Are Cost-of-Care Conversations Best Practice? A Qualitative Study of Oncologists' Attitudes and Practice

PURPOSE: Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them. Our objective was to examine oncologists' attitudes toward cost conversations and how those attitudes affect practice. METHODS: An experienced investigator conducted individual interviews with oncologists practicing in Kentucky. Participants were asked about their attitude toward and experience with cost conversations and their advice for discussing cost with patients. Interview transcripts were analyzed by a four-member team using qualitative descriptive analysis to identify themes. RESULTS: Participants were 32 MDs (male = 68.8%) age 31-77 years who were board-certified in medical oncology (53.1%), surgical oncology (25.0%), or radiation oncology (21.9%). We categorized participants into two groups: (1) those who viewed cost conversations as best practice and reported pursuing such conversations (37.5%) and (2) those who viewed cost conversations as not best practice and reported avoiding them (62.5%). Our analysis revealed three parallel themes for each category: Cost conversation attitudes and practice were based on (1) making good treatment decisions, (2) being a good clinician, and (3) having a good relationship with patients. CONCLUSION: Not all oncologists view cost conversations as best practice. To improve cost conversation attitudes and practice, cost conversations can be framed as a strategic tool that—when used well—fosters optimal decision making, professionalism, and the therapeutic relationship.

Use of methods of operational cost management in the planning and accounting organization at the enterprises in Ukraine

The efficiency of the use of methods of operational cost management at the enterprise depends on the consistency of functional methods. As a matter of actual practice, cost management at Ukrainian enterprises lacks such consistency causing managerial collision due to inconsistency of planning and actual data on the enterprise costs. The objective of the article is to resolve the mentioned managerial collision. There has been presented a criterion of consistency of functional cost management methods (identity of data about planning and actual costs of the enterprise according to the format, structure of the resulting data and period of their receipt). The consistency of functional methods – making it possible to deal with the issue of information communications in the enterprise management – is provided by reducing the methods of cost management at the enterprise, in the form of operationalization of concepts of methods of operational cost management in functional methods. With the objective of ensuring the consistency of functional methods of cost management, the article determines changes in the cost accounting, making it possible to provide the consistency of planning and actual data on the enterprise costs and to analyze them.

Challenges and Impacts of Human Resource Outsourcing (HRO) in Bangladesh

By HRO we mean using a third party to undertake HR functions for an organization. In Bangladesh, from the last ten to twelve years many private organizations (non-govt.) are getting accustomed with the practice. Cost and time reduction, touch of expert work etc. are the various reasons for which the practice is getting significance day by day. But the organizations that are providing services are facing some challenges. The purpose of the study is to work with these challenges in depth. As it is a very new practice the numbers of service providers are very limited (not more than 30) in the country. For data collection a questionnaire including both open-ended and close-ended questions was designed. Situational cases were also used. From the study it is found that govt. rules-regulations, service quality of providers and mismatch with organizational culture firms are the main sources of challenges in this sector.