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.

“A Study on Human Resource Management Practices in Private Hospitals in Kerala”

The healthcare sector in Kerala is witnessing a spiralling growth due to the healthy economic development and the serious outlook of individuals towards personal health. Private sector is thriving exuberantly well since there is a wide gap between demand and supply for healthcare due to the lack of government initiatives. The proliferation of these private hospitals have paved the way for many unhealthy practices like poor working conditions, low wages, excess workload and lack of retirement and welfare measures to the employees. This state of affairs demanded a serious investigation into the functioning of the private hospitals in Kerala, especially on the human resource management practices, as the success of every organisation depends on the satisfaction level of its employees, which, in turn, will benefit the consumer, i.e., the patients. Hence the present study was undertaken to find out the extent of human resource management practices in private hospitals in Kerala with a view to suggest appropriate remedial measures wherever required

Catalogue Interfaces of Integrated Library Management Systems (ILMS): Experiences in a Proprietary and Open Source Software

The Central Library of Cochin University of Science and Technology (CUSAT) has been automated by proprietary software (Adlib Library) since 2000. After 11 years, in 2011, the university authorities decided to shift to an open source software (OSS), for integrated library management system (ILMS), Koha for automating the library housekeeping operations. In this context, this study attempts to share the experiences in cataloging with both type of software. The features of the cataloging modules of both the software are analysed on the badis of certain check points. It is found that the cataloging module of Koha is almost in par with that of proven proprietary software that has been in market for the past 25 years. Some suggestions made by this study may be incorporated for the further development and perfection of Koha.

A survey of the distribution of information regarding hearing loss to parents by hospitals and pediatricians in the St. Louis area

This paper discusses a survey undertaken to review information on hearing loss distributed by St. Louis area hospitals and pediatricians.

Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses

OBJECTIVES: To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN: Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta-regression to investigate the effects of dementia and of study quality and design. DATA SOURCES: Medline, CINAHL, Embase, PsychInfo, Cochrane Database, Clinical Trials Register, and hand searching of references from reviews and guidelines to January 2005. RESULTS: 1207 references were identified, including 115 systematic reviews, expert reviews, or guidelines. Of the 92 full papers inspected, 43 were included. Meta-analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 (95% confidence interval 0.68 to 0.997) for falls but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies) the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes; removal of physical restraints in either setting; fall alarm devices in either setting; exercise in care homes; calcium/vitamin D in care homes; changes in the physical environment in either setting; medication review in hospital) meta-analysis was either unsuitable because of insufficient studies or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta-regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. CONCLUSION: There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, however, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes.

Comparative performance of UK PFI and non-PFI hospitals

Since the first PFI hospital was established in 1994, many debates centred on the value for money and risk transfer in PFIs. Little concern is shown with PFI hospitals’ performance in delivering healthcare. Exploratory research was carried out to compare PFI with non‐PFI hospital performance. Five performance indicators were analysed to compare differences between PFI and non‐PFI hospitals, namely the length of waiting, the length of stay, MRSA infection rate, C difficile infection rate and patient experience. Data was collected from various government bodies. The results show that only some indexes measuring patient experience emerge statistically significant. This leads to a conclusion that PFI hospitals may not perform better than non‐PFI hospitals but they are not worse than non‐PFI hospitals in the delivery of services. However, future research needs to pay attention to reliability and validity of data sets currently available to undertake comparison.

A buffering layer to support derived types and proprietary networks for Java HPC

MPJ Express is our implementation of MPI-like bindings for Java. In this paper we discuss our intermediate buffering layer that makes use of the so-called direct byte buffers introduced in the Java New I/O package. The purpose of this layer is to support the implementation of derived datatypes. MPJ Express is the first Java messaging library that implements this feature using pure Java. In addition, this buffering layer allows efficient implementation of communication devices based on proprietary networks such as Myrinet. In this paper we evaluate the performance of our buffering layer and demonstrate the usefulness of direct byte buffers. Also, we evaluate the performance of MPJ Express against other messaging systems using Myrinet and show that our buffering layer has made it possible to avoid the overheads suffered by other Java systems such as mpiJava that relies on the Java Native Interface.

A buffering layer to support derived types and proprietary networks for Java HPC

MPJ Express is our implementation of MPI-like bindings for Java. In this paper we discuss our intermediate buffering layer that makes use of the so-called direct byte buffers introduced in the Java New I/O package. The purpose of this layer is to support the implementation of derived datatypes. MPJ Express is the first Java messaging library that implements this feature using pure Java. In addition, this buffering layer allows efficient implementation of communication devices based on proprietary networks such as Myrinet. In this paper we evaluate the performance of our buffering layer and demonstrate the usefulness of direct byte buffers. Also, we evaluate the performance of MPJ Express against other messaging systems using Myrinet and show that our buffering layer has made it possible to avoid the overheads suffered by other Java systems such as mpiJava that relies on the Java Native Interface.