RESUMO
OBJECTIVE: To estimate indirect costs associated with rheumatoid arthritis (RA). METHODS: This was a retrospective study using 1996-2006 US Medical Expenditure Panel Survey data. Employed individuals were aged 18 to 65 years. A two-part model estimated the probability of time lost from work and annual number of workdays missed due to illness. RESULTS: Sixty-seven percent (209/312) of RA individuals missed work versus 58% (52,046/89,734) of those without RA (P = 0.0007). Among individuals who missed work, those with RA missed more workdays annually than those without RA ((Equation is included in full-text article.)= 13.659, 9.879, respectively; P = 0.008). Incremental per capita costs in annual lost workdays between those with and without RA were $596. Estimated national indirect costs of RA-related absenteeism were $252 million annually. CONCLUSIONS: Individuals with RA have higher probabilities of missing work and missing workdays than those without RA.
Assuntos
Absenteísmo , Artrite Reumatoide/economia , Efeitos Psicossociais da Doença , Adolescente , Adulto , Artrite Reumatoide/epidemiologia , Doença Crônica/economia , Comorbidade , Eficiência Organizacional/economia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Psicologia Industrial/economia , Estudos Retrospectivos , Estados Unidos , Adulto JovemRESUMO
Operating room (OR) managers must plan staffing in the face of uncertain demand for OR time. Planning too much staffing results in underutilized OR time. Planning too little staffing causes overutilized time, which is approximately twice as expensive as underutilized time. Deciding how much staffing to plan for an OR is analogous to the classic newsvendor problem in operations research. A newsvendor must decide how much product to order based on its cost c and sales price p, plus estimates of the uncertain future demand for the product. The newsvendor problem has a simple mathematical solution. The correct amount of product to order is the (p - c)/p quantile of the demand for the product. This optimal order quantity is analogous mathematically to the number of hours of OR time for which staffing should be planned. We performed a systematic review of the behavioral operations experimental literature on newsvendor problems relevant to OR management. Student volunteers participating in experimental studies have great difficulty knowing how much product to order, given c, p, and the demand distribution. Decision making is only modestly improved by more frequent feedback. Even scores of rounds of ordering are insufficient for much learning to occur. Suboptimal decisions result from innate psychological biases. Students anchor on mean demand, make insufficient adjustments, and rely disproportionately on the most recent demand values. The behavior of OR managers who plan staffing for the OR is analogous to that of students participating in a newsvendor experiment. Month after month, an OR manager will plan too little staffing for the surgeon who consistently ends the day late and too much staffing for the surgeon who consistently does not fill an OR. Experimental studies of the newsvendor problem provide mechanistic insights into the reasons that OR managers make poor decisions when planning OR staffing. The students face no organizational factors or personality issues that potentially influence OR managers, strongly suggesting that observed psychological biases are innate and play an important role in influencing the decisions of OR managers. Results suggest that only the use of computerized decision-support systems can effectively circumvent these biases.
Assuntos
Comportamento , Salas Cirúrgicas/organização & administração , Psicologia Industrial/economia , Tomada de Decisões , Tomada de Decisões Gerenciais , Educação Médica , Eficiência Organizacional , Retroalimentação Psicológica , Administração Hospitalar , Humanos , Modelos Organizacionais , Salas Cirúrgicas/economia , Admissão e Escalonamento de Pessoal , Recursos HumanosAssuntos
Economia , Teoria Psicológica , Psicologia Industrial , Condições Sociais , Comércio/economia , Comércio/educação , Comércio/história , Economia/história , Emprego/economia , Emprego/história , Emprego/psicologia , História do Século XX , Sindicatos/economia , Sindicatos/história , Psicologia/economia , Psicologia/educação , Psicologia/história , Psicologia Industrial/economia , Psicologia Industrial/educação , Psicologia Industrial/história , Psicologia Social/economia , Psicologia Social/educação , Psicologia Social/história , Condições Sociais/economia , Condições Sociais/história , Mobilidade Social/economia , Mobilidade Social/história , Fatores Socioeconômicos , Sociologia/economia , Sociologia/educação , Sociologia/história , Desemprego/história , Desemprego/psicologiaAssuntos
Minas de Carvão , Saúde Mental , Estresse Psicológico , Desemprego , Minas de Carvão/economia , Minas de Carvão/educação , Minas de Carvão/história , Minas de Carvão/legislação & jurisprudência , Economia/história , Economia/legislação & jurisprudência , Relações Familiares/etnologia , Obtenção de Fundos/economia , Obtenção de Fundos/história , Programas Governamentais/economia , Programas Governamentais/educação , Programas Governamentais/história , Programas Governamentais/legislação & jurisprudência , História do Século XX , Saúde Mental/história , Associações de Ajuda a Doentes Mentais/economia , Associações de Ajuda a Doentes Mentais/história , Psicologia Industrial/economia , Psicologia Industrial/educação , Psicologia Industrial/história , Psicologia Social/economia , Psicologia Social/educação , Psicologia Social/história , Recreação/economia , Recreação/fisiologia , Recreação/psicologia , Fatores Socioeconômicos , Estresse Psicológico/economia , Estresse Psicológico/etnologia , Estresse Psicológico/história , Estresse Psicológico/psicologia , Desemprego/história , Desemprego/psicologia , País de Gales/etnologiaAssuntos
Testes de Aptidão , Indústrias , Testes Psicológicos , Psicologia Industrial , Testes de Aptidão/história , Eficiência Organizacional/economia , Eficiência Organizacional/história , Eficiência Organizacional/legislação & jurisprudência , Eletricidade/história , Emprego/economia , Emprego/história , Emprego/legislação & jurisprudência , Emprego/psicologia , Alemanha/etnologia , História do Século XX , Indústrias/economia , Indústrias/educação , Indústrias/história , Testes Psicológicos/história , Psicologia Industrial/economia , Psicologia Industrial/educação , Psicologia Industrial/história , Psicologia Industrial/legislação & jurisprudência , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Racionalização , Identificação Social , Seguridade Social/economia , Seguridade Social/etnologia , Seguridade Social/história , Seguridade Social/psicologia , Tecnologia/economia , Tecnologia/educação , Tecnologia/história , Tecnologia/legislação & jurisprudênciaRESUMO
Business Process Reengineering (BPR) principles have been around for a long time, piecemeal and under other labels. In recent years they started coming together as a discipline, incorporating world class business principles and focusing on quantum improvements--not merely continuous gradual improvement. BPR is the complete or partial "reinventing" of how business processes are done to attain major performance improvement. It questions the underlying assumptions and principles, including what, why, by whom, and even if things should be done. This article will contribute by stating and helping to clarify a number of important principles, plus some useful insights, techniques, and hints--40 in all!
Assuntos
Comércio/organização & administração , Guias como Assunto , Administração de Materiais no Hospital/normas , Psicologia Industrial/economia , Gestão da Qualidade Total , Comércio/economia , Comportamento do Consumidor , Eficiência Organizacional , Humanos , Liderança , Administração de Materiais no Hospital/economia , Objetivos Organizacionais , Estados UnidosRESUMO
Efforts throughout your restructuring program should be as focused as your targets. If you are targeting large amounts of savings through infrastructure reduction, push for extensive service redeployment, implement new operational enablers and reexamine burdensome policies. If the savings are expected to come from skill mix reduction, analyze the workload, study licensure laws, get comfortable with competency thresholds and understand training costs. If management hierarchy reduction is the key, then put in place qualified managers, foster employee involvement to optimize SDWTs and modify your environment to reward risk taking and initiative. Lastly, if reduced LOS is the savings opportunity, rethink your patient groups. LOS reduction can also be achieved through improved care team continuity with physicians and patients. Understanding how your savings opportunities are influenced by ++your project decisions, direction and emphasis, will help you pull the "right" economic levers to meet your goals. Ultimately, that economic health will allow you to continue to provide uncompromised care and service quality to your communities.