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Journal of Health Organization and... May 2019The purpose of this paper is to identify the lean production (LP) practices applied in healthcare supply chain and the existing barriers related to their implementation. (Review)
Review
PURPOSE
The purpose of this paper is to identify the lean production (LP) practices applied in healthcare supply chain and the existing barriers related to their implementation.
DESIGN/METHODOLOGY/APPROACH
To achieve that, a scoping review was carried out in order to consolidate the main practices and barriers, and also to evidence research gaps and directions according to different theoretical lenses.
FINDINGS
The findings show that there is a consensus on the potential of LP practices implementation in healthcare supply chain, but most studies still report such implementation restricted to specific unit or value stream within a hospital.
ORIGINALITY/VALUE
Healthcare organizations are under constant pressure to reduce costs and wastes, while improving services and patient safety. Further, its supply chain usually presents great opportunities for improvement, both in terms of cost reduction and quality of care increase. In this sense, the adaptation of LP practices and principles has been widely accepted in healthcare. However, studies show that most implementations fall far short from their goals because they are done in a fragmented way, and not from a system-wide perspective.
Topics: Cost Control; Delivery of Health Care; Efficiency, Organizational; Humans; Quality of Health Care
PubMed: 31122116
DOI: 10.1108/JHOM-06-2018-0176 -
Health Policy (Amsterdam, Netherlands) Jan 2019Unsustainable growth in healthcare expenditure demands effective cost-containment policies. We review policy effectiveness using total payer expenditure as primary...
Unsustainable growth in healthcare expenditure demands effective cost-containment policies. We review policy effectiveness using total payer expenditure as primary outcome measure. We included all OECD member states from 1970 onward. After a rigorous quality appraisal, we included 43 original studies and 18 systematic reviews that cover 341 studies. Policies most often evaluated were payment reforms (10 studies), managed care (8 studies) and cost sharing (6 studies). Despite the importance of this topic, for many widely-used policies very limited evidence is available on their effectiveness in containing healthcare costs. We found no evidence for 21 of 41 major groups of cost-containment policies. Furthermore, many evaluations displayed a high risk of bias. Therefore, policies should be more routinely and rigorously evaluated after implementation. The available high-quality evidence suggests that the cost curve may best be bent using a combination of cost sharing, managed care competition, reference pricing, generic substitution and tort reform.
Topics: Cost Control; Health Care Costs; Health Policy; Humans
PubMed: 30429060
DOI: 10.1016/j.healthpol.2018.10.015 -
Clinical Microbiology and Infection :... Dec 2010Healthcare delivery in the USA and abroad has changed dramatically over the last several decades. Along with the growth in diagnostic and therapeutic interventions, the... (Review)
Review
Healthcare delivery in the USA and abroad has changed dramatically over the last several decades. Along with the growth in diagnostic and therapeutic interventions, the costs of healthcare have escalated out of proportion relative to other aspects of the economy. This growth has fostered careful scrutiny of both the effectiveness and efficiency of healthcare delivery. Because of this emphasis on the economics of healthcare, physicians require an understanding not only of the efficacy and clinical utility of their interventions, but also of the relative value in an economic sense of their efforts. In other words, physicians in the modern era must now appreciate the concept of cost-effectiveness. Cost-effectiveness and cost-utility analyses are critical evaluative tools. Explicit data on comparative cost-effectiveness are useful for allocating the increasingly stretched healthcare resources. This article provides a primer for understanding the methods and applications of cost-effectiveness and cost-utility analyses.
Topics: Communicable Diseases; Comparative Effectiveness Research; Cost Control; Cost-Benefit Analysis; Cross Infection; Delivery of Health Care; Health Care Costs; Humans; Outcome Assessment, Health Care; Treatment Outcome; United States
PubMed: 20673258
DOI: 10.1111/j.1469-0691.2010.03331.x -
International Journal of Environmental... Jun 2020Biologic drugs represent a large and growing portion of health expenditures. Increasing the use of biosimilars is a promising option for controlling spending growth in...
Biologic drugs represent a large and growing portion of health expenditures. Increasing the use of biosimilars is a promising option for controlling spending growth in pharmaceutical care. Amid the considerable uncertainty concerning physicians' decision to prescribe biosimilars, explicit cost control measures may help increase biosimilar use. We analyze the role of regional cost control measures for biosimilars and their association with physician prescriptions in ambulatory care in Germany. We collect data on cost control measures implemented by German physician associations and national claims data on statutory health insurance covering 2009 to 2015. We perform panel regressions that include time and physician fixed effects to identify the average associations between cost control measures and biosimilar share/use while controlling for unobserved physician heterogeneity, patient structure, and socioeconomic factors. We identify 44 measures (priority prescribing, biosimilar quota) for erythropoiesis-stimulating substances, filgrastim, and somatropin. Estimates of cost control measures and their consequences for biosimilar share and use are heterogeneous by drug, measure type, and physician group. Across specialists, biosimilar quotas accounted for 5.13% to 9.75% of the total average biosimilar share of erythropoiesis-stimulating substances. Explicit quota regulations are more effective than priority prescribing. Regional variation in biosimilar use can be partly attributed to the presence of cost control measures.
Topics: Aged; Biosimilar Pharmaceuticals; Cost Control; Drug Costs; Filgrastim; Germany; Humans; Male; Physicians
PubMed: 32526943
DOI: 10.3390/ijerph17114113 -
The Milbank Quarterly Mar 2021Policy Points Fixing the ACA requires real cost containment in addition to better subsidies. Private Medicare (Medicare Advantage) plans are uniquely empowered to...
Policy Points Fixing the ACA requires real cost containment in addition to better subsidies. Private Medicare (Medicare Advantage) plans are uniquely empowered to control costs and deliver good care. Medicare Advantage plans should serve as the public option on the ACA Marketplace. Medicare Advantage plans can also be deployed to voluntarily raise minimum employer-sponsored benefits and contain their costs.
Topics: Cost Control; Fee Schedules; Health Expenditures; Humans; Medicare Part C; National Health Insurance, United States; Patient Protection and Affordable Care Act; Public Opinion; United States
PubMed: 33463775
DOI: 10.1111/1468-0009.12499 -
Applied Health Economics and Health... Aug 2017Between 2000 and 2013, spending on medicines in Korea increased by 275.3%. In order to curb this trend, several pricing policies and measures were introduced. This study... (Review)
Review
Between 2000 and 2013, spending on medicines in Korea increased by 275.3%. In order to curb this trend, several pricing policies and measures were introduced. This study reviews these policies and their implications based on pricing regulations as well as a literature review. New medicines now undergo both a reimbursement assessment and price negotiations. The reimbursement of new medicines is based on their cost effectiveness. The prices of new medicines are subsequently fixed through negotiations between the payer, the National Health Insurance Service, and the relevant manufacturer. Generic drugs are automatically priced via a new standard methodology. Repricing mechanisms were complicated and now redundant. Simple and efficient measures rather than complex and inefficient measures are needed to maintain the value-for-money principle for new medicines as well as achieve financial efficiency through price competition among generic drugs.
Topics: Cost Control; Drug Costs; Health Policy; Humans; Republic of Korea
PubMed: 28138932
DOI: 10.1007/s40258-017-0307-0 -
Journal of Medical Radiation Sciences Jun 2018Recent technological advances in radiation therapy have allowed for greater accuracy in planning and treatment delivery. The development of hypofractionated radiation... (Review)
Review
Recent technological advances in radiation therapy have allowed for greater accuracy in planning and treatment delivery. The development of hypofractionated radiation treatment regimens is an example, and has the potential to decrease the cost per episode of care, relative to conventional treatments. Our aim was to analyse published literature on the cost-effectiveness and budgetary implications of hypofractionated radiation therapy. As such, this article will quantify the projected health care cost savings and address the optimal means of treatment delivery, associated patient outcomes, and implications arising from an increased use of hypofractionated regimens.
Topics: Cost Control; Health Care Costs; Humans; Radiation Dose Hypofractionation; Radiotherapy
PubMed: 29532613
DOI: 10.1002/jmrs.273 -
Cytotherapy Jul 2022Over the last decade, cancer immunotherapy has progressed from an academically interesting field to one of the most promising forms of new treatments in which not the...
Over the last decade, cancer immunotherapy has progressed from an academically interesting field to one of the most promising forms of new treatments in which not the cancer but the immune system is treated. In particular, genetic modification for purposeful redirection of autologous T cells is providing hope to many treatment-resistant patients. This personalized form of medicine is radically different from more traditional oncologic drugs. With these evolving medical advancements and more cellular therapies becoming available, some regulatory agencies have created new regulatory requirements to manage the production of these types of products. The regulations are specifically suited for the manufacture of gene and cell therapy products, as they use a risk-based approach towards product development and manufacturing, when there is limited characterization available. The correct interpretation of how and when requirements apply is crucial, since theoretical approaches to implementing GMP can easily lead to disproportionate and unwarranted restrictions that may not address the specific risks that regulators were intending to control. This is especially relevant for cell collection and biopreservation preceding the manufacturing process for products manufactured from autologous T cells. Both the fresh and cryopreserved apheresis materials can be filed as minimally manipulated starting materials to the authorities. The preservation of such cellular material can then routinely be managed using the available regulations for tissues and cells, allowing for a more fit-for-purpose approach to the control measures implemented.
Topics: Cell- and Tissue-Based Therapy; Cost Control; Cryopreservation; Humans; Neoplasms
PubMed: 35304076
DOI: 10.1016/j.jcyt.2022.02.004 -
Computational Intelligence and... 2022Under the background of the Internet of things (IoT), the problems between the actual production and the environment are also prominent. The environmental cost control...
Under the background of the Internet of things (IoT), the problems between the actual production and the environment are also prominent. The environmental cost control in the production process of manufacturing enterprises are discussed to reduce the environmental cost and promote the improvement of production efficiency. First, the environmental cost under the background of IoT is analyzed. Also, the environmental cost control methods in the production process of traditional manufacturing enterprises are investigated. Second, based on the principle of traditional genetic algorithm, the fast-nondominated sorting genetic algorithm (NSGA-II) of multiobjective genetic algorithm is introduced to complete the optimization of BP neural network (BPNN) algorithm in deep learning (DL), and the multiobjective GA optimization BPNN model is established. Finally, the multiobjective GA algorithm is used to empirically analyze the environmental cost control capability of a paper-making enterprise. It is compared with enterprises with excellent and poor environmental cost control capabilities in the same industry to find out secondary indexes. The results show that environmental costs have long-term and economic characteristics. The global search ability of BPNN optimized by multiobjective GA is improved, and the local optimal dilemma is avoided. Through empirical analysis, it is found that the comprehensive capability of the environmental cost control of the enterprise is better, scored 79 or more, and the indexes of insufficient development and advantages are obtained. As IoT rapidly develops, it is necessary to further improve the ability of enterprises in environmental cost management, which is very important to promote the development of enterprises and enhance their core competitiveness. It is hoped that this investigation can provide certain reference significance for improving the environmental cost management capability of enterprises, increasing production efficiency, and reducing environmental costs.
Topics: Algorithms; Cost Control; Deep Learning; Internet of Things; Neural Networks, Computer
PubMed: 36210986
DOI: 10.1155/2022/1721157 -
The Virtual Mentor : VM Nov 2012
Topics: Cost Control; Health Care Rationing; Humans; Social Responsibility
PubMed: 23351892
DOI: 10.1001/virtualmentor.2012.14.11.fred1-1211