title: Comparison of extracorporeal shock wave lithotripsy running models between outsourcing cooperation and rental cooperation conducted in Taiwan.
abstract: OBJECTIVE
  We conducted a retrospective study to compare the cost and effectiveness between two different running models for extracorporeal shock wave lithotripsy (SWL), including the outsourcing cooperation model (OC) and the rental cooperation model (RC).
  
  
  METHODS
  Between January 1999 and December 2005, we implemented OC for the SWL, and from January 2006 to October 2011, RC was utilized. With OC, the cooperative company provided a machine and shared a variable payment with the hospital, according to treatment sessions. With RC, the cooperative company provided a machine and received a fixed rent from the hospital. We calculated the cost of each treatment session, and evaluated the break-even point to estimate the lowest number of treatment sessions to make the balance between revenue and cost every month. Effectiveness parameters, including the stone-free rate, the retreatment rate, the rate of additional procedures and complications, were evaluated.
  
  
  RESULTS
  Compared with OC there were significantly less treatment sessions for RC every month (42.6±7.8 vs. 36.8±6.5, p=0.01). The cost of each treatment session was significantly higher for OC than for RC (751.6±20.0 USD vs. 684.7±16.7 USD, p=0.01). The break-even point for the hospital was 27.5 treatment sessions/month for OC, when the hospital obtained 40% of the payment, and it could be reduced if the hospital got a greater percentage. The break-even point for the hospital was 27.3 treatment sessions/month for RC. No significant differences were noticed for the stone-free rate, the retreatment rate, the rate of additional procedures and complications.
  
  
  CONCLUSIONS
  Our study revealed that RC had a lower cost for every treatment session, and fewer treatment sessions of SWL/month than OC. The study might provide a managerial implication for healthcare organization managers, when they face a situation of high price equipment investment.
authors: Department of Urology, Taipei City Hospital, Taipei, Taiwan; College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan; Graduate School of Business Administration, Fu-Jen Catholic University, New Taipei, Taiwan; College of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Chih-Kuang
authors: CK
authors: Liu
authors: Department of Urology, Taipei City Hospital, Taipei, Taiwan; College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan; College of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: mingchung77@gmail.com.
authors: Ming-Chung
authors: MC
authors: Ko
authors: Department of Urology, Taipei City Hospital, Taipei, Taiwan; College of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Shiou-Sheng
authors: SS
authors: Chen
authors: Department of Urology, Taipei City Hospital, Taipei, Taiwan.
authors: Wen-Kai
authors: WK
authors: Lee
authors: Graduate School of Business Administration, Fu-Jen Catholic University, New Taipei, Taiwan. Electronic address: charlesjhs55@yahoo.com.tw.
authors: Ben-Chang
authors: BC
authors: Shia
authors: College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.
authors: Han-Sun
authors: HS
authors: Chiang
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D008096:Lithotripsy / Q000191:economics*; D018803:Models, Economic; D020416:Outsourced Services / Q000191:economics*; D012189:Retrospective Studies; D013624:Taiwan; D014514:Ureteral Calculi / Q000628:therapy*
keywords: SWL; cost; outsourcing cooperation; rental cooperation