Personnel Costs Research Articles

How much does it cost to retain antiretroviral therapy (ART) clients in their first year? Routine financial costs of retention interventions at Lighthouse Trustin Lilongwe, Malawi.

Introduction Antiretroviral therapy (ART) improves the health of people living with HIV (PLHIV). However, a high loss to follow-up, particularly in the first year after ART initiation, is problematic. The financial expenses related to client retention in low- and middle-income countries (LMICs) in sub-Saharan Africa are not well understood. This study aimed to comprehensively assess and quantify the financial costs associated with routine ART retention services for clients in their first 12 months in care at Lighthouse Trust's (LT) Martin Preuss Centre (MPC), a large, public ART clinic in Lilongwe, Malawi. Methods We performed activity-based microcosting using routine data to assess the expenses related to routine ART retention services at the MPC for 12 months, from January to December 2021. MPC provides an "ART Buddy" from ART initiation to 12 months. The MPC's Back-to-Care (B2C) program traces clients who miss ART visits by at least 14 days. Clients may be traced and return to care multiple times per year. We assessed client retention costs for the first 12 months of treatment with ART and conducted a sensitivity analysis. Results The total annual cost of ART retention interventions at MPC was $237,564. The proactive Buddy phase incurred $108,504; personnel costs contributed $97,764. In the reactive B2C phase, the total cost was $129,060, with personnel expenses remaining substantial at $73,778. The Buddy unit cost was $34 per client. The reactive B2C intervention was $17 per tracing event. On average, the unit cost for ART retention in the first year of ART averaged $22 per client. Conclusion This study sheds light on the financial dimensions of ART retention during the first year on ART among clients in a routine public setting. ART retention is both costly and critical for helping clients adhere to visits and remain in care. Continued investment in the human resources needed for both proactive and reactive retention efforts is critical to engaging and retaining patients on lifetime ART.

What is the True Cost of Motion Preservation? A Time-driven Activity-Based Cost Analysis of Anterior Cervical Discectomy and Fusion Versus Disc Replacement

Total disc replacement (TDR) has become a viable alternative to anterior cervical discectomy and fusion (ACDF) for select patients. Although most comparative studies have assessed outcomes, cost differences remain largely uninvestigated. This information is critical as we move towards value-based reimbursement. To address this knowledge gap, we used time-driven activity-based costing (TDABC) to compare total intraoperative costs between the two procedures. Total cost was divided into direct (personnel and supply cost) and indirect costs (administrative and overhead costs). Individual costs were determined through direct observation, electronic medical records, and through querying multiple departments (including business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented, in conjunction with process mapping of the intraoperative period. Total intraoperative costs were estimated for all ACDFs (n=810) and TDRs (n=54) from 2017 to 2022. Regression analyses were performed to identify factors associated with total cost. A total of 810 and 54 patients underwent one- and two-level ACDFs and TDRs, respectively. The average total intraoperative cost for an ACDF was $6,776 +/- $2,808, compared to $12,026 +/- $4,235 for TDR. Supply cost accounted for the majority of total cost for both procedures ($4,173 +/- $2,225 for ACDF and $9,532 +/- $4,010 for TDR). On multivariable linear regression analysis, TDR was associated with roughly $3,885 of additional cost compared to ACDF (p<0.001), as well as $4,072 in additional supply cost (p<0.001), most of which was driven by the higher cost of implants (p<0.001). TDABC is a highly useful methodology for estimating differences in true costs between procedures and determining cost drivers. TDRs were associated with an additional $3,885 of total intraoperative cost as compared to ACDFs, the majority of which was driven by the cost of implants.

Time-Driven, Activity-Based Cost Analysis of Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment at a Large Academic Center

Purpose: To perform a time-driven, activity-based cost analysis of retinal detachment (RD) surgery and compare it with reimbursement rates. Methods: This economic analysis at a single academic institution used time-driven, activity-based costing methodology to determine the cost of rhegmatogenous RD repair with primary pars plana vitrectomy. A process flow map was created to highlight each surgical case’s operative episodes, including clinical follow-ups. Time logs were obtained from the electronic health record for each operative phase and clinical follow-up. The overhead and anesthesia costs were collected from the institution’s cost accounting system. The direct material and personnel costs were obtained from internal financial data. Results: Seventy-six cases that met the inclusion criteria were included in the cost analysis study. The time-driven, activity-based cost of RD was $6247.17, and the reimbursement was $5442.91. Therefore, each procedure had a net negative loss of $804.26. To break even, the average operation time would need to be reduced from the determined average of 90.49 minutes to 64.90 minutes. Conclusions: This study found that Medicare underestimates the true cost of RD surgery. Changes in referral patterns may be motivated by reimbursement rates lower than the cost of the procedure, which could ultimately affect patient access to care.

Cost-effectiveness of Dual Hypothermic Oxygenated Machine Perfusion Versus Static Cold Storage in DCD Liver Transplantation.

Ex situ machine perfusion of the donor liver, such as dual hypothermic oxygenated machine perfusion (DHOPE), is increasingly used in liver transplantation. Although DHOPE reduces ischemia/reperfusion-related complications after liver transplantation, data on cost-effectiveness are lacking. Our objective was to evaluate the cost-effectiveness of DHOPE in donation after circulatory death (DCD) liver transplantation. We performed an economic evaluation of DHOPE versus static cold storage (SCS) based on a multicenter randomized controlled trial in DCD liver transplantation (DHOPE-DCD trial; ClinicalTrials.gov number, NCT02584283). All patients enrolled in the 3 participating centers in the Netherlands were included. Costs related to the transplant procedure, hospital stay, readmissions, and outpatients treatments up to 1 y posttransplant were calculated. The cost for machine perfusion was calculated using 3 scenarios: (1) costs for machine perfusion, (2) machine perfusion costs plus costs for personnel, and (3) scenario 2 plus depreciation expenses for a dedicated organ perfusion room. Of 119 patients, 60 received a liver after DHOPE and 59 received a liver after SCS alone. The mean total cost per patient up to 1 y posttransplant was €126 221 for the SCS group and €110 794 for the DHOPE group. The most significant reduction occurred in intensive care costs (28.4%), followed by nonsurgical interventions (24.3%). In cost scenario 1, DHOPE was cost-effective after 1 procedure. In scenarios 2 and 3, cost-effectiveness was achieved after 25 and 30 procedures per year, respectively. Compared with conventional SCS, machine perfusion using DHOPE is cost-effective in DCD liver transplantation, reducing the total medical costs up to 1 y posttransplant.

АНАЛІТИКА ДІЯЛЬНОСТІ ПІДПРИЄМСТВ УКРАЇНИ З ВИРОБНИЦТВА ЦЕМЕНТУ В УМОВАХ СИСТЕМНИХ ВИКЛИКІВ

The article examines the activity of Ukrainian cement production enterprises in conditions of systemic challenges. The steady growth of the cement market in Ukraine in 2021 relative to 2020 has been determined. However, the full-scale war in Ukraine significantly affected the activities of cement manufacturing enterprises. The hostilities on the territory of the country have led to a decrease in the demand for cement due to the suspension of construction projects and infrastructure works, as well as due to instability and economic uncertainty. This was reflected in the decrease in business activity in the cement market in Ukraine. In 2022, the number of active cement production entities decreased by 22.2% compared to 2021. The decrease in the number of business entities in the cement industry of Ukraine led to a decrease in the number of employees, particularly, the number of employees decreased by 21.8% in 2022 compared to 2021. Such trends continued in the reduction of personnel costs of cement production enterprises by 25.1% over the last year under review. It has been proven that the most noticeable negative impact of the war on the development of the cement industry in Ukraine can be traced in the dynamics of the volumes of products sold (goods, services) of enterprises in 2022 compared to 2021: the value of this indicator decreased by UAH 7,499,298.9 thousand. or more than a third. As a result, the financial results of cement production enterprises in 2022 significantly worsened compared to 2021. In general, the level of profitability of the operational activities of cement production enterprises in 2022 significantly decreased compared to the previous three years. The most significant decrease was in profitability of operational activity resulting in a reduction of this indicator to the level of -25.6% in 2022. In general, the system challenges for the development of the cement market in Ukraine derived from war require adequate strategic decisions to support this exceptionally important activity for the post-war recovery of Ukraine. The further research of business responses for the current challenges is a perspective of the further studies in the field.

The impact of minimum wage on automotive companies' performance

This paper aims to verify the relationship between minimum wage growth and the financial indicators of automotive companies. As a hi-tech sector, the automotive industry is usually not expected to be affected by minimum wage policies. The introduction of the minimum wage in Germany and the dynamic development of the minimum wage in Eastern European countries make it possible to assess this relationship. German, Czech, Polish, and Slovak automotive company data was obtained from the Orbis database. Panel regression models were applied to test for dependencies. The paper detects the association between the growth of the minimum wage and the increase in personnel cost, which is next to the associations with several financial indicators at the company level. The identified impact is specific to small and medium-sized companies.

Financial performance of new circular economy companies in rural settings

AbstractThis study examines how rural conditions affect the establishment and performance of new circular economy (CE) companies—those that reduce, reuse, recycle, and recover materials in their processes—focusing on their longevity, financial performance, and distribution of economic value to stakeholders. We hypothesize that while rural conditions generally lead to fewer business establishments, the liability of rurality is less severe for CE companies than for others. We also anticipate that new CE companies will grow more slowly but achieve better performance, resulting in higher survival rates compared to those in other sectors. Our empirical analysis includes all CE companies established in Spain over the past decade. The results indicate that rural CE companies have higher survival rates than their urban counterparts, even after controlling for factors like subsidies and personnel costs. Although rural CE companies exhibit slower growth, they achieve greater profitability. Thus, the CE sector in rural areas demonstrates sustainability not only through its circular practices but also in financial terms, offering significant implications for investors seeking sustainable ventures.

Assessing the Efficacy of Budget in Detecting Fraudulent Personnel Cost Figure in Borno State Civil Service, Nigeria

Assessing the Efficacy of Budget in Detecting Fraudulent Personnel Cost Figure in Borno State Civil Service, Nigeria

CURRENT CHALLENGES AND OPPORTUNITIES OF PERSONNEL MANAGEMENT

In modern conditions, human capital is the most significant asset of any organization, because it is employees, both at the individual level and in the team, who contribute to achieving common goals. Effective management of human resources contributes to maintaining the competitive position of the organization in the market, successful activities in the face of fierce competition and provides opportunities for strategic development. In today’s business environment, HR management is becoming extremely important, because it is aimed at optimizing personnel costs and achieving high results of the organization. The article "Modern Challenges and Opportunities of HR Management" examines the main trends and problems faced by HR managers in the conditions of modern business. The author analyzes the influence of digitalization, remote work and changes in corporate culture on the function of personnel management. The issues of maintaining the well-being of employees, introducing innovative technologies and developing talents as key factors of successful HR management are separately covered. The article also focuses on new opportunities for HR managers to create effective strategies for managing human capital in response to modern challenges

The Cost of Lipoedema Treatment Exceeds the DRG Revenues - Evaluation of the Surgical Treatment Costs of Lipoedema (Stage III) at a German University Clinic

Liposuction for stage III lipoedema is a guideline-based but also time-consuming treatment, which can be carried out under specific conditions at the expense of the German statutory health insurance companies (SHI) based on a decision made by the German Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA), the highest decision-making body in the German healthcare system, in 09/2019. We postulate that the treatment is not reflected in a cost-covering manner in the university cost system. This monocentric, retrospective study examined the economic aspects of 92 cases in 48 lipoedema patients treated during the period from 09/2019 to 08/2023 at the expense of the SHI. These cases were filtered out using DRG coding and the Operation and Procedure Classification system ("Operationen- und Prozedurenschlüssel", OPS), and the costs and revenues per patient were calculated using the data from our internal service accounting. After an inpatient stay of 2.64±1.33 days, the total revenue was € 4,726.79±680.98. This included € 1,532.92±856.99 inpatient costs, € 2,686.02±1,174.70 in operating costs, € 940.76±189.18 in anaesthesia costs and € 63.19±125.38 in other costs that had to be paid within the clinic. On average across all treatments, this resulted in a loss of -€ 875.22 /case. In 54 cases (59%), the costs exceeded the revenue. In total, the calculation of all cases resulted in a loss of € -80,520.63. If medical personnel costs are included, this amount rises to over € 100,000. The results show that the surgical treatment of lipoedema in the German DRG and university cost systems is not cost-covering. This could be relevant in the final economic assessment of the G-BA, which may result in an adjustment of the DRG revenue.

Direct Variable Cost Comparison of Monitored Anesthesia Care Versus Wide Awake Local Anesthesia No Tournique Carpal Tunnel Release: A Time-Driven Activity-Based Costing Analysis

Time-driven activity-based costing (TDABC) provides a more accurate and granular estimation of direct variable costs compared with traditional accounting methods. This study used TDABC to quantitatively compare the same-day facility costs of open carpal tunnel release (CTR) performed under monitored anesthesia care (MAC) versus wide awake local anesthesia no tourniquet (WALANT). We retrospectively identified 474 unilateral CTR (182 MAC and 292 WALANT) performed at an orthopedic specialty hospital between 2015 and 2021. Itemized facility costs were calculated using a TDABC algorithm. Patient demographics, surgical characteristics, and itemized costs were compared between those treated under MAC (MAC-CTR) and WALANT (WALANT-CTR). Multivariable regression was performed to determine the independent effect of MAC on true facility costs. Total facility costs were $170 higher in MAC-CTR compared with WALANT-CTR ($652 vs $482). Monitored anesthesia care-CTR cases had higher personnel costs ($537 vs $394), likely because of higher surgery personnel ($303 vs $185) and postanesthesia care unit personnel costs ($117 vs $95). Monitored anesthesia care-CTR cases also had higher supply costs ($119 vs $81). When controlling for demographics and comorbidities, MAC-CTR was independently associated with an increase in personnel costs by $150.65 (95% CI, $131.09-$170.21), supply costs by $24.99 (95% CI, $9.40-$40.58), and total facility costs by $175.66 (95% CI, $150.18-$201.09) per case. Using TDABC, MAC-CTR was found to be 35% more costly to the facility compared with WALANT-CTR. Notably, WALANT-CTR facility costs presented here do not include additional cost savings from anesthesiologist service fees or preoperative laboratory clearance required for MAC-CTR surgeries. To reduce costs related to CTR surgery, greater efforts should be made to reduce the number of intraoperative personnel and maximize the use of WALANT-CTR in an outpatient setting. Economic and Decision Analysis II.

A new decision-support tool in a multi-center randomized trial for personalized, optimized, and simplified fertility treatment in non-PCOS patients.

This study aimed to evaluate the effectiveness of a clinical decision support tool, Opt-IVF, in achieving the following outcomes: reducing the total cumulative dosage of Gonadotropins (Gns) used during controlled ovarian stimulation cycles and reducing the repeated ultrasonograms (USG) for monitoring follicular growth without compromising the number of good quality blastocysts obtained. The study design employed a multi-center randomized trial. The study enrolled 115 women aged 25-45 years undergoing IVF. Among the participants, 55 were randomly assigned to the intervention group (Opt-IVF), and 60 were randomly assigned to the control group. The intervention involved using a clinical decision support tool, Opt-IVF, to guide Gn dosing and trigger dates. The participants in the intervention group required significantly lower cumulative Gn dosage. The intervention group had higher numbers of oocytes retrieved and M2 retrieved than the control group. The number of good-quality blastocysts, the good-quality blastocyst rate, the ovarian sensitivity index (OSI), and the pregnancy rate in the intervention group were significantly higher than in the control group. The utilization of the clinical decision support tool led to several positive outcomes, including eliminating the need for ultrasound exams after day 5, reducing the dosage of Gn required, and yielding significantly higher numbers of high-quality blastocysts and higher pregnancy rates. Thus, Opt-IVF can successfully provide a personalized, optimized, and simplified approach to superovulation. Opt-IVF consistently outperformed the clinical teams in most of the outcomes. Clinical trials registration: ClinicalTrials.gov (ID - NCT05811065). Date of Registration: 15 March 2023. Date of enrollment of the first subject: 20 March 2023. The high cost of IVF is a result of costly drugs, fixed prices for infrastructure, extensive testing required, and labor costs for physicians and other healthcare personnel. Superovulation, which involves the drug-induced release of multiple eggs needed for IVF, accounts for a significant share of these costs. Current approaches to superovulation involve almost daily monitoring of follicle development using ultrasound and/or blood tests. The daily dosage of stimulatory hormones is then prescribed by physicians based on empirical data and clinical experience. However, the dose is not optimized for each patient, and overstimulation complications can occur. The cost of testing and drugs makes this stage very expensive. To overcome the shortcomings of this system, we have developed a decision support tool (Opt-IVF) that can provide a personalized model-optimized dosage profile for each patient. The clinical results show that Opt-IVF optimizes and personalizes dosage, reduces testing, and provides better outcomes for patients.

A fast and genotype-independent in planta Agrobacterium-mediated transformation method for soybean

Efficient genotype-independent transformation and genome editing are highly desirable for plant biotechnology research and product development efforts. We have developed a novel approach to enable fast, high-throughput, and genotype-flexible Agrobacterium-mediated transformation using the important crop soybean as a test system. This new method is called GiFT (genotype-independent fast transformation) and involves only a few simple steps. The method uses germinated seeds as explants, and DNA delivery is achieved through Agrobacterium infection of wounded explants as in conventional in vitro-based methods. Following infection, the wounded explants are incubated in liquid medium with a sublethal level of selection and then transplanted directly into soil. The transplanted seedlings are then selected with herbicide spray for 3 weeks. The time required from initiation to fully established healthy T0 transgenic events is about 35 days. The GiFT method requires minimal in vitro manipulation or use of tissue culture media. Because the regeneration occurs in planta, the GiFT method is highly flexible with respect to genotype, which we demonstrate via successful transformation of elite germplasms from diverse genetic backgrounds. We also show that the soybean GiFT method can be applied to both conventional binary vectors and CRISPR-Cas12a vectors for genome editing applications. Analyses of T1 progeny demonstrate that the events have a high inheritance rate and can be used for genome engineering applications. By minimizing the need for tissue culture, the novel approach described here significantly improves operational efficiency while greatly reducing personnel and supply costs. It is the first industry-scale transformation method to utilize in planta selection in a major field crop.

Pilot Assessment of Piezoelectric Transducers as a Cost-Effective Alternative to EndoPAT

Introduction: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. Methods: Twenty-five adults (aged 20–64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. Results: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman’s r = 0.67, p = 0.0002; Pearson’s r = 0.76, p = 0.00001). Conclusion: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.

Application of instance segmentation algorithm incorporating attention mechanism and BiFPN for sinter ore particle size recognition

The particle size composition of sinter plays a decisive role in the output and energy consumption of blast furnace ironmaking. To reduce energy consumption and achieve efficient production, accurate measurement of sinter particle size and distribution has become an important issue. Due to the problems of adhesion, large size difference and edge effect in sinter image, the traditional image segmentation algorithm makes it difficult to effectively separate sinter. This paper proposes an intelligent recognition method of sinter particle size based on an improved BlendMask instance segmentation algorithm. Bidirectional feature pyramid network is used to replace the feature pyramid network structure (FPN), and the attention mechanism Convolutional Block Attention Module (CBAM) is introduced to improve the ability to extract shallow features and enhance the ability to identify adherent sinter. The test results show that the average detection accuracy mean average precision (mAP) of the model proposed in this article is 71.0%, and the mAP50 is 93.8%. The average segmentation accuracy mAP is 68.0% and mAP50 is 93.8%. The identified sinter images were then edge-refined using morphological methods to collect statistics on the particle size distribution of the sinter. Compared with the actual measured sinter particle size, the average relative error is 4.9%. This method can accurately identify sinter in complex environments, improve the production efficiency of sinter, optimise resource utilisation and reduce personnel costs and has important application prospects.

Costs and cost drivers of comprehensive sexual reproductive health services to female sex workers in Kenya

BackgroundComprehensive sexual reproductive health (SRH) programs for female sex workers (FSW) offering clinical, behavioural, and structural interventions have contributed to declining rates of HIV in this population. However, data on costs and cost drivers is needed to support programs and their donors to better allocate resources, make an investment case for continued funding, and to identify areas of improvement in program design and implementation. We aimed to estimate the annual per-FSW costs of comprehensive services for a standalone FSW program in Kenya.MethodsWe implemented a top–bottom and activity-based costing study of comprehensive FSW services at two drop-in centres (DICs), Mtwapa and Kilifi town, in Kilifi County, Kenya. Service costs were obtained from routinely collected patient data during FSW scheduled and unscheduled visits using Kenyan Ministry of Health records. Costing data were from the program and organization’s expenditure reports, cross checked against bank documents and supported by information from in-depth interviews. Data were collected retrospectively for the fiscal year 2019. We obtained approval from the AMREF Research Ethics Committee (AMREF-ESRC P862/2020).ResultsIn 2019, the unit cost of comprehensive services was 105.93 USD per FSW per year, roughly equivalent to 10,593 Kenya shillings. Costs were higher at Mtwapa DICs compared to Kilifi town DIC; 121.90 USD and 89.90 USD respectively. HIV counselling and testing cost 63.90 USD per person, PrEP was 34.20 USD and family planning was 9.93 USD. Of the total costs, staff salaries accounted for about 60%. Adjusted for inflation, costs in 2024 would be approximately 146.60.ConclusionPrograms should strive to maximize the number of FSW served to benefit from economies of scale. Given that personnel costs contribute most to the unit costs, programs should consider alternative designs which reduce personnel and other costs.

『스마트상점 기술 도입』이 소상공인 점포의 매출과 만족도에 미치는 영향

This study decomposes the local gap through the oaxaca factor analysis to find out how differences in housing prices affect the management costs with data the average value of three-year management costs between 2014 and 2016 to 536 complexes in three Gangnam and Gangbuk districts in Seoul. The results of the analysis of 290 complexes in three Gangnam and 246 complexes in three Gangbuk districts are as follows. First, housing prices did not affect administrative costs within the region, but were variables that affected data pooling. Second, when compared with the three Gangnam districts, the results of the characteristic coefficient, which can be explained by the characteristics of the complex and the external environment, showed that the gap in the management cost increased when the number of security personnel, repair and maintenance costs, elevator maintenance cost, floor area ratio, and 60m2 or more to 85m2. Third, the factors behind the gap between Gangnam 3 districts, which have higher housing prices than Gangbuk 3 districts, were confirmed to be the number of security personnel, repair costs, floor area ratio and elevator maintenance costs, and the higher the size and income of their holdings, the more they lived in Gangnam 3 districts, where local infrastructure was expanded, causing social inequality due to differences in housing welfare, such as safety, comfort and convenience.

The Interplay of Compensation and Working Facilities on Local Tax Revenue: A Data Panel Evidence of Municipalities in East Borneo

This study investigates the relationship between employee compensation, working facilities, and local tax revenue generation in East Kalimantan Province, Indonesia. Utilizing panel data multiple linear regression analysis, the research analyzes financial reports from ten Regencies and Cities (Balikpapan, Samarinda, Bontang, Kutai Timur, Kutai Barat, Kutai Kartanegara, Penajam Paser Utara, Berau, Mahakam Ulu, and Paser) over the period of 2017-2023. Employee compensation, represented by growth of employee expenditures (PBP), captures the year-to-year increase in personnel costs. Working facilities, represented by growth of goods and service expenditures (PBBJ), reflect the year-to-year change in spending on operational resources. The findings reveal a positive association between both growth in employee expenditures and growth in goods and services expenditures with local tax revenue, but these relationships are not statistically significant. This suggests that factors beyond employee compensation and working facilities likely play a more prominent role in driving regional tax revenue growth.

COST-ANALYSIS OF REDUCING MORTALITY RATE FOR LBW BABIES AT FATMAWATI HOSPITAL'S NICU

Background: As a developing country that still struggles with infant mortality, Indonesia needs high-quality and efficient neonatal care. However, due to the complexity of neonatal care, the neonatal intensive care unit (NICU) still has a high cost, approximately USD 950 - 31,000, as the last line of care. Aims: This study analyzes the cost incurred due to service improvement at Fatmawati General Hospital. The cost analysis may serve as useful evidence for other hospitals with NICUs that seek to improve their service. Methods: We used cost analysis to examine pre-intervention costs in 2015 and post-intervention costs in 2021. Our data were gathered primarily in the NICU of Fatmawati General Hospital for three months in 2023. Results: The results showed an increase in total cost of IDR 1,898,040,489 (55%). The largest cost increase was personnel and supplies costs, which accounted for 83.8% of the cost increase. However, this cost increase was also followed by a significant decrease in mortality rates, from 128 deaths per 1,000 births to 17 deaths per 1,000 births. Conclusion: This study found a correlation between investment in service improvements and decreased infant mortality rates in the NICU of Fatmawati General Hospital. Although the 55% increase in total cost was associated with a significant decrease in infant mortality rates in the NICU of Fatmawati General Hospital, further studies are needed to determine the effectiveness of improvements in the NICU's services. Keywords: cost, Indonesia, LBW, NICU

ПУТИ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ ЭКСПЛУАТАЦИИ ТРАДИЦИОН-НЫХ И ГИБРИДНЫХ РАСПРЕДЕЛИТЕЛЬНЫХ СЕТЕЙ

The main goals, development methodology and existing problems in distribution networks are con-sidered. It has been established that a promising direction for the development of electrical networks is the introduction of hybrid DC-AC networks, which combine the advantages of AC and DC net-works. Hybrid networks are promising, and already at the design stage, “smart” networks can be cre-ated on their basis, which can facilitate the work of the power system dispatcher, reduce personnel and maintenance costs