Hwd Case Study

Financially, the treatment of dialysis in the Philippines is approximately, $ 70.00 for each treatment after insurance. Her treatments are once a week, a total of 280.00 a month, not including any extras According to the daughter, she has dialysis once a week; the payment includes the red blood cells that are necessary for her to survival. RO has insurance in the Philippines and in the United States because of her dual citizenship. Her out of pocket cost is extremely low, compared to others in the Philippines. The monies are being paid from the family pooling together to get their mother the medical treatment that is needed. Here in the Unites States if the patient is not covered by an insurance plan the cost is approximately $ 480.00 for

Overhead costs are the costs of support services that contribute to the effective running of the Aneurin Bevan University Health Board. They are costs not driven by the level of patient activity and are apportioned to service costs because there are no clear patient activity based allocation methods. Examples include the chief executive’s salary, business planning, and human resources.

Irrelevant Costs, Insurance (General Liability, Physical Damage, Workers Compensation, Health insurance), Security, Depreciation, Salaries Benefits, Bad Debt Expense, Permits, Rental Equipment, Payroll Taxes, Accounting Fees, Supplies, Computer Maintenance, Miscellaneous.

I really enjoyed this article, as it went into effective financial planning. The 2 major categories of cost are total charges (the patient's bill) and the cost of providing services. These 2 costs can be defined mathematically in the following indices: average revenue per patient day and the cost per patient day.

After twenty years the true allocation facility cost for the Dialysis Center should be zero, since the facility would be paid off and should have only minimal allocating facility costs such as opportunity costs and costs of using the center. If after the twenty years the building is not occupied it can be used from other medical centers or it could be rented out or sold. It is difficult to try to determine the opportunity costs for space occupied by all activities. The current system of facility allocation assigns equal opportunity cost across all activities and services and avoids the problem inherited in the new method.

Patients who use peritoneal dialysis change their own cleansing solutions at home, usually about six times per day. This procedure can be done manually when active or automatically by machine when sleeping. However, the patient’s overall condition, as well as the positioning of the catheter, must be monitored regularly by nurses and technicians at the Dialysis Center (Gapenski, pg. 27-28). The Outpatient Clinic currently takes up 80 percent of the space it shares with the Dialysis Center. The recent growth in volume has created a need of 25 percent more space for the Clinic. Its large size compared to the Dialysis Center and its patients frequent use of other departments in the hospital are justifications as to why it was decided to move the Dialysis Center to another building. Big Bend Medical Center currently doesn’t have adequate space to house the Dialysis Center, so it was also decided to build a new 20,000-square-foot building. This expansion and move were went to benefit both departments and help increase patient volume. The goal of increased patient volume is expected, but the directors and other department heads did not agree with the new allocation of indirect costs. In the past, facilities costs were aggregated, so all departments were charged cost based on the average embedded cost regardless of actual age of the space occupied. Since many department heads considered this

Under the current indirect cost allocation scheme (Exhibit 1) the Dialysis Center’s Revenues and Direct Costs are as follows: total revenue is $2,700,000, direct expenses are $2,100,000, the contribution margin is $600,000, and their percent of revenues is 22.2%. Their indirect costs are as follows: facilities cost is $300,000, general overhead is $270,000, and total overhead is $570,000. This leaves the Dialysis Center with $30,000 in net profit and 1.1% in percent of revenues. Additionally, square footage is allocated at $15.00 per square foot on an aggregated basis. Lastly, their general overhead costs are set at 10% of their total revenues.

When referring to health care economics, “cost” refers to the funds that are used to deliver health care to patients. Cost can also mean the amount of funds used to access health care or to deliver health care (Getzen, 2007). It is applied in many different ways such as, health care professionals applying economic principles like cost benefit analysis, or cost effect analysis to determine if the choice is good or bad. The principles help the government to provide the best intervention in health care (Getzen, 2007).

A few service models are generally accepted as an outpatient dialysis service line. Healthcare organizations have to decide which mode of dialysis they deem most effective in serving their patients: 1) Outsourcing their dialysis service line to a specialized service provider such as Fresenius or Davita, 2) instituting a home dialysis service 3) Implementing a hospital stand alone outpatient dialysis center 4) Free standing dialysis clinic. In addition, organizations need to establish protocols on the two-dialysis treatments, hemodialysis or peritoneal dialysis, and reach a consensus which to provide.

Cost drivers can be identified for each activity or cost category based on observation, discussions with management, simulations and statistical studies. The key is to determine the behavior of indirect costs with respect to activity or resource usage in each activity center (Leslie, 2009). These efforts have identified the eight cost drivers shown in Table 3.

My community assessment project focused on adults with chronic renal disease who are receiving peritoneal dialysis under the care of the Davita Dialysis Clinic located in Dothan, Alabama. This modality of artificial kidney replacement minimizes the disruption of the user’s daily life by allowing them to remove waste products from their bodies on daily basis during their ordinary sleeping hours. According the Centers for Disease Control and Prevention, it was estimated that as many as 10% of adults or more than 20 million people in the United States may be suffering from chronic kidney disease and in 2011 alone, 113,136 of these individuals began treatment for their end stage renal disease ("National chronic kidney disease fact sheet,

Based on my understanding facilities have fixed expenses like their utilities, rent, malpractice insurance and the list can go on of the things that will remain the same every month despite the volume in patients. They also have variable expenses like payroll, marketing, supplies and the list can also go on in expenses that can vary each month depending of the volume of business the department is doing. I think no one is exempt of change so I will choose the variable expense department. A fixed expense departments might not change in production because everything stays the same and their job is not directly involved with situations that can make a budget vary. Variable expense departments, are usually the ones in direct contact with the patients

unit, two types of costs are distinguished. Firstly the direct costs, consisting of the direct

Included in cost allocation are direct, indirect, and incremental costs. Direct costs, or separable costs, are costs that are related to a single type of service and are related to one type of output or user such as, a sector-to-sector hand-off. Indirect costs, or common costs, are related to more than one type of service, such as, the physical en-route facility. Incremental costs change with the level of

There are two classifications of costs associated with construction projects, direct costs and indirect costs. Direct costs include the labor, material and equipment operating costs necessary to put work in place. Indirect costs include supervision, job and home office overhead, profit, financing, and the cost of inflation. Direct costs can be allocated to each activity on the project. Indirect costs, on the other hand, cannot be realistically prorated and assigned to each separate activity.