Cost accountancy and cost control in hospitals

It is a fact that there now exists a sound framework of accounting theory to ascertain the working results and the investment status of hospitals. Yet, there is no system of accounting in practice to conduct its activities with utmost efficiency. No attempts have hitherto been made for the continuous improvement in the servics rendered by hospitals. Personal investments in hospitals have made the interaction of business to some extent.Planning, decision making and control assume increasing importance as hospitals grow in size and complexity. Moreover, wise and effective utilisation of resources should be ensured. The importance of cost cannot be overlooked in this context. Cost is the most effective factor in the determination of the prices of hospital services rendered. The important managerial functions have to rely heavily on accurate and timely cost information. More people can be provided with services if no services cost more than what is a must to provide the necessary level of care. The price paid for high cost technology for a few is no technology at all for the many. Hence no pains must be spared in ascertaining, presenting, controlling and reducing costs. An effective system of Cost Accountancy and Cost Control is imperative for the survival of hospitals in the intensely competitive conditions of today. The valuable objective of "better patient care" can be attained only if the management can make use of the various tools and techniques to ascertain, control and reduce each item of cost in hospitals. Constant efforts must be made by the management to continuously improve their services and bring down costs and prices of all hospital services. Cost Accountancy has made its impresssive impact on almost all the spheres of human activities. It is high time a comprehensive Cost Accountancy and Cost Control system be implemented in hospitals. The problem under study thus is the designing of a sound and full-fledged Cost Accountancy and Cost Control system that suits the requirements of hospitals. It is for the first time in India during the evolution of Cost Accountancy that a comprehensive cost system is tried in hospitals.

Analysis and Control of Robot Manipulators with Kinematic Redundancy

A closed-form solution formula for the kinematic control of manipulators with redundancy is derived, using the Lagrangian multiplier method. Differential relationship equivalent to the Resolved Motion Method has been also derived. The proposed method is proved to provide with the exact equilibrium state for the Resolved Motion Method. This exactness in the proposed method fixes the repeatability problem in the Resolved Motion Method, and establishes a fixed transformation from workspace to the joint space. Also the method, owing to the exactness, is demonstrated to give more accurate trajectories than the Resolved Motion Method. In addition, a new performance measure for redundancy control has been developed. This measure, if used with kinematic control methods, helps achieve dexterous movements including singularity avoidance. Compared to other measures such as the manipulability measure and the condition number, this measure tends to give superior performances in terms of preserving the repeatability property and providing with smoother joint velocity trajectories. Using the fixed transformation property, Taylor's Bounded Deviation Paths Algorithm has been extended to the redundant manipulators.

Subclinical mastitis caused by staphylococcus aureus: Analysis cost benefit of antibiotic therapy in lactating cows

The cost benefit analysis of treatment of bovine subclinical mastitis caused by S. aureus was evaluated. Two hundred and seventy udder quarters with subclinical mastitis and healthy were selected in four groups, in conformity to lactational stage and with the treatment or not. Group 1 included treated animals 10 to 60 days in milk; group 2 included treated animals 61 days in milk until two months before the end of lactation; group 3 included animals not treated 10 to 60 days in milk; group 4 included animals not treated from 61 days in milk until two months before the end of lactation. Treatment with gentamicin (150 mg) was accomplished by intramammary doses, once a day, after sensitivity tests. The mammary quarters were evaluated after 30 days again. The costs with the treatment were calculated considering a S. aureus prevalence of 5%, expenses with antibiotic, loss in milk, tests of sensitivity and workload. There was loss of income of 2% and 14% in the groups 1 and 2, respectively, when compared with the incomes before treatment. In such case, the treatment of bovine subclinical mastitis by S. aureus in the lactation was economically not practicable.

Representation and analysis of control surface freeplay nonlinearity

Different representations for a control surface freeplay nonlinearity in a three degree of freedom aeroelastic system are assessed. These are the discontinuous, polynomial and hyperbolic tangent representations. The Duhamel formulation is used to model the aerodynamic loads. Assessment of the validity of these representations is performed through comparison with previous experimental observations. The results show that the instability and nonlinear response characteristics are accurately predicted when using the discontinuous and hyperbolic tangent representations. On the other hand, the polynomial representation fails to predict chaotic motions observed in the experiments. (c) 2012 Elsevier Ltd. All rights reserved.

Numerical analysis of control surface effects on AUV

Computational fluid dynamics, CFD, is becoming an essential tool in the prediction of the hydrodynamic efforts and flow characteristics of underwater vehicles for manoeuvring studies. However, when applied to the manoeuvrability of autonomous underwater vehicles, AUVs, most studies have focused on the de- termination of static coefficients without considering the effects of the vehicle control surface deflection. This paper analyses the hydrodynamic efforts generated on an AUV considering the combined effects of the control surface deflection and the angle of attack using CFD software based on the Reynolds-averaged Navier–Stokes formulations. The CFD simulations are also independently conducted for the AUV bare hull and control surface to better identify their individual and interference efforts and to validate the simulations by comparing the experimental results obtained in a towing tank. Several simulations of the bare hull case were conducted to select the k –ω SST turbulent model with the viscosity approach that best predicts its hydrodynamic efforts. Mesh sensitivity analyses were conducted for all simulations. For the flow around the control surfaces, the CFD results were analysed according to two different methodologies, standard and nonlinear. The nonlinear regression methodology provides better results than the standard methodology does for predicting the stall at the control surface. The flow simulations have shown that the occurrence of the control surface stall depends on a linear relationship between the angle of attack and the control surface deflection. This type of information can be used in designing the vehicle’s autopilot system.

3-Phase Rectifier System with very demanding dynamic load: Architecture analysis and control strategy

A distributed power architecture for aerospace application with very restrictive specifications is analyzed. Parameters as volume, weight and losses are analyzed for the considered power architectures. In order to protect the 3 phase generator against high load steps, an intermediate bus (based in a high capacitance) to provide energy to the loads during the high load steps is included. Prototypes of the selected architecture for the rectifier and EMI filter are built and the energy control is validated.

Global instability analysis and control of three-dimensional long open cavity flow

The three-dimensional wall-bounded open cavity may be considered as a simplified geometry found in industrial applications such as leading gear or slotted flats on the airplane. Understanding the three-dimensional complex flow structure that surrounds this particular geometry is therefore of major industrial interest. At the light of the remarkable former investigations in this kind of flows, enough evidences suggest that the lateral walls have a great influence on the flow features and hence on their instability modes. Nevertheless, even though there is a large body of literature on cavity flows, most of them are based on the assumption that the flow is two-dimensional and spanwise-periodic. The flow over realistic open cavity should be considered. This thesis presents an investigation of three-dimensional wall-bounded open cavity with geometric ratio 6:2:1. To this aim, three-dimensional Direct Numerical Simulation (DNS) and global linear instability have been performed. Linear instability analysis reveals that the onset of the first instability in this open cavity is around Recr 1080. The three-dimensional shear layer mode with a complex structure is shown to be the most unstable mode. I t is noteworthy that the flow pattern of this high-frequency shear layer mode is similar to the observed unstable oscillations in supercritical unstable case. DNS of the cavity flow carried out at different Reynolds number from steady state until a nonlinear saturated state is obtained. The comparison of time histories of kinetic energy presents a clearly dominant energetic mode which shifts between low-frequency and highfrequency oscillation. A complete flow patterns from subcritical cases to supercritical case has been put in evidence. The flow structure at the supercritical case Re=1100 resembles typical wake-shedding instability oscillations with a lateral motion existed in the subcritical cases. Also, This flow pattern is similar to the observations in experiments. In order to validate the linear instability analysis results, the topology of the composite flow fields reconstructed by linear superposition of a three-dimensional base flow and its leading three-dimensional global eigenmodes has been studied. The instantaneous wall streamlines of those composited flows display distinguish influence region of each eigenmode. Attention has been focused on the leading high-frequency shear layer mode; the composite flow fields have been fully recognized with respect to the downstream wave shedding. The three-dimensional shear layer mode is shown to give rise to a typical wake-shedding instability with a lateral motions occurring downstream which is in good agreement with the experiment results. Moreover, the spanwise-periodic, open cavity with the same length to depth ratio has been also studied. The most unstable linear mode is different from the real three-dimensional cavity flow, because of the existence of the side walls. Structure sensitivity of the unstable global mode is analyzed in the flow control context. The adjoint-based sensitivity analysis has been employed to localized the receptivity region, where the flow is more sensible to momentum forcing and mass injection. Because of the non-normality of the linearized Navier-Stokes equations, the direct and adjoint field has a large spatial separation. The strongest sensitivity region is locate in the upstream lip of the three-dimensional cavity. This numerical finding is in agreement with experimental observations. Finally, a prototype of passive flow control strategy is applied.

President's Private Sector Survey on Cost Control : report on the Environmental Protection Agency, the Small Business Administration and the Federal Emergency Management Agency.

J. Peter Grace, Executive Committee Chairman.

President's Private Sector Survey on Cost Control : report on financial asset management.

Also known as The Grace report.

President's Private Sector Survey on Cost Control : report on the Department of the Navy.

"Approved by the Subcommittee for the Full Executive Committee, spring-fall 1983."

President's Private Sector Survey on Cost Control : report on personnel management.

Distributed to depository libraries in microfiche.

President's Private Sector Survey on Cost Control : report on Department of Health and Human Services, Public Health Service/Health Care Financing Administration.

Mode of access: Internet.