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New Indicators Based on Personnel Cost for Management Efficiency in a Hospital

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Abstract

A simple and fair benchmarking system or financial indicators for use on the clinical department level have been lacking to evaluate the management efficiency and activity of each clinical department or division of a hospital. New financial indicators have therefore been developed based on personnel costs. Indicator 1: The ratio of marginal profit after personnel cost per personnel cost (RMP). Indicator 2: The ratio of investment (=indirect cost) per personnel cost (RIP). The difference between RMP and RIP demonstrates the operation profit in US Dollars for personnel cost (OPP). A turning point in profitability similar to the break-even point (BEP) and break-even ratio (BER) could be also defined by the combination of the RMP and RIP. The merits of these two indicators are not only the ability to indicate the relationship between the medical profit and the investments in the hospital, but also the capability to demonstrate such indicators as BEP, BER and OPP on a single graph. The two indicators were applied to the hospitals in the National Hospital Organization and to the clinical department in one hospital. Using these two indicators, it was possible to evaluate the management efficiency and medical activity not only in the whole hospital but also in each department and DPC/DRG group. This will be of use to a manager of a hospital in checking the management efficiency of his/her hospital despite the variations among hospitals, departments and divisions.

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References

  1. Cleverley, W. O., The hospital cost index: a new way to assess relative cost-efficiency. Healthc. Financ. Manage. 56 (7)36–42, 2002.

    Google Scholar 

  2. Schuhmann, T. M., Hospital financial performance trends to watch. Healthc. Financ. Manage. 62 (7)59–66, 2008.

    Google Scholar 

  3. Nakagawa, Y., Noguchi, M., Takemura, T., and Yoshihara, H., Change of the management strategy before and after DPC introduction.—Influence on the hospital profit caused by improvement of sickbed turnover ratio. J Jpn Soc Health Care Manage. 9 (4)511–518, 2009.

    Google Scholar 

  4. Balicki, B., Kelly, W. P., and Miller, H., Establishing benchmarks for ambulatory surgery costs. Healthc. Financ. Manage. 49 (9)40–46, 1995.

    Google Scholar 

  5. Melony, W., Benchmarking to improve financial performance. Health Manag. Technol. 16 (2)10–12, 1995.

    Google Scholar 

  6. Diagnosis Related Groups (DRGs) and the Medicare Program: Implications for Medical Technology—A Technical Memorandum. US Congress Office of Technology Assessment, Washington DC, OTA-TM-H-17, 1983.

  7. Fushimi, K., Hashimoto, H., Imanaka, Y., Kuwabara, K., Horiguchi, H., Ishikawa, K., and Masuda, S., Functional mapping of hospitals by diagnosis-dominant case-mix analysis. BMC Health Serv. Res. 7:50, 2007. (http://www.biomedicentral.com/1472-6963/7/50).

    Article  Google Scholar 

  8. Yasunaga, H., Ide, H., Imamura, T., and Ohe, K., Impact of the Japanese diagnosis procedure combination-based payment system on cardiovascular medicine-related costs. Int. Heart J. 46 (5)855–866, 2005.

    Article  Google Scholar 

  9. Yasunaga, H., Ide, H., Imamura, T., and Ohe, K., Influence of Japan’s new diagnosis procedure combination-based payment system on the surgical sector: does it really shorten the hospital stay? Surg. Today. 36 (7)577–585, 2006.

    Article  Google Scholar 

  10. West, T. D., Balas, E. A., and West, D. A., Contrasting RCC, RVU, and ABC for managed care decisions. Healthc. Financ. Manage. 50 (8)54–61, 1996.

    Google Scholar 

  11. Canby, J. B. 4th, Applying activity-based costing to healthcare settings. Healthc. Financ. Manage. 49 (2)50–2, 54–6, 1995.

    Google Scholar 

  12. Tanaka, K., Sato, J., Guo, J., Takada, A., and Yoshihara, H., A simulation model of hospital management based on cost accounting analysis according to disease. J. Med. Syst. 28 (6)689–710, 2004.

    Article  Google Scholar 

  13. Cooper, R., and Kaplan, R., Activity-based systems: measuring the cost of resource usage. Account. Horiz. 6 (3)1–14, 1992.

    Google Scholar 

  14. Kaplan, R., Flexible budgeting in an activity-based costing framework. Account. Horiz. 8 (2)104–109, 1994.

    Google Scholar 

  15. Chan, Y. C. L., Improving hospital cost accounting with activity-based costing. Health Care Manage. Rev. 18 (1)71–77, 1993.

    Google Scholar 

  16. Player, S., Activity-based analyses lead to better decision making. Healthc. Financ. Manage. 52 (8)66–70, 1998.

    Google Scholar 

  17. Biorn, E., Hagen, T., Iversen, T., and Magnussen, J., The effect of activity-based financing on hospital efficiency: a panel data analysis of DEA efficiency scores 1992–2000. Health Care Manage. Sci. 6:271–283, 2003.

    Article  Google Scholar 

  18. Peden, A. L., and Baker, J. J., Allocation physicians’ overhead costs to service: an econometric/accounting-activity based-approach. J. Health Care Finance. 29:57–75, 2002.

    Google Scholar 

  19. Nakagawa, Y., Noguchi, M., Takemura, T., and Yoshihara, H., New accounting system for financial balance based on personnel cost after the introduction of a DPC/DRG system. J. Med. Syst. 2009. (http://www.springerlink.com/content/k1141r4312263602/).

  20. Nakagawa, Y., Noguchi, M., Takemura, T., and Yoshihara, H., The construction of the medical profit analysis system and verification before and after induction of DPC system. Jpn J Med Inform. 28 (2)61–72, 2009.

    Google Scholar 

  21. Tanaka, K., Sato, J., Guo, J., Takada, A., and Yoshihara, H., Cost accounting by diagnosis in a Japanese University Hospital. J. Med. Syst. 28 (5)437–445, 2004.

    Article  Google Scholar 

  22. Mooney, S. E., Russell, M. A., Prairie, B., Savage, C., and Weeks, W. B., Group preanatal care: an analysis of cost. J. Health Care Finance. 34 (4)31–41, 2008.

    Google Scholar 

  23. Gandjour, A., and Lauterbach, K. W., A method for assessing the cost-effectiveness and the break-even point of clinical practice guidelines. Int. J. Technol. Assess. Health Care. 17 (4)503–516, 2001.

    Google Scholar 

  24. Gee, P., DRG do over the need for a service-line strategy. Healthc. Financ. Manage. 60 (8)52–55, 2006.

    Google Scholar 

  25. Nakagawa, Y., Takemura, T., Shirakami, G., and Yoshihara, H., The cost analysis and problems of Day Surgery Unit in the University Hospital-Second Report: study of the performance improvement. J Jpn Soc Hosp Admin. 44 (3)263–272, 2007.

    Google Scholar 

  26. Schreyogg, J., Stargardt, T., Tiemann, O., and Busse, R., Methods to determine reimbursement rates for diagnosis related groups (DRG)—a comparison of nine European countries. Health Care Manage. Sci. 9:215–223, 2006.

    Article  Google Scholar 

  27. Bellanger, M. M., and Tardif, L., Accounting and reimbursement schemes for inpatient care in France. Health Care Manage. Sci. 9:295–305, 2006.

    Article  Google Scholar 

  28. Fattore, G., and Torbica, A., Inpatient reimbursement system in Italy: how do tariffs relate to cost? Health Care Manage. Sci. 9:251–258, 2006.

    Article  Google Scholar 

  29. Makie, T., Miyazaki, M., Kobayashi, S., Yamanaka, T., Kinukawa, N., Hanada, E., and Nose, Y., A simple method for calculating the financial balance of hospital based on proportional dividing. J. Med. Syst. 26 (2)105–112, 2002.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Informatics, Graduate School, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan

    Yoshiaki Nakagawa & Hiroyuki Yoshihara

  2. Kagawa National Children’s Hospital, National Hospital Organization, Zentsuji-cho 2609, Zentsuji City, Kagawa, 765-8501, Japan

    Yoshinobu Nakagawa

Authors
  1. Yoshiaki Nakagawa
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  2. Hiroyuki Yoshihara
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  3. Yoshinobu Nakagawa
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Correspondence to Yoshiaki Nakagawa.

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Nakagawa, Y., Yoshihara, H. & Nakagawa, Y. New Indicators Based on Personnel Cost for Management Efficiency in a Hospital. J Med Syst 35, 625–637 (2011). https://doi.org/10.1007/s10916-009-9400-8

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  • DOI: https://doi.org/10.1007/s10916-009-9400-8

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