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Introduction
Cost analysis is an activity that uses engineering, time and motion studies, timekeepers records, and planning schedules from production supervisors. Cost analysis techniques include break-even analysis, comparative cost analysis, capital expenditure analysis and budgeting techniques. After determining what is happening, management should identify available alternatives. Professional judgment is then needed to apply and interpret the results of each costing technique.
In an organization, there is a direct relationship between the amount of time (that the funds management is willing to spend on cost analysis) and the degree of reliability desired. If a company wants detailed records with a high degree of accuracy, managers should provide additional time and money for compiling and maintaining cost information. Managers should only use cost analysis and control techniques when anticipated benefits in helping achieve management goals exceed the cost.
In undertaking this project cost analysis of a womans cardiac screening program, it will involve utilizing a budget that was developed based on share allocation amongst four different health system facilities. The analysis will consider certain aspects of the cardiac program and more specifically, the cost items that will be derived from the budget. These cost items will be covered by reviewing two sections, section one will cover the budget line items consisting of FTE full time, travel, medical director fee, purchase of screening tool, space modifications and renovations of the four hospitals, equipment, marketing and print material (education).
Section 2 will deal with the offsetting direct revenue model and consist of the charge (screening or counseling), the total number of screenings per week for four hospitals, weeks Open and total Screenings per year. The comparison of all the above items in the two sections will be the sole basis for the cost analysis of a womans cardiac screening program.
Broad Scope of Analysis
In the estimation of the analysis of cost in a womans screening program, we need to consider a certain aspect of the cost that are vital and they include making a comparison of the cost of doing a cardiac screening procedure within the four hospitals under consideration. It also includes the cost of a woman not seeking the cardiac screening procedure in a hospital and prefers having prescription drugs, going for ED visits and hospitalization.
The summary of the cost of this project, as outlined in the comparison above, can be as follows. The total estimated cost of screening as per the planned project is $57,600. This figure is based on the total yearly projected screenings and charge per screening. The total estimated cost of the planned project as outlined by the budget is $261,424, while the one-time expense will be estimated to be $59,000.
There are legislative bills on womens heart diseases that also outline the relevant cost criteria that should be adopted in certain screening and heart procedures. This can be listed as follows. The Heart for Women Act authorized the expansion to all 50 states of the Centers for Disease Control and Prevention (CDC). The funded WISEWOMAN program provides screening for low-income, uninsured women at risk for heart disease and stroke. The CDC Heart Disease and Stroke Prevention appropriations bill allow CDC to add the 9 states that receive no funding for the competitively awarded Heart Disease and Stroke Prevention Program. It elevates up to 18 states to basic program implementation and supports the other funded states.
Estimation of Program
Cardiac disease is said to be one of the leading causes of death in women in the United States, though most women do not know of this fact as it is. There are certain factors that women also seem to forget, and these factors are about symptoms. The symptoms of heart disease in men and women vary so much and in essence, women overlook this fact and sometimes ignore the signs. This explains why it is important to visit a hospital for a necessary check-up.
Certain factors are also important when dealing with women cardiac problems and how they can be addressed. These include aspects such as chest pain, cardiac workup and the length of time a woman would stay in the hospital for such problems to be addressed. The number of medications prescribed especially when a patient is not educated on certain diet plans might be a major cause of cardiac diseases. Risk assessment and prevention utilize the procedures for assessing an individuals risk factors for heart diseases. It also proposes the possible ways of managing those risks. Cardiac diagnostic evaluation deals with the review of medical history and diagnostic tests if necessary.
Pregnancy care is also a factor that is overlooked in many cardiac issues since it makes a woman know whether (or not) it is safe to have a baby. Lifestyle is also a way of helping women manage their risk factors for heart diseases (Stampfer, Hu, Manson, Rimm, & Willett, 2000).
All the above factors are considered in coming up with the proper cost estimation for a womans cardiac screening program. However, reasons for visiting the ED may vary and most commonly include Stomach and Abdominal Pain, Cramps, Spasms, Chest Pain and Related Symptoms, Back Symptoms, Headache, Pain in the Head, shortness of Breath, Vomiting, Pain, Site Not Referable to a Specific Body Part, lacerations, cuts, and upper extremity.
Estimate the monetary value of outcomes
In coming up with the estimate of the monetary value of outcomes, there is a need to estimate certain incremental costs that will arise as a result of implementing the program and comparing it with the benefits of not implementing the womans cardiac screening program. This will include calculation of the general cost for an individual within the program, other program costs, drug costs as well as the cost of other health services within the program.
The estimated cost of an ED visit will thus be calculated based on the hospital budget line items. The cost of each day in the hospital will depend on the total hospital expenditure and the number of women that turn up for cardiac screening. The monetary value of outcomes as a result of the screening program and the visit of women to this program will be estimated based on the projection listed in the following manner. The estimated costs per year using the sum of $6,680 per testing and cardiology referral will total the projected earnings of $793,604.
If women fail to turn up for cardiac screening, it will highly affect the sustainability of the program and potentially affect its existence since it will make the running of the facility very challenging since the necessary funds would not be available. However, the cardiac screening program will make the women realize potential heart problems early in advance and thus enable proper treatment to be actuated in time. This will reduce the ED visits of women to hospitals and decrease the number of nights spent in hospitals. This is because they will be able to manage their conditions in the comfort of their home.
Account for Effects of Time
The introduction of the womans cardiac screening program will have a lasting effect on the saving of money associated with visits to the hospital. The womans work productivity will increase and provide a real-life balance to a woman with cardiac problems. It will enable women to manage their cardiac problems more effectively since they will be aware of the risks they are already exposed to.
The cardiac screening program will also increase the womans overall productivity in terms of measuring her efficiency in the available resource inputs. It will ensure maximization of outputs from scarce resources, measure the effectiveness of achieving her goals and objectives towards health issues as well as the overall wellbeing.
Distributional Consequences
The benefits that accrue from the introduction and usage of the cardiac screening program has been far reaching in term of improving the quality of life, reduction in cost, education pertaining the cardiac complications and reducing stress level.
Women who are at risk of heart diseases will be in a more convenient position by undertaking the cardiac screening since this will enable them to know of the potential risk and seek medical intervention and care. This will save her a lot of trouble when the family is for emergencies due to admission to the hospital. Another trouble that they will be delivered from is the taking of leave days from work by spouses to cater for them.
Insurance companies, on the other hand, also stand a chance of benefiting especially as pertains to paying claims to the medical insurance holders. This occurs when a woman is admitted as a result of a cardiac illness. The cardiac screening will enable insurance companies to foresee the event of cardiac risk in women and adjust their policy requirements or simply save costs of risks being incurred in future when the cardiac disease is discovered early in advance. Therefore it becomes easily treatable and with less money from the insurance company.
The cost of teaching and education using RNS concerning cardiac ailments will gradually decrease and most nurses and doctors end up having more time to do other duties and follow different patients.
The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) was meant to elaborate on the problems experienced by very sick patients in acute care settings. The idea was that, if physicians, nurses and families had adequate information about the chances of death, care could be appropriately adjusted and decisions on proper care enhanced. This will lead to a decreased length of stay in the hospital as a result of proper care and in turn, resource utilization will be decreased in terms of the number of hours allocated per patient in a day. Resource utilization is measured differently in different hospitals. However, it is generally measured using hospital charges.
Sensitivity Analysis
Sensitivity analysis is the test of how certain changes in resources affect the optimal solution. In sensitivity analysis, we consider the effect of additional limiting or non-limiting constraints in these situations salaries, foundation funding, and efficiencies of scale by using technology. These are some constraints in question.
This is the analysis of the effect of adjusting variables or constraints and determining whether the objective solution will be affected. It shows how much of the objective coefficient (or the maximum available amount of a constraint) can be reduced or increased without affecting the objective solution.
Salaries, as seen in the program budget, are as follows. The regular Labor salary for a full-time nurse practitioner is rated at $118,300. The additional compensation for PRN vacation coverage for a full-time nurse practitioner cost $55.00 per hour to cover 4 weeks per year. The paid time-off for full-time nurse practitioners is at a total of $8,800. When it comes to travel costs, one hospital charges $ 3,124 per trip to each site. This occurred 48 weeks a year and makes the labor expense to total $ 130,224. If the salaries increase, then the total labor cost increases. This will change the cost estimation and thus the cost analysis of a Womans Cardiac Screening Program.
This can be seen from the fact that if an element of cost changes be its labor cost, funding, use of technology the overall cost and budget of the project change and so this affects the cost evaluation and determination especially on the screening of women in the cardiac screening program.
Qualitative Residual
The womens cardiac screening program has brought about a lot of benefits to both the patients and their families. The patients get to realize their ailment early in advance and thus have proper treatment procedures that are both costs effective to the family and the patient.
Cardiac disease management appears effective in reducing dangers associated with heart ailments and improving quality of life. Most clinical trials of heart failure disease programs that have been completed over the past several years have become successful in changing womens lives. Womens cardiac screening program is one of those programs that have facilitated an improvement in the way of life of most women in terms of seeking treatment and better living conditions. Although the designs of these programs vary, education and support have been incorporated to enhance the quality of patient self-management as the key thing in the program.
The content of self-management education normally includes teaching on aspects like taking medications, maintaining a healthy weight, regular health screenings, checking on a diet, exercise and smoking cessation, and recognizing the symptoms (Finkelstein, Troped, Will, & Palombo, 2002). Many of the follow-up programs include engaging at a personal level with the patients. This includes visiting the person at his or her home or contacting the person.
This program assists clients to be aware of the signs and symptoms of the disease. They are educated on how to know when the heart conditions are worsening. They are taught to do self-adjustments that include watching their weight. Otherwise, they could be accorded with alternative treatment procedures. However, some nurses are usually reluctant to educate some patients. The patients with low literacy levels are most vulnerable.
Studies have shown that those patients that have undergone rigorous training readily accept to undertake the exercise themselves. They do this at daily intervals and it has been considered successful since there has been an improvement in their self-care behaviour. Practicing self-care by the patients has been fuelled by the desire to maintain normal body weight. This has seen this kind of treatment to be more successful than when nurses are relied upon as the care providers.
It is important to train patients on the proper dosage that is applied in the self-adjustment program. This is one of the most important aspects of this program. There are other programs to improve patient self-management. However, they are not entirely focused on empowering patients to become self-reliant. The results from this exercise may be comparable to others but it is much preferable since the power is vested upon the patient. The patient is in control of his health.
This program can be seen to have a very close relationship with the early womans cardiac screening, which normally has an impact on the womans health in terms of controlled BP and weight, a more productive regimen and improvement in quality of life. Only a decade ago, many people were heard talking of women health issues and giving their take on those issues. They were mostly in favor of the women going for mammograms. No one disputes this, of course, but we simply cannot stop there since it truly has an impact on womens health. Certain questions that would address every aspect of a womans life must be raised.
For instance, a question that seeks to discover the percentage of women who smoke can be asked. If the number is high, then this means that the chances of more women being at risk of contracting cardiac disease are high and vice versa. There is a question that seeks to find out whether young ladies go for regular screening for such complications as cardiac ailments. If this were so, cardiac diseases could be arrested. Various factors influence a womans health. These include the environment, various responsibilities in the home and at work, her lifestyle and various other factors.
As much as the mothers care dearly about their daughters, they may lack some important knowledge that they need to pass to them. It is for this reason that the girls lead lives without knowing how to make the correct choices. She may lack the knowledge to make certain decisions that are not only crucial to her future but also her health in general. This may develop from a tender age and those decisions may affect a girls future health and put her at risk of having heart complications, which could have otherwise been prevented if she received the right information at the right time.
However, some women may be well of and have plenty of economic resources. They may have the capacity to get very well paying jobs due to their high levels of education. They may also have the capacity to support the family. Women of this caliber are most likely to have the time, money and emotional energy to be concerned about their health since they have too much at stake to lose. Thus, they may engage in practicing regular exercise programs, taking healthy meals every day and having a regular doctor check-up all of which reduce the chances of having heart disease,
This program was designed to help prevent cardiovascular disease. Studies suggest that African American women are at a high risk of dying of heart-related ailments. These include heart disease and stroke. Their numbers exceed those of white women. Hence, the Centre of Disease Control normally works with urban church ministers in a program to make African American women more aware of cardiovascular disease preventive behaviors, which include aspects like nutrition, exercise and not smoking (Walker & Reamy, 2009).
Conclusion
In conclusion, the extent of health issues associated with women led to the creation of the Womens Health office in 1994. However, as time passes, more and more pressing health issues such as cardiovascular disease continue to evolve. This makes all stakeholders, including the government, private sector, public sector, media as well as women themselves to be involved in the process of ensuring that this change in health issues as well as the cost factors are constantly being reviewed and closely monitored. This would be to provide the required support and information needed to prevent all sorts of diseases through all the stages of their lives.
References
Finkelstein EA, Troped PJ, Will JC & Palombo R. (2002). Costeffectiveness of a cardiovascular disease risk reduction program aimed at financially vulnerable women: The Massachusetts WISEWOMAN Program. Journal of Womens Health & Gender Based Medicine, 11(6):519526.
Stampfer, M., Hu, F., Manson, J., Rimm, E., & Willett, W. (2000). Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle. New England Journal of Medicine, 343(7):16-22.
Walker, C & Reamy B. (2009). Diets for cardiovascular disease prevention: what is the evidence? Journal of Am Family Physician, 79 (7): 5718.
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