Profit and loss analysis for an intensive care unit (ICU) in Japan: a tool for strategic management

BACKGROUND: Accurate cost estimate and a profit and loss analysis are necessary for health care practice. We performed an actual financial analysis for an intensive care unit (ICU) of a university hospital in Japan, and tried to discuss the health care policy and resource allocation decisions that have an impact on critical intensive care. METHODS: The costs were estimated by a department level activity based costing method, and the profit and loss analysis was based on a break-even point analysis. The data used included the monthly number of patients, the revenue, and the direct and indirect costs of the ICU in 2003. RESULTS: The results of this analysis showed that the total costs of US$2,678,052 of the ICU were mainly incurred due to direct costs of 88.8$ 2,295,044. However, it was determined that the ICU required at least 1,986 patient days within one fiscal year based on a break-even point analysis. As a result, an annual deficit of US$ 383,008 has occurred in the ICU. CONCLUSION: These methods are useful for determining the profits or losses for the ICU practice, and how to evaluate and to improve it. In this study, the results indicate that most ICUs in Japanese hospitals may not be profitable at the present time. As a result, in order to increase the income to make up for this deficit, an increase of 437 patient days in the ICU in one fiscal year is needed, and the number of patients admitted to the ICU should thus be increased without increasing the number of beds or staff members. Increasing the number of patients referred from cooperating hospitals and clinics therefore appears to be the best strategy for achieving these goals

Cultural Differences in the Hedonic Rewards of Recalling Kindness: Priming Cultural Identity with Language.

Recent theory suggests that members of interdependent (collectivist) cultures prioritize in-group happiness, whereas members of independent (individualist) cultures prioritize personal happiness (Uchida et al. Journal of Happiness Studies, 5(3), 223-239 Uchida et al., 2004). Thus, the well-being of friends and family may contribute more to the emotional experience of individuals with collectivist rather than individualist identities. We tested this hypothesis by asking participants to recall a kind act they had done to benefit either close others (e.g., family members) or distant others (e.g., strangers). Study 1 primed collectivist and individualist cultural identities by asking bicultural undergraduates (N = 357) from Hong Kong to recall kindnesses towards close versus distant others in both English and Chinese, while Study 2 compared university students in the USA (n = 106) and Hong Kong (n = 93). In Study 1, after being primed with the Chinese language (but not after being primed with English), participants reported significantly improved affect valence after recalling kind acts towards friends and family than after recalling kind acts towards strangers. Extending this result, in Study 2, respondents from Hong Kong (but not the USA) who recalled kind acts towards friends and family showed higher positive affect than those who recalled kind acts towards strangers. These findings suggest that people with collectivist cultural identities may have relatively more positive and less negative emotional experiences when they focus on prosocial interactions with close rather than weak ties.Supplementary informationThe online version contains supplementary material available at 10.1007/s42761-020-00029-3

Value-Based Healthcare Paradigm for Healthcare Sustainability

Healthcare represents a paramount issue in the current debate around sustainability. Developing sustainable practices within health systems is fundamen- tal not only to guarantee the right of care, but also to enhance the growth of a country. The widespread dissemination of innovation, on the one hand, could represent a way for providing a better service, in terms of quality and access. On the other hand, it is severely undermining the sustainability of health organisations due to high costs and magnitude on existing organisational arrangements. Among the various research strands aimed to identify theoretical framework to face the various challenges, Value-Based Healthcare is largely considered as the blueprint for promoting sustainable management approaches in healthcare. This paradigm stresses the importance to deliver care towards enhanced value for the patient, which could be measured through the ratio between outcomes and costs. This chapter has a twofold aim. First of all, it is aimed at exploring the concept of Value-Based Healthcare to realise the state-of-art and to identify main issues and open questions around the drivers of value in health. Besides, it attempts to under- stand whether this approach could effectively contribute to the attainment of sus- tainable development goals. To do that, an in-depth explanation of the concepts of outcome and cost in healthcare has been carried out. At the end of the analysis, principles of Value-Based Healthcare seem to be usefulness to cope with the need of improved practices. The focus on the value of patient, instead, allows to foster behaviours that could support the achievement of sustainable goals aimed to provide better and more accessible infrastructures. Within this complex mosaic, accounting could represent the common language to orient health management towards a higher sustainable value for the patient