title: Time-based analysis of total cost of patient episodes: a case study of hip replacement.
abstract: OBJECTIVE
  Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue.
  
  
  METHODS
  Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year.
  
  
  RESULTS
  The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency.
  
  
  CONCLUSIONS
  Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.
authors.affiliation: Department of Industrial Engineering and Management, Helsinki University of Technology, Helsinki, Finland. antti.peltokorpi@hut.fi
authors.forename: Antti
authors.initials: A
authors.lastname: Peltokorpi
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kujala
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D003365:Costs and Cost Analysis; D017050:Episode of Care; D005387:Finland; D006801:Humans; D008875:Middle Aged; D013997:Time Factors