Time‐based analysis of total cost of patient episodes

International Journal of Health Care Quality Assurance - 2006
AnttiPeltokorpi1, JaakkoKujala1
1Department of Industrial Engineering and Management, Helsinki University of Technology, Helsinki, Finland

Tóm tắt

PurposeHealthcare in the public and private sectors is facing increasing pressure to become more cost‐effective. Time‐based competition and work‐in‐progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue.Design/methodology/approachPresents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC‐process development approach. The framework is used to analyse hip replacement patient episodes in Päijät‐Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year.FindingsThe work‐in‐progress concept is applicable to healthcare – notably that the DMAIC‐process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient‐in‐process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency.Originality/valuePresents a framework that combines patient‐in‐process and DMAIC‐process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

Từ khóa


Tài liệu tham khảo

Blocher, J., Garrett, R. and Schmenner, R. (1999), “Throughput time reduction: taking one's medicine”, Production and Operations Management, Vol. 8 No. 4, pp. 357‐73.

De Feo, J. and Barnard, W. (2003), Juran Institute's Six Sigma Breakthrough and Beyond: Quality Performance Breakthrough Methods, McGraw‐Hill, New York, NY.

Eddy, D. (2005), “Evidence‐based medicine: a unified approach”, Health Affairs, Vol. 24 No. 1, pp. 9‐17.

Evans, J.H., Hwang, Y. and Nagarajan, N.J. (1997), “Cost reduction and process reengineering in hospitals”, Journal of Cost Management, Vol. 11 No. 3, pp. 20‐7.

Gustafson, D., Helstad, C., Hung, C., Nelson, G. and Batalden, P. (1995), “The total cost of illness: a metric for healthcare reform”, Hospital and Health Services Administration, Vol. 40 No. 1, p. 154.

Harrington, H. (1987), The Improvement Process: How America's Leading Companies Improve Quality, McGraw‐Hill, New York, NY.

Karr, V. (1997), “‘Episode of care’ approach fine tunes case management”, Employee Benefit Plan Review, Vol. 52 No. 5, pp. 46‐7.

Lillrank, P., Kujala, J., Kämäräinen, V. and Kronström, V. (2003), “Patient in process – a new approach to managing patient processes in healthcare”, paper presented at The Hospital of the Future – 3rd International Conference on The Management of Healthcare and Medical Technology, Warwick, 7‐9 September.

MDF (2004), “Keskeneräisen potilaan kustannukset”, Kunnallisalan kehittämissäätiön tutkimusjulkaisut, nro 45, The Municipal Development Fund of Finland (in Finnish).

MSAH (2003), “National project to secure the future of healthcare: access to healthcare and waiting list management”, Memorandums of the Ministry of Social Affairs and Health 2003:33, Ministry of Social Affairs and Health, Finland (summary in English), available at: www.stm.fi/Resource.phx/publishing/documents/1442/summary_en.htx (accessed 12 November 2004).

Peltokorpi, A. (2004), “Keskeneräinen potilas‐konseptin sovellusmahdollisuudet terveydenhuollon kehittämisessä ja toiminnanohjauksessa”, Master's thesis (in Finnish).

Peltokorpi, A. and Kujala, J. (2004), “Application of time based management in the improvement of patient process efficiency”, paper presented at the 1st Conference of the POMS College of Service Operations: Operations Management in Services: Theory and Practice, Columbia University, New York, NY, 3‐4 December.

Shortell, S., Gillies, R., Anderson, D., Erickson, K. and Mitchell, J. (2000), Remaking Health Care in America: The Evolution of Organized Delivery Systems, Jossey‐Bass, San Fransisco, CA.

Stalk, G. and Hout, T. (1990), Competing against Time, The Free Press, London.

Tarte, J. and Bogiages, C. (1992), “Patient‐centred care delivery and the role of information systems”, Computers in Healthcare, Vol. 13 No. 2, pp. 44‐6.

Vissers, J. (1998), “Healthcare management modelling: a process perspective”, Healthcare Management Science, Vol. 1, pp. 77‐85.

Thông tin
Thông tin xuất bản

International Journal of Health Care Quality Assurance

Thông tin tác giả