‫بسم اهلل الر ‪%%‬حمن الر ‪%%‬حيم‬

‫وال تجعل يدك مغلولة الى عنقك‬

‫وال تبسطها كل البسط فتقعد‬
‫ملوما محسورا‬
‫صدق اهلل العظيم‬
major/ Enas mohamed
Out line
• Introduction

•Definition
• categories of cost
•Causes that increase hospitals expenditure
•Purpose of cost containment
• value analysis ( reducing cost not quality )
• the process of cost containment
• elements of cost containment program
• the nurse role in cost containment
•Legal and ethical aspect of cost containment
•Reference
introduction
cost containment includes all of those effort
directed toward preventing the rise in cost of health care

cost containment in term of time and materials,

begins at the beside the nurse carefully balances the
quality of care with conservative management of
available resources . It is legal responsibility of nurse to
maintain the standard of care and not risk the patient
safety
Definations

cost ;- is defined by Gill (1984) as the expenditure

.required to achieve a desired objective or condition

containment :- the word containment is defined as

the policy , process , or result of preventing the
expansion of hospital
Cost containment - it means reduction of cost

Cost Containment : - Process of maintaining

organizational costs within a specified budget; restraining
expenditures to meet organizational or project.
Cost containment include all effort directed toward
. preventing the steep rise in cost of health care
• incurrent by the organization
• not profitable business
• include capital charge staff
costs taxes .
• these are as a result of indirect
business
• it is vary as a function of operation or
activity
• they consist of raw material eg .
Electricity used in operate machines
also ,food for meals services
cost composed of a mixture of fixed and variable
components. Costs are fixed for a set level of
production or consumption, becoming variable
after the level is exceeded. Also known as a
"."semi-fixed cost

•Examples
• the cost of nursing training will change with an
increase in volume of nursing care delivered and
numbers of nurses hired but that not mean increase care
delivered bec nurses can be oriented
•Equipment repair and maintenance
 Causes increase hospital expenditure
mark basket -1
higher price hospital pays for goods ( food – fuel- supplies )

2- the increasing use of hospital services

• the number of hospital admission
• days of hospital care increased
• out patient visits increasing
the changing character -3
service intensity of hospital by continually add services
for example lab tests and x ray more frequently

technological development -4
5- rising personal income
 Purpose of cost containment
to provide safe effective care at
the lowest cost per patient day

1- reduce waste of limited recourses

2-reduce time-
3-more effective means of
accomplishing the desired health care
out come
Value analysis reduce cost not quality

Less cost without affecting its quality

Cost containment process
1-information gathering
basic fact needs related to
components and costs of
performance service
information is recorded from
direct observation and direct
measurement of quality of
work in service
as
1.What is function of service?
2.What are the technical procedure
required to provide the service ?
3.What kinds of input are required?
4.How many days are required to
providing the service ?
5.Where is the service performed?
6.Who perform the service?
7.What are the costs of providing the
service?
8.Is the is any duplication or over
lapping of activities in performing the
service?
analysis of fact-2

this step reconsider the-1

purpose and function of
service
the place it is performed -2
specific components and -3
the means by which it is done
and equipment
3-creative search
seek answer from specialists as
physicians and pharmacist nurses
quality control engineers etc to
question such as
1.can alternative materials or other inputs
to be used?
2.can the service be simplified ?
3.can alternated method be used ?
4.can cost be used by turning to alternate
or equipment ?
5.can any step be eliminated ?
6.can the duration of service be reduced?
1-cost awareness
•focus is on all costs and by all
individual
• increasing organization
awareness of what costs are and
how they can managed and the
process to contain the cost
2-cost monitoring
• focus is on where and how much
and why dollars are spent
• providing mechanism and the
media for
identifying , reporting / and
monitoring all costs
• function of organization
performance
3-cost management
• Focus is on what can be done and
will be done to contain costs and
by whom
• Establishing the responsibility and
accountability system for
communication and controlling
the attainment of plans,
strategies. Program and
objectives involving cost
containment
4-cost incentives
• focus is on where and when
the effort is most appropriate
and reward
• performance in proportion to
containment
 cost containment
strategies
 short term Purchase Delays :
 There are a number of short-term
strategies to pursue for an
immediate expense reduction
and reduce the physical quantity
of resources utilized per out
measurement unit :
 minor benefits to employees
might be reduced.
cost containment strategies
 Educational programs cut back.
 Community relation reduced
 Plant and equipment replacement
deferred
 Implementation of new service
and equipment purchases delayed
 These short –term strategies
reduce existing operating
expenses associated with new
program
 Examples
 Resource reducing projects
 close low activity department
during holiday
 replace incandescent lighting
with florescent
 Staffing by patient activity
2- improved production
efficiency :
 example

 outpatient surgery
 pre admission testing
 expansion of outpatient services
 meals and wheel
improved market efficiency ( volume
reduction)

 example
 utilization review ( reduce the
number of admission sand
length of stay)
involving all individuals-4
 example inform them of the
financial as well as effects
of their effort
 The role of nurse in cost
-:containment
 managing time
 time is money each hour counts
should used wisely
• organize her time
• plan carefully her meeting
• delegate effectively
• set objectives and dead lines
• reduce paperwork
 2-managing supplies
 using supplies judiciously
using correct product for
need aer essential for cost
containment
participating in planning
• involving directly in budget process
through participation on unit
committee
• developed efficient documentation
system for time saving through
prevention of unnecessary
transcription of information from one
sheet to another
• Narrative documentation of only
abnormal finding
Legal and ethical aspects of
cost containment
 The effectiveness and efficiency of the
use of recourses other than money
 Legal and ethical standards for nursing
care require adherence to standards of
care defined by the profession
standards of care and patient safety
must not be compromised in the name
of cost containment