Standard costing is used as a control for product costing. But with life cycle becoming shorter, costing should be done at the design and development stage of a product. This is achieved through target costing.The imp...Standard costing is used as a control for product costing. But with life cycle becoming shorter, costing should be done at the design and development stage of a product. This is achieved through target costing.The implementation of target costing and target pricing is done with the ultimate purpose of cost reduction, cost understanding, continuous improvement, competitiveness, early purchasing and supplier involvement, and improved design and accountability by manufacturers. The study explores the participation of the purchasing and supply chain management's role in target costing and target pricing process. Supply management plays an active role in monitoring the ongoing cost and performance of suppliers during the early stages of product development. Implementation of target costing and target pricing in various organizations are also explored. Leading Japanese manufacturers have used target costing and target pricing systems to their advantage and the paper also examines the adaptation of the Western companies to these proactive cost management techniques to improve their product development processes.展开更多
BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hosp...BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.展开更多
BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers account...BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.展开更多
Activity based costing (ABC) is a method which can solve many limitations of the traditional cost systems in manufacturing management. In this paper, we investigate how to integrate ABC with workflow technology, and ...Activity based costing (ABC) is a method which can solve many limitations of the traditional cost systems in manufacturing management. In this paper, we investigate how to integrate ABC with workflow technology, and build a workflow meta model supporting ABC. Firstly, the concept and concept model of activity based costing (ABC) are introduced. Next, the meta model of P -PROCE (Process, Product, Resource, Organization, and Cost & Evaluation) is presented. Then the cost meta model is defined by adding ABC to P -PROCE model. Object constraint language (OCL) is used to express meta model and constraints. Finally, we show an enterprise modeling and simulation tool based on the workflow meta model. We can systematically construct an enterprise model and easily and efficiently conduct simulation. Moreover it enables us to analyze and evaluate business processes and its costs.展开更多
Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examinatio...Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examination time, long waiting before being hospitalized and short time of diagnosis and treatment of the traditional outpatient services. With the increasing diversification of payment methods, it is necessary for the hospitals to establish a unified payment platform in order to support different business scenarios according to needs and standardize the interfaces of various developers and manufacturers. In addition, it will help the Financial Department timely identify the problems in the tons of transaction data and better serve the goals of the hospitals to streamline the procedures of medical services and achieve concentrated information management.展开更多
This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their percep...This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.展开更多
Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further contro...Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further control the costs.Methods: The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page(IMRHP) dataset.The data were then processed with SAS(Version 9.3; SAS Institute, Cary, NC, USA). Indicators like means,increase(decrease) percentages were used to descriptively analyze the average hospitalization expense of each time(AHEET) and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results:In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance(URBMI)were the next,and those covered by New Rural Cooperative Medical System(NRCMS)had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions:The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.展开更多
In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance syst...In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD), a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A, clinical pathway B and clinical pathway C). Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment (β=2382.988, P〈0.001) and fixed-reimbursement case payment β=2613.564, P〈0.001), and clinical pathway C (β=1996.467, P〈0.001) were risk factors of per capita total medical expenses. Clinical pathway A (β=-1443.409, P〈0.001) and clinical pathway B (β=-1583.791, P〈0.001) were protective factors. The interactive effects of case payment with hospital level (β=0.710, P〈0.001) lowered the readmission rate within 30 days. Meanwhile, clinical pathways A (β=18.949, P〈0.001), B (β=-19.752, P〈0.001) and C (β=-1.882, P〈0.1) were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.展开更多
We present a multi-signature scheme based on DSA and describes a faireleetronic payment scheme based on improved DSA signatures. The scheme, makes both sides in e-qualpositions during the course of electronic transact...We present a multi-signature scheme based on DSA and describes a faireleetronic payment scheme based on improved DSA signatures. The scheme, makes both sides in e-qualpositions during the course of electronic transaction A Trusted Third Party (TTP)is involved in thescheme to guarantee the fairness of the scheme for both sides. However, only during the course ofregistration and dispute resolution will TTP be needed TTP is not needed during the normal paymentstage.展开更多
Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to phys...Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.展开更多
Technological developments are changing how users pay for goods and services.In the context of the COVID-19(coronavirus disease 2019)pandemic,new payment systems have been established to reduce contact between buyer a...Technological developments are changing how users pay for goods and services.In the context of the COVID-19(coronavirus disease 2019)pandemic,new payment systems have been established to reduce contact between buyer and seller.In addition to the pandemic,the future is payment processing is also uncertain due to the new EU security regulations of the Payment Services Directive(PSD2).Biometric payments one option that would guarantee the security of transactions and reduce the risk of conta-gion.This research analyses the intention to recommend the use of the mobile phone as a tool for collecting payments in a shop using iris reading as a biometric measure of the buyer.The moderating effect of the fear of contagion in the proposed relationships was also analysed.An online survey was carried out,which yielded a sample of 368 respondents.The results indicate that the main antecedents of intention to use,which precedes intention to recommend,are perceived trust,habit,personal innovativeness and comfort of use.Additionally,the moderating effect of COVID-19 was checked among users with a higher perception of risk.The results obtained have interesting implications for purchase management among manufacturers and retailers.展开更多
From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the T...From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the Technology Ac ceptance Model (TAM) to examine determinant factors affecting consumers' acceptance intentions of mobile payment. We adopt Hofstede's cultural dimensions as moderators to extend the TAM model for exploring the impact of uncertainty a voidance on mobile payment acceptance.展开更多
Life Cycle Costing (LCC) is always a major concern in the Architecture, Engineering and Construction (AEC) industry. This paper presents the implementation of Building Information Modeling (BIM) technology in the deve...Life Cycle Costing (LCC) is always a major concern in the Architecture, Engineering and Construction (AEC) industry. This paper presents the implementation of Building Information Modeling (BIM) technology in the development of a lifecycle cost-estimating tool. The IFC (Industry Foundation Classes) model as an interoperable building information model has been adopted as the central data repository to deliver the integrated information of building designs from CAD design systems into the lifecycle-costing database. In this paper, the conceptions and relevant factors, which could affect the LCC estimation, have been introduced. The problems of current LCC applications have been identified as the lack of LCC data and the complexity of LCC exercises. The software application of IFC models and relevant auxiliary are depicted as a solution of the problem identified. The lifecycle costing tool is a part of the nD Modeling tool and as such is based on its integrated interface prototype toolkit and is able to holistically present an IFC model into a 3D virtual reality view, a tree-view and a list of element properties. The functions and some technical points are also detailed in the paper. Through the research, it demonstrates the potential and possibility of implementing BIM methods and techniques, particularly IFCs to enhance the computer applications in the processes of building construction and facility management.展开更多
In international trade,exporters prefer to receive payments as quickly as possible,and importers want to make payments as late as possible.In this respect,the payment field,an essential condition for trade transaction...In international trade,exporters prefer to receive payments as quickly as possible,and importers want to make payments as late as possible.In this respect,the payment field,an essential condition for trade transactions,also represents the positions of exporters and importers conflict.In addition,there are many cases in which various variables must be considered rather than only one specific variable representatively affecting payment,particularly in the case of import-export Small and Medium-Sized Enterprises(SMEs)from emerging countries.A selection of proper payment methods can be categorized as a Multi-Criteria Decision-Making(MCDM)issue.Therefore,this study aims to propose a novel and efficient Spherical Fuzzy Weighted Aggregated Sum Product Assessment based Entropy Objective Weighting method(SF-EW and WASPAS-SF)to evaluate international payment methods with uncertain information.First,SF-EW model is applied to determine the relative weights of critical factors.Second,international payment method alternatives are prioritized by the WASPAS-SF approach.Five essential factors for four international payment methods are proposed based on experts’opinions and the existing literature.A real-world case study from Vietnamese import-export SMEs is presented to validate the applicability of the proposed framework.The results indicated that“Characteristics of payment method(PA)”had the most significant impact on international payment method selection.In comparison,“Letters of Credit(L/C)”was the most reliable payment method with the highest ranking available to international traders.Furthermore,a sensitivity analysis was performed to examine the validity and robustness of the proposed decision support model.Consequently,this study could contribute to international payment services and in the context of globalization and international trade.展开更多
<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for...<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.展开更多
Implementing effective cost management approaches has recently gained momentum due to intense competition and increasing customer demands. Moreover, effective cost management approaches have contributed to firms' com...Implementing effective cost management approaches has recently gained momentum due to intense competition and increasing customer demands. Moreover, effective cost management approaches have contributed to firms' competitive advantage in relation to cost leadership strategy. Consequently, firms have implemented contemporary cost management systems, such as activity-based management, business process re-engineering, life-cycle costing, target costing, and theory of constraint (TOC), to enable them to become low-cost producers and compete effectively and sustain their performance. Furthermore, focusing on cost management to improve profitability has led to the integration of activity-based costing (ABC) and TOC. Therefore, the aim of this study is to review literature and discuss how integration of ABC and TOC can result in improved and sustained cost management. While these methods have different approaches in addressing cost management, treating them as complementary cost management approaches can result in improved cost management due to improved product costing, improved cost reporting, improved product-mix decisions, and improved cycle-time management. Improvement in cost management will then result in sustained cost management. Sustained cost management is further enhanced with the investment in information customer and shareholder value technology that supports cross-functional decision making to continue creating to remain competitive in the market.展开更多
The study examines the extent of adoption of Activity Based Costing (ABC) among naanufacturing companies in Nigeria. The primary data were sourced through questionnaires administered to the Management Accountants of...The study examines the extent of adoption of Activity Based Costing (ABC) among naanufacturing companies in Nigeria. The primary data were sourced through questionnaires administered to the Management Accountants of 40 selected manufacturing companies in South Western part of Nigeria. Descriptive statistics was employed to analyze the data. The study reveals that inability of the traditional cost systems to provide relevant cost was the most highly ranked reason in their decision to adopt ABC. Traditional methods of allocating overhead were therefore believed to be deficient in terms of improving global competitiveness. Also, 60% of the respondents have adopted ABC due to increased ranges of products, competition and increased overhead. Familiarity with and adoption of ABC was found to be across the manufacturing, more than half of the sample are familiar with it. The 40% of respondents who have not adopted ABC cited the cost and complexity involved with implementation as the main reason in non-adoption. However, cost of implementing ABC was enormous which hinder the small scale manufacturing from adopting it. This result may reflect the fact that larger firms are more likely to have the diverse mix of products or services that makes the use of ABC advantages. Consequently, the study recommends that the companies who have not adopted ABC because of its high cost of implementation should endeavor to consider its adoption because in the long run the benefits derive from it will outweigh its cost. It helps to identify inefficient products, departments and activities and helps to allocate more resources on profitable products. In conclusion, the senior management should also give their utmost support to the implementation and success of ABC.展开更多
Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulat...Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulators.However,prior studies have mostly focused on qualitative mechanism analysis,and have rarely examined quantitative risk assessment based on actual operational risk events.Therefore,this study attempts to assess the operational risk on TPP platforms in China by constructing a systematic framework incorporating database construction and risk modeling.First,the operational risk database that covers 202 events between Q1,2014,and Q2,2020 is constructed.Then,specific causes are clarified,and the characteristics are analyzed from both the trend and loss severity perspectives.Finally,the piecewise-defined severity distribution based-Loss Distribution Approach(PSD-LDA)with double truncation is utilized to assess the operational risk.Two main conclusions are drawn from the empirical analysis.First,legal risk and external fraud risk are the two main causes of operational risk.Second,the yearly Value at Risk and Expected Shortfall are 724.46 million yuan and 1081.98 million yuan under the 99.9%significance level,respectively.Our results are beneficial for both TPP platform operators and regulators in managing and controlling operational risk.展开更多
A new fair e-eash payment scheme based on credit is present in this paper. In the scheme, an overdraft credit certificate is issued to user by hank. Using the overdraft credit certificate, user can produce e-cash hims...A new fair e-eash payment scheme based on credit is present in this paper. In the scheme, an overdraft credit certificate is issued to user by hank. Using the overdraft credit certificate, user can produce e-cash himself to pay in exchanges. Merchant can verify the e-cash received from user. Bank can make a fair dis pute resolution when there is a dissension between user and merchant. It can avoid 'the problem of partition e-cash for changes, prevent from reusing e-cash and fa- king e-cash, It. fits justice, anonymity, non deny and impartiality.展开更多
文摘Standard costing is used as a control for product costing. But with life cycle becoming shorter, costing should be done at the design and development stage of a product. This is achieved through target costing.The implementation of target costing and target pricing is done with the ultimate purpose of cost reduction, cost understanding, continuous improvement, competitiveness, early purchasing and supplier involvement, and improved design and accountability by manufacturers. The study explores the participation of the purchasing and supply chain management's role in target costing and target pricing process. Supply management plays an active role in monitoring the ongoing cost and performance of suppliers during the early stages of product development. Implementation of target costing and target pricing in various organizations are also explored. Leading Japanese manufacturers have used target costing and target pricing systems to their advantage and the paper also examines the adaptation of the Western companies to these proactive cost management techniques to improve their product development processes.
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.
文摘Activity based costing (ABC) is a method which can solve many limitations of the traditional cost systems in manufacturing management. In this paper, we investigate how to integrate ABC with workflow technology, and build a workflow meta model supporting ABC. Firstly, the concept and concept model of activity based costing (ABC) are introduced. Next, the meta model of P -PROCE (Process, Product, Resource, Organization, and Cost & Evaluation) is presented. Then the cost meta model is defined by adding ABC to P -PROCE model. Object constraint language (OCL) is used to express meta model and constraints. Finally, we show an enterprise modeling and simulation tool based on the workflow meta model. We can systematically construct an enterprise model and easily and efficiently conduct simulation. Moreover it enables us to analyze and evaluate business processes and its costs.
文摘Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examination time, long waiting before being hospitalized and short time of diagnosis and treatment of the traditional outpatient services. With the increasing diversification of payment methods, it is necessary for the hospitals to establish a unified payment platform in order to support different business scenarios according to needs and standardize the interfaces of various developers and manufacturers. In addition, it will help the Financial Department timely identify the problems in the tons of transaction data and better serve the goals of the hospitals to streamline the procedures of medical services and achieve concentrated information management.
基金supported by China Fundamental Research Funds for the Central Universities under Grant No.BUPT2011RC1005
文摘This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further control the costs.Methods: The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page(IMRHP) dataset.The data were then processed with SAS(Version 9.3; SAS Institute, Cary, NC, USA). Indicators like means,increase(decrease) percentages were used to descriptively analyze the average hospitalization expense of each time(AHEET) and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results:In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance(URBMI)were the next,and those covered by New Rural Cooperative Medical System(NRCMS)had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions:The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.
基金This project was supported by grants from the National Natural Science Foundation of China (No.71373091, No. 71603132) and by the Humanities and Social Sciences Research Program of the Ministry of Education of China (No. 16YJA840013).
文摘In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD), a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A, clinical pathway B and clinical pathway C). Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment (β=2382.988, P〈0.001) and fixed-reimbursement case payment β=2613.564, P〈0.001), and clinical pathway C (β=1996.467, P〈0.001) were risk factors of per capita total medical expenses. Clinical pathway A (β=-1443.409, P〈0.001) and clinical pathway B (β=-1583.791, P〈0.001) were protective factors. The interactive effects of case payment with hospital level (β=0.710, P〈0.001) lowered the readmission rate within 30 days. Meanwhile, clinical pathways A (β=18.949, P〈0.001), B (β=-19.752, P〈0.001) and C (β=-1.882, P〈0.1) were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.
文摘We present a multi-signature scheme based on DSA and describes a faireleetronic payment scheme based on improved DSA signatures. The scheme, makes both sides in e-qualpositions during the course of electronic transaction A Trusted Third Party (TTP)is involved in thescheme to guarantee the fairness of the scheme for both sides. However, only during the course ofregistration and dispute resolution will TTP be needed TTP is not needed during the normal paymentstage.
基金supported by Guiyang Science and Technology Correspondent Program of China(No.2012207)
文摘Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.
基金support provided by the Spanish Ministry of Science,Innovation and Universities,National R&D&I Plan and FEDER(B-SEJ-209-UGR18).
文摘Technological developments are changing how users pay for goods and services.In the context of the COVID-19(coronavirus disease 2019)pandemic,new payment systems have been established to reduce contact between buyer and seller.In addition to the pandemic,the future is payment processing is also uncertain due to the new EU security regulations of the Payment Services Directive(PSD2).Biometric payments one option that would guarantee the security of transactions and reduce the risk of conta-gion.This research analyses the intention to recommend the use of the mobile phone as a tool for collecting payments in a shop using iris reading as a biometric measure of the buyer.The moderating effect of the fear of contagion in the proposed relationships was also analysed.An online survey was carried out,which yielded a sample of 368 respondents.The results indicate that the main antecedents of intention to use,which precedes intention to recommend,are perceived trust,habit,personal innovativeness and comfort of use.Additionally,the moderating effect of COVID-19 was checked among users with a higher perception of risk.The results obtained have interesting implications for purchase management among manufacturers and retailers.
基金the National Natural Science Foundation of China,the State Major Science and Technology Special Projects,the Science Technology Innovation Foundation for Young Teachers in BUPT
文摘From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the Technology Ac ceptance Model (TAM) to examine determinant factors affecting consumers' acceptance intentions of mobile payment. We adopt Hofstede's cultural dimensions as moderators to extend the TAM model for exploring the impact of uncertainty a voidance on mobile payment acceptance.
文摘Life Cycle Costing (LCC) is always a major concern in the Architecture, Engineering and Construction (AEC) industry. This paper presents the implementation of Building Information Modeling (BIM) technology in the development of a lifecycle cost-estimating tool. The IFC (Industry Foundation Classes) model as an interoperable building information model has been adopted as the central data repository to deliver the integrated information of building designs from CAD design systems into the lifecycle-costing database. In this paper, the conceptions and relevant factors, which could affect the LCC estimation, have been introduced. The problems of current LCC applications have been identified as the lack of LCC data and the complexity of LCC exercises. The software application of IFC models and relevant auxiliary are depicted as a solution of the problem identified. The lifecycle costing tool is a part of the nD Modeling tool and as such is based on its integrated interface prototype toolkit and is able to holistically present an IFC model into a 3D virtual reality view, a tree-view and a list of element properties. The functions and some technical points are also detailed in the paper. Through the research, it demonstrates the potential and possibility of implementing BIM methods and techniques, particularly IFCs to enhance the computer applications in the processes of building construction and facility management.
文摘In international trade,exporters prefer to receive payments as quickly as possible,and importers want to make payments as late as possible.In this respect,the payment field,an essential condition for trade transactions,also represents the positions of exporters and importers conflict.In addition,there are many cases in which various variables must be considered rather than only one specific variable representatively affecting payment,particularly in the case of import-export Small and Medium-Sized Enterprises(SMEs)from emerging countries.A selection of proper payment methods can be categorized as a Multi-Criteria Decision-Making(MCDM)issue.Therefore,this study aims to propose a novel and efficient Spherical Fuzzy Weighted Aggregated Sum Product Assessment based Entropy Objective Weighting method(SF-EW and WASPAS-SF)to evaluate international payment methods with uncertain information.First,SF-EW model is applied to determine the relative weights of critical factors.Second,international payment method alternatives are prioritized by the WASPAS-SF approach.Five essential factors for four international payment methods are proposed based on experts’opinions and the existing literature.A real-world case study from Vietnamese import-export SMEs is presented to validate the applicability of the proposed framework.The results indicated that“Characteristics of payment method(PA)”had the most significant impact on international payment method selection.In comparison,“Letters of Credit(L/C)”was the most reliable payment method with the highest ranking available to international traders.Furthermore,a sensitivity analysis was performed to examine the validity and robustness of the proposed decision support model.Consequently,this study could contribute to international payment services and in the context of globalization and international trade.
文摘<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.
文摘Implementing effective cost management approaches has recently gained momentum due to intense competition and increasing customer demands. Moreover, effective cost management approaches have contributed to firms' competitive advantage in relation to cost leadership strategy. Consequently, firms have implemented contemporary cost management systems, such as activity-based management, business process re-engineering, life-cycle costing, target costing, and theory of constraint (TOC), to enable them to become low-cost producers and compete effectively and sustain their performance. Furthermore, focusing on cost management to improve profitability has led to the integration of activity-based costing (ABC) and TOC. Therefore, the aim of this study is to review literature and discuss how integration of ABC and TOC can result in improved and sustained cost management. While these methods have different approaches in addressing cost management, treating them as complementary cost management approaches can result in improved cost management due to improved product costing, improved cost reporting, improved product-mix decisions, and improved cycle-time management. Improvement in cost management will then result in sustained cost management. Sustained cost management is further enhanced with the investment in information customer and shareholder value technology that supports cross-functional decision making to continue creating to remain competitive in the market.
文摘The study examines the extent of adoption of Activity Based Costing (ABC) among naanufacturing companies in Nigeria. The primary data were sourced through questionnaires administered to the Management Accountants of 40 selected manufacturing companies in South Western part of Nigeria. Descriptive statistics was employed to analyze the data. The study reveals that inability of the traditional cost systems to provide relevant cost was the most highly ranked reason in their decision to adopt ABC. Traditional methods of allocating overhead were therefore believed to be deficient in terms of improving global competitiveness. Also, 60% of the respondents have adopted ABC due to increased ranges of products, competition and increased overhead. Familiarity with and adoption of ABC was found to be across the manufacturing, more than half of the sample are familiar with it. The 40% of respondents who have not adopted ABC cited the cost and complexity involved with implementation as the main reason in non-adoption. However, cost of implementing ABC was enormous which hinder the small scale manufacturing from adopting it. This result may reflect the fact that larger firms are more likely to have the diverse mix of products or services that makes the use of ABC advantages. Consequently, the study recommends that the companies who have not adopted ABC because of its high cost of implementation should endeavor to consider its adoption because in the long run the benefits derive from it will outweigh its cost. It helps to identify inefficient products, departments and activities and helps to allocate more resources on profitable products. In conclusion, the senior management should also give their utmost support to the implementation and success of ABC.
基金supported by grants from the National Natural Science Foundation of China(71425002,72101166)the Capital University of Economics and Business for the Fundamental Research Funds for Universities affiliated to Beijing(XRZ2021066).
文摘Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulators.However,prior studies have mostly focused on qualitative mechanism analysis,and have rarely examined quantitative risk assessment based on actual operational risk events.Therefore,this study attempts to assess the operational risk on TPP platforms in China by constructing a systematic framework incorporating database construction and risk modeling.First,the operational risk database that covers 202 events between Q1,2014,and Q2,2020 is constructed.Then,specific causes are clarified,and the characteristics are analyzed from both the trend and loss severity perspectives.Finally,the piecewise-defined severity distribution based-Loss Distribution Approach(PSD-LDA)with double truncation is utilized to assess the operational risk.Two main conclusions are drawn from the empirical analysis.First,legal risk and external fraud risk are the two main causes of operational risk.Second,the yearly Value at Risk and Expected Shortfall are 724.46 million yuan and 1081.98 million yuan under the 99.9%significance level,respectively.Our results are beneficial for both TPP platform operators and regulators in managing and controlling operational risk.
基金Supported bythe National High TechnologyDevelopment 863 Programof China under Grant (863-301-1-3)
文摘A new fair e-eash payment scheme based on credit is present in this paper. In the scheme, an overdraft credit certificate is issued to user by hank. Using the overdraft credit certificate, user can produce e-cash himself to pay in exchanges. Merchant can verify the e-cash received from user. Bank can make a fair dis pute resolution when there is a dissension between user and merchant. It can avoid 'the problem of partition e-cash for changes, prevent from reusing e-cash and fa- king e-cash, It. fits justice, anonymity, non deny and impartiality.