used to determine the odds ratio for risk-adjusted prolonged LOS. LOS predictors were obtained based on the regression coefficients and converted into a point score model. Results: Of the 209 aSAH patients observed, 117 patients had prolonged LOS (> 14 days of hospital stay). A clinical score was developed with a range of 0–7 points. Four variables were chosen as predictors of prolonged LOS: the presence of high-grade aSAH (1 point), aneurysm treatment (endovascular coiling: 1 point; surgical clipping: 2 points), cardiovascular comorbidities (1 point), and hospital-acquired pneumonia (3 points). The score showed good discrimination with an area under the receiving operating characteristics curve (AUC) of 0.8183 (SE 0.0278) and a p-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.9322. Conclusion: This simple clinical score reliably predicted prolonged LOS in aneurysmal subarachnoid hemorrhage cases and may aid clinicians in improving patient outcomes and decreasing healthcare costs. [ABSTRACT FROM AUTHOR]

This study examines the initiation and administration of Mercy Hospital in Republican Shanghai. It explains the protracted negotiations that underpinned the collaboration between the Chinese founder Lu Bohong, the Shanghai Municipal Council (SMC) of the International Settlement and the Municipal Administration (FMA) of the French Concession. Despite mutual needs for a psychiatric hospital, the collaboration was undermined by disputes over funding shares and administrative direction. While Lu expected a symbolic modern philanthropy, the SMC and FMA saw it as an economic tool to relieve the responsibility of regulating refugees and the increasing mental patients. They repeatedly forced Lu to make concessions with financial instruments, but ended up non-cooperation, leading the patrons to compromise to keep their problem solver. However, after Lu's murder and the subsequent dysfunction of the Chinese municipal government, the SMC and FMA could not help but take on this task to protect their settlements from the threat. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted by researchers from the University of Pécs in Hungary, published in the journal "Central European Journal of Public Health," which aimed to assess the impact of Hungary's public health product tax (PHPT) implemented in September 2011. The study found that while the tax generated significant revenue for healthcare and health-promoting programs, it did not effectively change households' purchasing habits of unhealthy food and beverage.

Background: Care for Black patients is concentrated at a relatively small proportion of all US hospitals. Some previous studies have documented quality deficits at Black-serving hospitals, which may be due to inequities in financial resources for care. Objective: To assess disparities in funding between hospitals associated with the proportion of Black patients that they serve. Participants: All Medicare-participating hospitals, 2016–2018. Main Measures: Patient care revenues and profits per patient day at Black-serving hospitals (the top 10% of hospitals ranked by the share of Black patients among all Medicare inpatients) and at other hospitals, unadjusted and adjusted for differences in case mix and hospital characteristics. Key Results: Among the 574 Black-serving hospitals, an average of 43.7% of Medicare inpatients were Black, vs. 5.2% at the 5,166 other hospitals. Black-serving hospitals were slightly larger, and were more often urban, teaching, and for-profit or government (vs. non-profit) owned. Patient care revenues and profits averaged $1,736 and $−17 per patient day respectively at Black-serving hospitals vs. $2,213 and $126 per patient day at other hospitals (p<.001 for both comparisons). Adjusted for patient case mix and hospital characteristics, mean revenues were $283 lower/patient day (p<.001) and mean profits were $111/patient day lower (p<.001) at Black-serving hospitals. Equalizing reimbursement levels would have required $14 billion in additional payments to Black-serving hospitals in 2018, a mean of approximately $26 million per Black-serving hospital. Conclusions: US hospital financing effectively assigns a lower dollar value to the care of Black patients. To reduce disparities in care, health financing reforms should eliminate the underpayment of hospitals serving a large share of Black patients. [ABSTRACT FROM AUTHOR]

We study the effect of losing insurance on psychiatric - mental health disorder (MHD) and substance use disorder (SUD) - hospital-based care. Psychiatric disorders cost the U.S. over $1T each year and hospitalizations provide important and valuable care for patients with these disorders. We use variation in public insurance coverage (Medicaid) eligibility offered by a large-scale and unexpected disenrollment in the state of Tennessee in 2005 that lead to 190,000 individuals losing their insurance. Medicaid enrollees are at elevated risk for psychiatric disorders. Following the disenrollment, hospitalizations for SUDs declined by 15.4%. Findings suggest that MHD hospitalizations declined by 4.2%, but the coefficient estimate is imprecise. The expected financing of hospital care received also changed, with the probability that Medicaid was listed as the expected payer for MHD and SUD hospitalizations declining by 27.5% and 30.8% respectively post-disenrollment. We provide suggestive evidence that psychiatric health declined post-disenrollment. [ABSTRACT FROM AUTHOR]

Background: Accurate potassium measurements are necessary for effective clinical management of hyperkalaemia. Pre-analytical factors may affect laboratory measurements, leading to erroneous results and inappropriate patient management and negatively impact the efficiency and finances of laboratories and hospitals. Objective: This study evaluated the impact of rejected potassium test requests on laboratory service. Methods: We conducted a retrospective descriptive study to assess potassium test data at a public laboratory in Pretoria, Gauteng, South Africa, using samples collected from an academic hospital, peripheral hospitals, and outpatient clinics between January 2018 to December 2018. We assessed the relationship between reasons for rejection and health facility type, as well as financial implications for the laboratory. Results: The potassium result rejection rate was 15.1% (29 806 samples), out of the 197 405 requests received. The most common reasons for rejection were old sample (> 1 day old) (41.4%; 12 348 rejections) and haemolysis (38.2%; 11 398 rejections). The most frequent reason for rejections at the central, academic hospital was haemolysis (42.0%), while old sample was the most common reason for rejection at peripheral hospitals (43.4%; 4119/9493 requests) and outpatient health facilities (57.2%; 7208/12 605 requests) (p = 0.022). The total cost of potassium sample rejection over the study period was substantial, given the resource constraints in this setting. Conclusion: Peripheral hospitals and outpatient departments accounted for the majority of rejected potassium testing results, possibly resulting from delays in transportation; causing substantial financial impact on the laboratory. Improved sample collection, handling, and expedited transportation are recommended. What this study adds: This study highlights the importance of appropriate sample collection and handling and the undesirable consequences of non-adherence to these pre-analytical considerations. [ABSTRACT FROM AUTHOR]

The August issue of the magazine "GesR: Gesundheitsrecht" contains various articles on legal topics in the healthcare sector. One essay deals with the effects of the reform of partnership law on medical partnerships. Another article deals with the claim to the use of a medication during pregnancy at the expense of the statutory health insurance. The case law comments, among other things, deal with the requirements for a deemed approval and the requirements for communication between outpatient and inpatient pregnancy care. The magazine also includes a list of court decisions and current news from the field of health law, including topics such as compensation for survivors, liability of contracted doctors for prescription forgery, and financing of hospitals. It also refers to a study on the hospital landscape and a pharmaceutical reform, with the information coming from various sources such as the Federal Court of Justice, the Higher Regional Court, and various associations and ministries. [Extracted from the article]

According to a survey by the German Hospital Institute (DKI), hospital employees are increasingly affected by violent attacks. The main causes of violence were identified as a general lack of respect towards hospital staff and long waiting times. Hospitals are trying to prevent such incidents through de-escalation training and structural measures, but they also demand stricter penalties. It is pointed out that police statistics do not reflect the reality in hospitals. Despite hopes for a catch-up effect after the end of the pandemic, the weak growth rates during the pandemic have not been compensated for. It is estimated that there will be a shortage of 30,000 to 50,000 doctors by the year 2040. However, the German healthcare system continues to benefit from the influx of foreign doctors. The boards of the National Association of Statutory Health Insurance Physicians (KBV) express positive views on the draft law to strengthen healthcare provision in municipalities (GVSG) and emphasize the importance of the freedom of self-administration. The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) demands early recognition of healthcare needs, ensuring quality, and adequate financing of hospitals. [Extracted from the article]

This article discusses the cost implications of using biodegradable pancreatic stents compared to conventional plastic stents in the prevention of post-ERCP pancreatitis. The study found that while biodegradable stents have higher item costs, they eliminate the need for additional post-procedure care, such as repeat hospital visits and further endoscopic interventions. The overall costs, taking into account both patient and healthcare expenditure, were found to be similar between the two types of stents. This suggests that biodegradable stents may offer patient care benefits without significantly increasing overall costs. [Extracted from the article]

We study the relationship between diagnosis‐related group (DRG) financing and the availability of computed tomography (CT) scanners in Switzerland. A number of Swiss hospitals switched to DRG payment for a portion of their payments progressively between 2002 and 2011. As of 2012, all hospitals were required to use DRG payment for a substantial portion of reimbursement. We conducted two main analyses. First, we studied hospitals switching in 2002–2011 and estimated event study models to compare changes in CT availability before and after the adoption of DRG financing, using the hospitals that did not switch during this time as a comparison group. In the second, we compared trends in CT availability before and after 2012, for the hospitals that switched in that year. In both analyses, we find a statistically significant association between the switch to DRG financing and lower levels of CT availability. [ABSTRACT FROM AUTHOR]

Based on the development background of the interweaving and integration of computer technology and Internet technology, China's artificial intelligence industry is quietly rising. In the social life of the information age, the artificial intelligence industry represented by machine deep learning is playing a very important role. This study in combination with the background of the new health reform, in view of the reform of the medical industry, analyzes the connotation of financial wisdom based on the important role of the hospital financial development problems, puts forward the development direction of artificial intelligence hospital financial wisdom development measures, designed to meet the changing external environment demand, reduces human costs, and improves the overall efficiency of hospital financial fund management. Based on the evaluation results, this paper proposes the correct direction for the development of hospital intelligence finance by using the BP neural network model. After the analysis, it is found that the development of artificial intelligence is an important measure to promote the development of hospital intelligent finance. In other words, hospital intelligent financial management is the product of the continuous progress of artificial intelligence technology. At the present stage, the intelligent financial management problems of hospitals are mainly as follows: (1) lack of financial informatization, (2) lack of perfect financial risk early warning system, and (3) the phenomenon of "information island" in the financial system. After analyzing the above problems, the research believes that the development of hospital intelligent finance based on artificial intelligence needs to solve the above thorny problems, so as to improve the outcome of hospital intelligent finance development. The following work should be done: (1) strengthen the design of information sharing module, (2) intelligent control of the cost of hospitals, and (3) intelligent treatment of hospital accounting. Combining the development of artificial intelligence and hospital intelligent finance theory, combined with the actual trend of financial intelligence development under the background of artificial intelligence development in the new era, it provides scientific basis for the development of hospital intelligent finance. [ABSTRACT FROM AUTHOR]

Several studies have shown that Medicaid expansion has improved hospital financial performance. All of these studies have either used data from the Internal Revenue Service (IRS) or the Centers for Medicare and Medicaid Services (CMS), and none of them has examined the state-level impact of expansion on hospital finances. Using data for not-for-profit hospitals from both IRS and CMS for 2011-2016, we described the difference in costs related to uncompensated care and Medicaid shortfalls. We then estimated the impact of Medicaid expansion on hospitals' financial status nationally and by state. Nationally, the estimated net effect of expansion reduced not-for-profit hospital costs by 2 percentage points based on IRS data and 0.83 percentage points based on CMS data. Across expansion states, the estimated net effects varied widely with approximately a 10-fold difference for hospitals based on IRS data and a 2-fold difference based on CMS data. Future studies should further explore the differences across IRS and CMS data. [ABSTRACT FROM AUTHOR]

This research is aimed at, first, observing the impacts of the hospital management information system on the financial reports quality of Hospital X. Second, observing the impacts of hospital management information system performance on the financial report quality at Hospital X as moderated by HR competence. The research applied the quantitative method. Three variables were applied to this study, namely independent variable, namely hospital management information system performance. The moderation variable applied was HR competence and the dependent variable applied to this study was Financial Report quality. Its population includes all accounting and IT unit staff with 82 samples. Structural Equation Modeling (SEM) data analysis technique was applied during the data analysis process, whereas for the data input process, the study used SmartPLS software. The research results show that Hospital Management Information System Performance has an impact on the Financial Report Quality and Hospital Management Information System Performance has no impact on Financial Report Quality as moderated by HR competence. [ABSTRACT FROM AUTHOR]

The article reports on the urgency of a hospital reform to ensure high-quality and patient-oriented medical care throughout Germany. The National Association of Statutory Health Insurance Funds emphasizes that the current draft law on hospital reform does not sufficiently achieve the reform goals and a great opportunity could be missed. It is pointed out that the performance structures of hospitals should be defined and made transparent nationwide in order to improve the quality of care. The federal states are seen as obstructing sustainable changes in the healthcare structures. It is also criticized that the draft law provides for exceptions for the federal states and maintains unnecessary structures. The planned increase in the state base rates is seen as a careless handling of contribution funds. It is also pointed out that the draft law predicts high savings potentials but does not provide a concrete derivation of these potentials. The transformation fund for financing hospital structures is criticized because the costs are ultimately to be borne by the contributors to the statutory health insurance funds. It is emphasized that the construction and restructuring of the healthcare infrastructure is a task for society as a whole. [Extracted from the article]

Background: Many residents are exposed to negative attitudes towards primary care during hospital training. Attractive add-on training programs exist, but it is unclear whether these need to be tailored to the location of training (hospital vs. office). We report differences in learner attitudes from a large German add-on training program. Methods: Between 2017 and 2020, a regional network offered 31 quarterly seminars to primary care residents. The seminars addressed medical content, practice management and mentoring. We elicited participants' satisfaction, perceived topic relevance, preferences for future seminars, work situation and employer support for participation. A proportionate odds model was used to assess predictors of ratings; results were stratified by training location (hospital vs. office). Results: Most respondents were female (380/575 = 70.0%), aged between 26 and 40 (80.8%), and had on average 3.54 ± 1.64 years of residency training. The majority (83.8%) was working in an office and full-time (63.0%). Overall evaluations were positive (very satisfactory 72.1%). Comparing residents in the hospital phase vs. the office phase, overall seminar ratings of the perceived impact on the motivation for primary care did not differ (p = 0.73 vs. 0.18, respectively). Hospital-based residents were less likely to rate the topics as relevant (39.4% vs. 55.7%, p = 0.02) and had different preferences for future seminar topics (top 3: palliative care, emergencies and chronic care vs. billing, disease management and practice finances for hospital and office phase, respectively). Conclusions: Keeping primary care residents motivated may require education tailored to training location. Our findings may be of interest to teachers, administrators and policymakers. [ABSTRACT FROM AUTHOR]

Purpose: With rising health-care costs and the financial constraints in most developing countries, prioritization of needs have become an issue of strategic importance in public hospitals. As a result, there is the intense competition of scare resources between core health care and non-core facilities management (FM) services. Given that financial resources are needed to facilitate the smooth operation of the FM department, this paper aims to investigate the direct and indirect effects of finance on the relationship between service quality and performance of hospital FM services. Design/methodology/approach: The paper adopts a quantitative approach following a general questionnaire survey which was conducted on the research population. Partial least squares structural equation modelling was used to investigate the relationships between service quality and performance of hospital FM services. Findings: The study highlights the relevance of service quality to improving FM performance and demonstrate the direct and indirect influence of finance to ensure quality FM services delivery to improve core health care outcomes in hospitals. Practical implications: The result of this study should motivate hospital management to prioritize attention on FM in scare resources management in public hospitals to create and maintain a decent health-care environment for better health outcomes. Further, managerial commitment to facilitate employee training, empowerment, incentives, awards and compensation should be strengthened in the quest of ensuring quality services delivery. Originality/value: The paper extends knowledge by mediating the influence of finance on the relationship between service quality and FM performance. Proposes a parsimonious financial mediation framework which can easily be adaptable to several developing countries health-care FM management. [ABSTRACT FROM AUTHOR]