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- Ridderstolpe, Lisa, et al.
(författare)
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Clinical process analysis and activity-based costing at a heart center
- 2002
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Ingår i: Journal of medical systems. - : Springer. - 0148-5598 .- 1573-689X. ; 26, s. 309-322
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Tidskriftsartikel (refereegranskat)abstract
- Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR®) containing two interrelated parts, “ProcessGuide and CostControl,” was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.
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| 2. |
- Jönsson, Björn, 1951-, et al.
(författare)
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A new probe for ankle systolic pressure measurement using Photoplethysmography (PPG)
- 2005
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 33:2, s. 232-239
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Tidskriftsartikel (refereegranskat)abstract
- An automated method for ankle systolic pressure measurement, less operator dependent than the standard continuous wave (CW) Doppler technique, would imply an advantage both in patient measurements and in epidemiological studies. We present a new photoplethysmographic (PPG) probe that uses near-infrared light (880 nm) to detect pulsatory blood flow underneath the distal end of a standard pneumatic cuff. The probe is adapted to the anatomical conditions at the ankle, permitting recording of pressures in both ankle arteries separately. The validity of the equipment was tested with CW Doppler-derived systolic pressures and invasive blood pressure measurements for reference. In 20 healthy subjects, visual analysis of the PPG curves revealed a mean difference between CW Doppler and PPG measurements of –0.5 mmHg (SD 6.9). Corresponding results for the anterior and posterior tibial arteries separately were –1.8 mmHg (SD 6.2) and 0.9 mmHg (SD 7.3), respectively. A correct probe position was essential for the results. In direct recordings from the dorsalis pedis artery in 10 intensive care patients, PPG underestimated systolic pressure in the anterior tibial artery by 4.5 mmHg (SD 12.1). With further development, the PPG probe, integrated in the pneumatic cuff, may simplify measurements of ankle systolic pressures.
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| 5. |
- Jönsson, Björn, 1951-, et al.
(författare)
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Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination
- 2005
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 30:4, s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate a new technique using a photoplethysmographic (PPG) probe for automatic ankle pressure measurements.DesignComparative study on two techniques for ankle pressure measurement.SettingUniversity hospital.MaterialThirty-five patients with leg arterial disease and eight healthy volunteers. Ankle-brachial indices (ABPI) were measured using conventional CW Doppler technique and PPG-based prototype equipment for the ankle pressure recordings.Chief outcome measuresABPIs calculated from CW Doppler and PPG ankle pressure measurements. The PPG signals were analysed both by visual judgement and by a software based, automatic algorithm.Main resultsThe mean difference between ABPIs calculated from CW Doppler recordings and PPG (visual analysis) was −0.01 (limits of agreement (±two standard deviations) +0.16 to −0.19). The correlation coefficient was 0.93. When the algorithm was used, the mean difference (CW Doppler−PPG) was 0.05 (limits of agreement 0.28 to −0.18, r=0.89).ConclusionsThe PPG method is a promising technique with an inherent potential for automatisation of the ankle pressure measurements, thereby reducing the observer-dependency in ABPI recordings.
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