Increase Cost Efficiency Research Articles

3D printing: can it make surgery more accessible?

The advancement of 3-Dimensional (3D) printing technology has made the design and production of items increasingly ubiquitous amongst the public. This technology is increasingly being used widely in various medical fields. With its increasing cost efficiency and accessibility, it is the author's perspective that 3D technology can improve accessibility to surgical procedures in low- and medium-income countries (LMIC) by providing proceduralists with the basic equipment required to perform routine operations.

Specialist consultation activity and costs in Australia: Before and after the introduction of COVID-19 telehealth funding

This study describes and analyses the Medicare Benefits Schedule (MBS) activity and cost data for specialist consultations in Australia, as a result of the coronavirus disease 2019 (COVID-19) pandemic. To achieve this, activity and cost data for MBS specialist consultations conducted from March 2019 to February 2021 were analysed month-to-month. MBS data for in-person, videoconference and telephone consultations were compared before and after the introduction of COVID-19 MBS telehealth funding in March 2020. The total number of MBS specialist consultations claimed per month did not differ significantly before and after the onset of COVID-19 (p = 0.717), demonstrating telehealth substitution of in-person care. After the introduction of COVID-19 telehealth funding, the average number of monthly telehealth consultations increased (p < 0.0001), representing an average of 19% of monthly consultations. A higher proportion of consultations were provided by telephone when compared to services delivered by video. Patient-end services did not increase after the onset of COVID-19, signifying a divergence from the historical service delivery model. Overall, MBS costs for specialist consultations did not vary significantly after introducing COVID-19 telehealth funding (p = 0.589). Telehealth consultations dramatically increased during COVID-19 and patients continued to receive specialist care. After the onset of COVID-19, the cost per telehealth specialist consultation was reduced, resulting in increased cost efficiency to the MBS.

Key Technologies for Deep Horizontal Well Drilling of Shale Gas in Luzhou of Sichuan Basin

The drilling of deep shale gas horizontal wells in Luzhou block of Sichuan Basin has been chanllenged by long drilling cycle, low rate of penetration (ROP), high drilling tool vibration, poor drillability of special lithological formations, horizontal wellbore instability, high formation temperature, and high friction torque and sticking risk etc.. To solve these problems and to ensure operation safety and increase cost-efficiency, technological research was carried out on casing program design of horizontal wells, wellbore trajectory control and optimization of horizontal sections. As a result, the optimal parameters of the radical drilling method were recommended, and shock absorption, speed-up, and high efficient rock breaking technologies for special lithological formations were preferentially adopted. In addition, drilling fluid system and performance parameters were recommended based on pilot tests of ground cooling equipment. In this way, key drilling technologies with high operation safety and efficiency were formed for the deep shale gas horizontal wells in Luzhou block. Through the application of the key technologies in four wells in Luzhou block, the experimental results show that the drilling cycle was redcued by 14.5% and no downhole failure was reported for average well depth of 5,601.00 m and the horizontal section length of 1,884.00 m. So these technologies can meet the requirement of safe and efficient drilling as well as wide application scope in Luzhou.

Increasing Cost Efficiency in Adult Spinal Deformity Surgery: Identifying Predictors of Lower Total Costs.

Retrospective study of a prospective multicenter database. The purpose of this study was to identify predictors of lower total surgery costs at 3 years for adult spinal deformity (ASD) patients. ASD surgery involves complex deformity correction. Inclusion criteria: surgical ASD (scoliosis ≥20°, sagittal vertical axis [SVA] ≥5 cm, pelvic tilt ≥25°, or thoracic kyphosis ≥60°) patients >18 years. Total costs for surgery were calculated using the PearlDiver database. Cost per quality-adjusted life year was assessed. A Conditional Variable Importance Table used nonreplacement sampling set of 20,000 Conditional Inference trees to identify top factors associated with lower cost surgery for low (LSVA), moderate (MSVA), and high (HSVA) SRS Schwab SVA grades. Three hundred sixtee of 322 ASD patients met inclusion criteria. At 3-year follow up, the potential cost of ASD surgery ranged from $57,606.88 to $116,312.54. The average costs of surgery at 3 years was found to be $72,947.87, with no significant difference in costs between deformity groups (P > 0.05). There were 152 LSVA patients, 53 MSVA patients, and 111 HSVA patients. For all patients, the top predictors of lower costs were frailty scores <0.19, baseline (BL) SRS Activity >1.5, BL Oswestry Disability Index <50 (all P < 0.05). For LSVA patients, no history of osteoporosis, SRS Activity scores >1.5, age <64, were the top predictors of lower costs (all P < 0.05). Among MSVA patients, ASD invasiveness scores <94.16, no past history of cancer, and frailty scores <0.3 trended toward lower total costs (P = 0.071, P = 0.210). For HSVA, no history of smoking and body mass index <27.8 trended toward lower costs (both P = 0.060). ASD surgery has the potential for improved cost efficiency, as costs ranged from $57,606.88 to $116,312.54. Predictors of lower costs included higher BL SRS activity, decreased frailty, and not having depression. Additionally, predictors of lower costs were identified for different BL deformity profiles, allowing for the optimization of cost efficiency for all patients.Level of Evidence: 3.

Mathematical modelling of ultrasonic treatment of asphaltene deposits

Objective. The removal of asphaltene deposits at oil and gas facilities is one of the urgent and important problems and requires significant material and labor costs. It is possible to reduce costs by creating and implementing effective technical means, which requires an in-depth study of the processes of organic matter deposition at oil and gas facilities and their use as a secondary raw material. Methods. This paper discusses modern views on the state of the problem of asphaltene deposits in oil shipping and storage equipment and possible ways to solve it. The paper provides an overview of various ways to clean shipping and storage objects from asphaltene deposits: chemical (adding additives, solvents), thermal (heating by special devices or injection of superheated steam during exploitation), mechanical (using scrapers and pistons), and refers, among other things, to scientific works on the use of ultrasound to accelerate the removal of deposits. Results. The paper considers methods for removing deposits, as well as using the positive effect of the removed layer as a secondary energy source. A procedure for model calculation of the use of ultrasonic equipment to remove deposits has been developed. As a result, the deposit melting front velocity was determined depending on the duration of exposure. Conclusion. Taking into account the positive world experience, the level of development of the ultrasonic method for removing asphaltene deposits in the oil and gas industry and the use of asphaltene deposits as a secondary raw material, this area needs further development. The widespread implementation of equipment and, from the standpoint of rational use of natural resources, the use of deposits as a secondary raw material will increase cost efficiency and equipment efficiency, and reduce environmental impact.

ACCELERATION AND STRENGTHENING OF SHARIA FINANCIAL INCLUSION THROUGH MERGING SHARIA BANKING IN INDONESIA

Islamic banking in Indonesia is slowly experiencing significant developments both in terms of number of assets and its financial performance. On the other hand, the market share was only able to grow by 6.18 percent with grow rate less than 5 percent. Therefore, one of the strategies to increase and accelerate the growth of Islamic banking is through a merger. The purpose of this study is to provide an overview of the potential development of Islamic banking after the merger as an effort to strengthen the inclusion and acceleration of Islamic finance in Indonesia. The method used is in the form of a systematic analysis review by collecting various secondary data and then conducting a quality assessment to obtain in-depth research objectives. The results found through content analysis indicate that the merger strategy provided added value to the banking industry through greater market expansion, increased cost efficiency, financial performance, and lowering prices, to meet the public need for sharia-based financial services. Through a merger strategy, Islamic banking is able to become a new pillar of national economic strength and encourage Indonesia to become the center of the world on Islamic finance.

A method for preliminary rotor design – Part 2: Wind turbine Optimization with Radial Independence

Abstract. A novel wind turbine rotor optimization methodology is presented. Using an assumption of radial independence it is possible to obtain an optimal relationship between the global power (CP) and load coefficient (CT, CFM) through the use of Karush–Kuhn–Tucker (KKT) multipliers, leaving an optimization problem that can be solved at each radial station independently. It allows solving load constraint power and annual energy production (AEP) optimization problems where the optimization variables are only the KKT multipliers (scalars), one for each of the constraints. For the paper, two constraints, namely the thrust and blade root flap moment, are used, leading to two optimization variables. Applying the optimization methodology to maximize power (P) or annual energy production (AEP) for a given thrust and blade root flap moment, but without a cost function, leads to the same overall result with the global optimum being unbounded in terms of rotor radius (R̃) with a global optimum being at R̃→∞. The increase in power and AEP is in this case ΔP=50 % and ΔAEP=70 %, with a baseline being the Betz optimum rotor. With a simple cost function and with the same setup of the problem, a power-per-cost (PpC) optimization resulted in a power-per-cost increase of ΔPpC=4.2 % with a radius increase of ΔR=7.9 % as well as a power increase of ΔP=9.1 %. This was obtained while keeping the same flap moment and reaching a lower thrust of ΔT=-3.8 %. The equivalent for AEP-per-cost (AEPpC) optimization leads to increased cost efficiency of ΔAEPpC=2.9 % with a radius increase of ΔR=17 % and an AEP increase of ΔAEP=13 %, again with the same, maximum flap moment, while the maximum thrust is −9.0 % lower than the baseline.

Analysis of Modular House Fabrication Technology Application in Subsidized Housing Construction Based on Project Planning

Technology in the construction industry is now rapidly developing. Construction technology, which synergies with good construction management, can increase cost efficiency, time, and project quality. In conventional construction methods, there is a high level of uncertainty. The high level of uncertainty impacts poor project control resulting in project delays, high overhead costs, and a decrease in project quality. Modular home fabrication technology was developed to reduce project costs and time and improve project quality. The increasing demand for proper housing is currently encouraging Indonesia’s Government to create a Subsidized Housing Program. ‘Y’ subsidized housing is one of the subsidized housing in Indonesia. The ‘Y’ subsidized housing construction still uses conventional construction. How to compare the achievement of efficiency in cost and time plans as well as project quality between the application of modular home fabrication technology with traditional construction in ‘Y’ subsidized housing construction, with potential project cost savings of 5-15%, acceleration of project duration of 9 months from planning, and inspection the quality of the project is done in stages? The achievement of cost and time efficiency of the project and improving the quality of the project affect the choice of the construction method. Modular home fabrication technology can be implemented if the modular manufacturer meets the criteria. These criteria are: including being qualified in modernization, having a consistent level of productivity, having adequate mobilization, and commitment that is always maintained to see prospects.

Lean Hospital: Strategy of Operational Financing Efficiency in Supply Chain Management

Health financing in Indonesia has increased from 27 US $ (2003) to 115 US $ (2017) and will continue to increase as the population increases. The JKN era is also a burden where health financing managed by BPJS is always deficit every year. Hospitals as health service providers must be able to carry out operational cost efficiency as mandated by the JKN era, namely quality control and cost control. One of the cost efficiency methods is the implementation of lean management in hospital operational processes, especially the supply chain management process (procurement, inventory control, distribution planning and demand management). This study aims to evaluate the improvement process and cost efficiency after the implementation of lean management in the supply chain management process at the hospital. This study used a single holistic case study method with the unit of analysis at the Lean team level at Panti Rapih Hospital, Yogyakarta. Research subjects are employees in the team who are directly involved in the implementation of lean management. Selection of research subjects based on purposive sampling. Total sample of 7 respondents for in-depth interview process. The research instrument used an interview guide. The result of this research is that lean management which is applied in the logistic unit of the neat orphanage hospital can reduce waste such as motion, inventory, and waiting time. In addition, another benefit that can be felt by management is increasing cost efficiency. The conclusion of this study is that lean management is recommended to be applied in health services such as hospitals.

Strategy for increasing tender success in Jakarta’s e-tender construction project

Electronic tender or e-tendering system in the procurement of goods and services in Indonesia from the perspective of the government is considered to be a tool to realize good governance and public services, because it will increase cost efficiency, effectiveness, faster cycle times, increase package transparency tendered work, provides better public monitoring, promotes fair competition and increases government accountability. However, in the implementation of e-tendering for construction projects, many tenders have failed. This research aims to identify the factors that cause tender failures and develop strategies to increase the success of e-tendering for construction projects in Jakarta. Identification of the factors causing the tender failure was obtained from a literature study and these factors were validated by experts. Questionnaires were distributed to project owners, tender committee, and contractors who have participated in e-tendering system for public construction projects in Jakarta. From the data obtained, statistical analysis using validity test, reliability test, comparative analysis and descriptive statistical analysis used to obtain factors that cause e-tender failures. Proposed strategies for increasing e-tender success for construction projects were obtained from literature studies and expert judgment.

Advanced Technologies for Applied Particle Accelerators and Examples of Their Use (Review)

This review presents the author’s view on modern trends in the development of charged particle accelerators for various applications, which is based on his own experience in this research field. The most promising, in the author’s opinion, areas of application of resonance accelerators are shown, in which substantial progress has been made by using new technologies. The use of high-gradient structures, novel materials, new manufacturing technologies, cooling systems, and new principles of acceleration made it possible to achieve miniaturization, to increase cost efficiency, and to succeed in adjusting accelerator parameters (to achieve variability) for industrial, medical, and research purposes, as well as for applications in security systems and quantum computers.

Artificial intelligence in healthcare: opportunities and risk for future

ObjectiveThis study aimed to find out the opportunity of artificial intelligence (AI) and the risk in health service. MethodA comprehensive literature search was collected from three databases (Web of Science, Google Scholar, and EBSCOhost) to identify articles studied Implementing AI in improving in health services. Two reviewers independently assessed the quality of studies using the Joanna Briggs Institute. ResultsThe application will improve diagnostics, prevention, and treatment of patients, increasing cost efficiency and equality and equality in health services. For the challenge, there is no AI adoption in public sector, patients’ privacy, patient autonomy rights become problems in AI applications. ConclusionsImplementation of AI is needed in the efficiency of health service management as well as making medical decisions. The challenge is facilitating early adoption and ongoing implementation in the health care system, and we consider some of the ethical problem lists faced by AI clinical application.

ОСНОВНІ АСПЕКТИ ОРГАНІЗАЦІЇ ОБЛІКОВО-АНАЛІТИЧНОГО ЗАБЕЗПЕЧЕННЯ ТА УПРАВЛІННЯ ВИТРАТАМИ ПІДПРИЄМСТВА

One of the most important indicators of production and economic activity of enterprises, which has a direct impact on financial performance is costs. The article defines the economic meaning of the concept of "costs", "production costs". Features of accounting and analytical support, organization of accounting and cost management, cost classification are considered. Classification is one of the methods of cognition and study of phenomena, processes, objects, which consists in their division into classes on the basis of certain features, properties and patterns of relations between them. The classification of costs helps to assess the costs incurred, to find possible features to increase cost efficiency and make the right decisions about their management. Classification of costs is the basis of their accounting, analysis and planning in the enterprise. Cost management takes into account such components as rationing, planning, cost accounting, deviation control and cost analysis, cost management and decision making. The problem of cost management is quite relevant for Ukrainian enterprises. Today, all businesses face the problem of applying International Financial Reporting Standards. The peculiarities of cost reflection according to International Financial Reporting Standards and National Accounting Standards (standards) are studied and analyzed. Achieving a high or sufficient level of each of the production or management processes of financial activities of economic entities must be accompanied by certain costs, the economic content of which will vary depending on the object. However, the owners (managers) of the enterprise or its individual structural unit must be clearly aware of what exactly the costs contribute to the creation and maintenance of the organization and their timely optimization. The Conceptual Basis of Preparation and Submission of Financial Statements means true presentation, prevalence of substance over form, prudence, completeness. These requirements formed the basis for the formation of accounting principles in International Standards and, accordingly, in Ukraine.

The efficiency of public procurement in the health sector – the platform on sustainable public finances

At present, public procurement processes and their efficiency represent one of the key determinants of public finance system. Many countries of the European Union work intensively on reforming public procurement processes. The main aim of public procurement is to create an open competition in order to achieve the most efficient use of public funds. The Slovak hospitals, that have been inefficiently managed in the long run, are the weakest segment of the healthcare system. Also, the public hospitals continue to generate substantial losses even if many reforms had been implemented to increase cost efficiency. However, medical debt consolidation did not help the hospitals to set optimal functioning of the economic processes in order to improve their management permanently. The primary aim of the study is to examine an impact of selected determinants on an efficiency of public procurement processes in the healthcare system of the Slovak Republic during the 2014 – 2017. The data were obtained from the registers of the Public Procurement Office of the Slovak Republic. The multinomial logistic regression was used to determine the following findings: in case of zero, or positive savings, the number of offers, year of public procurement, type of public procurement procedure, NUTS level of procurement and participation of a subcontractor in procurement process are significant categorical variables. The study results enable a creation of multi-dimensional analyses and support models in order to make effective public procurement processes in the healthcare system. Similarly, these results enable to create comparative benchmarking analyses, and may lead to a creation of new agencies and institutions.

Unraveling the impact of variable external input use on the cost efficiency of dairy farms in Europe

There has been a global shift towards intensification in the dairy sector in recent years which may have considerable impact on the cost efficiency and economic returns of farms. Considering this, the goal of this study is to offer an empirical analysis of the effect of variable external input use on dairy farms. Employing a novel Activity Analysis Model (AAM), the study analysis was conducted in two distinct but complementary steps. In the first step, we discriminated two technologies (low and high inputs) which allow us to classify a sample of dairy farms according to their level of intensification, while in the second step, we evaluated two cost efficient frontiers instead of assessing individual farm inefficiency scores. With this approach, we explore different technologies within a sample of EU dairy farms. Our results, on average, shows that agricultural practices using low inputs dominates the high input ones for farms operating on a large scale while a slight dominance of high input over low inputs exist for small scale farmers. While we reckon that low input can be cost competitive with their high input counterparts, we also note that regional differences do exist. Thus, showing that the significant gap between the two discriminating frontiers depends not only on farm size but also on farm region. We found that increased cost efficiency can reduce the negative environmental impact of EU-dairy farms while simultaneously reducing farmers’ production costs. The results of the study can therefore provide a direction to policymakers and dairy farmers alike as regards the efficient use of external inputs which may consequently reduce environmental burdens associated with dairy farms. • Grazing Livestock units differentiates our sample into unique technologies and sizes. • Low Input farms can be cost competitive with their high input counterparts. • Gap between two farming systems largely depend on farm size and regions. • Increased cost efficiency has an impact on the environmental performance of dairy farmers.

Cost efficiency of principal crops in Bihar (India) – A stochastic frontier approach

In the present study, an attempt has been made to test the cost efficiency of cereal crops like paddy, wheat and maize separately in the state of Bihar using Stochastic Cost Frontier model. It has been tried to determine the determinants of cost inefficiencies. The study is also aimed to know the factors affecting the cost inefficiencies in production of major cereals of the state so as to ascertain proper steps to increase cost efficiency in production. Most important observation emerged that there existed non-linear relationship between cost inefficiency and farm category. Cost inefficiency first increased with the increase of farm size then it decreased. In case of paddy mechanization could negatively affect the cost inefficiency and proportion to family labour in total labour was found positive implying increase in cost inefficiency. But in wheat, family labour showed positive value, indicating thereby increase in cost inefficiency. In case of maize, coefficient of fertilizer use was observed positive indicating increase in cost inefficiency. Coefficients of land holding size were positive in all the crops for all categories of farms. This advocated non-linear relation between farm category and cost inefficiency which showed larger farms were less cost efficient. The cost inefficiency depends on proportion of family labour, mechanization, type of seed used. The result enables to identify the determinants of cost inefficiency, which will certainly guide the state to adopt suitable policies. Farmers may be made aware about rational allocation of resources to reduce cost and make farming cost efficient.

Predictive model of preoperative blood preparation for transfusion in isolated coronary artery bypass graft surgery

<h3>Introduction</h3> Patients undergoing isolated coronary artery bypass graft (CABG) at our heart centre require two packed red blood cells (RBC) pre-operatively based on the data from Maximum Surgical Blood Order Schedule (MSBOS). Transfusion-related mortality and morbidity have been shown to be dose dependent, suggesting that the lowest effective number of units should be transfused. Pre-operative identification of patient's characteristic requiring blood transfusion during procedure will allow for better utilization of blood, reduce wastage and increase cost efficiency. We aim to define a set of parameters to indicate necessity for blood transfusion hence, consideration will be given to supply one instead of two packed RBC to patients who do not require transfusion. <h3>Methods</h3> This cross-sectional study obtained integrated data-set from the hospital information system and clinical database (Cardio thoracic Surgery Registry) from January 2015 to December 2018. A total of 4,646 patients who underwent isolated CABG were included in this study and 28 independent predictors associated with transfusion were identified and analyzed. A predictive model for preoperative requirement of blood transfusion was developed using logistic regression and machine learning approach ie; Decision tree, Logistic Regression, KNN, Naïve Bayes, Gradient Boosted Tree, and Random Forest using RapidMiner. <h3>Results</h3> In 2015-2018, only 25.7% of patients utilized two packed RBC's whereas 20.2% utilized only one for blood transfusion during procedure. The remainder 54.1% of non-utilized blood were returned to the blood bank within 48 hours. Logistic regression and machine learning algorithm unveiled similar significant predictors to predict the requirement of blood transfusion pre-operatively. There are 24 significant predictors identified from the highest accuracy algorithm which is Random Forest (99.78%), as compared to others machine learning approaches particularly the Decision Tree 79.55%, Logistic Regression 85.25, KNN 75.35%, Naïve Bayes 79.76%, and Gradient Boosted Tree 83.32%. <h3>Discussion</h3> A clinical predictive model was developed for preoperative risk stratification of patients requiring blood transfusion and to further assist clinicians for better utilization of blood bank resources. Variables significantly associated with blood transfusion were female gender, EF<50%, BMI<30, age>40 serum creatinine>100mmol/L, and previous cardiac procedures. This tool may prospectively optimize the ordering of blood with the potential to reduce adverse events and costs related to transfusion in the future. However, for the consideration to supply only one packed RBC in retrospect to patients who do not require transfusion, more data and predictors should be added in this study.

Big Banks versus Agricultural Banks: Has Too‐Big‐To‐Fail Regulation Affected Efficiency and Scale Economies Measures?

The Dodd‐Frank Wall Street Reform and Consumer Protection Act of 2010 aimed to improve the financial stability of the banking industry. This reform was intended to reduce the too‐big‐to‐fail practices for very large banks. However, it might also affect the performance of relatively small asset size banks with different lending portfolios. Using the Call Report data from 2006 to 2016, evidence suggests that the Dodd‐Frank Act has affected the estimates of cost efficiency and returns to scale measures of both big banks and small agricultural banks. Results indicate that Dodd‐Frank Act has increased cost efficiency, discouraged mergers, and encouraged product specialization for banks above the $50 billion asset size. However, none of these results hold for the banks just above the $10 billion asset size. This appears to suggest that Dodd‐Frank Act has mainly affected the economic measures of those very big banks that are subject to the more stringent regulations. Nevertheless, Dodd‐Frank has reduced agricultural banks' cost efficiency and increased incentives for mergers. In addition, the Dodd‐Frank Act has dampened the incentives for product diversification in agricultural banking. Likewise, evidence exists that this act has slowed productivity growth, efficiency, and technological change in agricultural banks. Taken together, Dodd‐Frank reduced consolidations in very big banks that are subject to greater oversight but adversely affected U.S. agricultural lending.

How Volunteer Involvement Affects Professionals’ Basic Needs Satisfaction and Intrinsic Motivation

As governments around the world seek to increase the capacity of public organizations to deliver high-quality services to its citizenry, volunteers are increasingly seen as a critical resource. While volunteers can bring a number of positive resources to public organizations and help increase cost-efficiency, service quality and impact, research has largely overlooked how professionals respond to volunteer involvement. We contribute to the nascent literature on how volunteers are perceived by individuals with a professional identity by integrate insights from studies on coproduction and volunteering with the established social psychology theory of self-determination to propose how that characteristic of the tasks allocated to volunteers affect professionals’ work motivation through the satisfaction of basic psychological needs for feeling autonomous, competent and related to others. Using structural equation modeling and an instrumental variables estimation approach, our results show that intrinsic motivation is negatively impacted when volunteers solve tasks that are core–in contrast to complementary–to the profession, and the identity of professionals. Moreover, these negative effects are transmitted through the needs for feeling competent and related to others, while results are more mixed for satisfaction of the basic need for feeling autonomous.

Day Surgery Program at West China Hospital: Exploring the Initial Experience.

Healthcare facilities in China are facing increasing demands as the country has the fastest aging populations in the world. Day surgery can be utilized to address some of these demands. Benefits of day surgery include shortened hospital stay, decreased risk of hospital-associated infections, and increased cost efficiency. We present a retrospective study of eight years of day surgery data from West China Hospital, one of the largest hospitals in China, with an emphasis on an examination of the growth in day surgeries. We examined patterns of utilization of day surgery versus inpatient surgery (including types of surgeries performed in the Day Surgery Center and the ratio of day surgery versus elective surgery), as well as unplanned readmission and return to inpatient department rates, and a comparison of average costs and length of stay for day surgery versus hospital surgery.Day surgery has a safe and cost-effective way to alleviate the soaring healthcare demands in West China. There is potential opportunity to further address the ever-increasing demands on the healthcare system in this area by performing more complex surgeries as day surgeries. This article presents an effective organizational protocol and proposes a reliable medical quality assurance system, which prioritizes safety of the growing day surgery program; furthermore, it describes the factors and lessons learned from the successful implementation of a day surgery system.