697 research outputs found

    Hospital cost functions for developing countries

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    There is extensive literature on hospital cost functions for industrial countries, but very little literature for developing countries. Yet the issues facing policy-makers in all countries are much the same: are hospitals overcapitalized, as is often claimed of U.S. hospitals? Are hospitals inefficient in other respects? Do hospitals vary in efficiency? Are private hospitals more efficient than their public counterparts? Should hospitals specialize or provide a broad range of services? Should costs be reduced by concentrating cases in fewer hospitals? The authors critically survey the techniques available for analyzing hospital costs and review the few hospital cost-function studies undertaken for developing countries. Although the paper is intended primarily for those working in developing countries, the discussion for cost function methodology has broad implications for interpreting econometric cost functions and for examining economies of scale and scope in both developing and industrial countries. The authors survey of econometric techniques is not uncritical. They question, for example, the validity of recent tests of over-capitalization undertaken on American hospitals. They also make general observations about the methods used to investigate economies of scope and economies of scale.Economic Theory&Research,Environmental Economics&Policies,Business in Development,Business Environment,Banks&Banking Reform

    National Eldercare System Project: A National Study Comparing Successful Community-based Systems of Care for Older People

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    The purpose of this project was to compare three different models of building and strengthening community-based systems of care for older adults. Models were distinguished by the type of organization that took the lead in developing the system of services: Area Agency on Aging, acute care hospital, and residential facility. Specific questions addressed in this project were: (1) What conditions in a local community give rise to a community-based system of care (CBSC) for older adults? (2) What are the necessary steps in planning and designing CBSCs? (3) How are successful CBSCs established and maintained? (4) How does the type of lead organization influence a CBSCs accessibility, responsiveness, and effectiveness? (5) To what extent and under what conditions can successful CBSCs be replicated? Answers to these questions were meant to assist leaders in new communities wishing to develop CBSCs for older adults in their own locales

    Special Libraries, October 1960

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    Volume 51, Issue 8https://scholarworks.sjsu.edu/sla_sl_1960/1007/thumbnail.jp

    Special Libraries, October 1960

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    Volume 51, Issue 8https://scholarworks.sjsu.edu/sla_sl_1960/1007/thumbnail.jp

    Modeling and analysis of hospital facility layout problem

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    The optimal solution to any facility layout problem is an important aspect and a major concem as it involves significant material handling and transportation cost. The objective is to arrange the departments within the predefined facility boundaries in the way that the interaction between the functions is efficient and the overall movement cost is minimized. While facility layout problems have traditionally focused on manufacturing facilities, there has been little work on analyzing layouts for hospitals. The thesis focuses on hospital facility layout problems (HLP) to (i) minimize the movements of patients and (ii) minimize the movements of accompanying resources such as doctors, nurses, equipment and paramedical staff. The thesis consists of two sections. In the first section, a model for the multi-floor layout problem is presented based on the minimization of movement cost. The model has travel frequency or number of trips, trip difficulty rating, baseline travel cost and distance as parameters for determining the movement cost. In the second section, some additional parameters and constraints are imposed on the model and it is simulated using Microsoft Excel. Simulations are also run to study the effect of different proposed strategies on movement cost. These proposed strategies show a reduction in movement cost from the sample layout strategy in section one. A representative example is used to illustrate the applicability of the proposed formulation

    Resilience of critical structures, infrastructure, and communities

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    In recent years, the concept of resilience has been introduced to the field of engineering as it relates to disaster mitigation and management. However, the built environment is only one element that supports community functionality. Maintaining community functionality during and after a disaster, defined as resilience, is influenced by multiple components. This report summarizes the research activities of the first two years of an ongoing collaboration between the Politecnico di Torino and the University of California, Berkeley, in the field of disaster resilience. Chapter 1 focuses on the economic dimension of disaster resilience with an application to the San Francisco Bay Area; Chapter 2 analyzes the option of using base-isolation systems to improve the resilience of hospitals and school buildings; Chapter 3 investigates the possibility to adopt discrete event simulation models and a meta-model to measure the resilience of the emergency department of a hospital; Chapter 4 applies the meta-model developed in Chapter 3 to the hospital network in the San Francisco Bay Area, showing the potential of the model for design purposes Chapter 5 uses a questionnaire combined with factorial analysis to evaluate the resilience of a hospital; Chapter 6 applies the concept of agent-based models to analyze the performance of socio-technical networks during an emergency. Two applications are shown: a museum and a train station; Chapter 7 defines restoration fragility functions as tools to measure uncertainties in the restoration process; and Chapter 8 focuses on modeling infrastructure interdependencies using temporal networks at different spatial scales

    Hospital administration

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    The Administrator of a hospital, particularly of a teaching hospital, is faced with the task of organising increasingly complex and specialised, high technology institutions, under constant pressure to improve patient care and community services, training of health personnel, and to seek new knowledge, therapies and techniques. In addition, acute general hospitals are being forced to re-examine their goals and functions in the light of greater competition from other health and social services for scarce resources - and of changing environmental circumstances. These activities must be undertaken in the context of new theories of management with greater emphasis on the psycho-social aspects of organisation, decision-making processes and advances in information-processing techniques. To be equipped for this task the hospital administrator must also acquire new knowledge and skills. It was therefore frustrating to discover that no training courses for hospital administrators, medical or otherwise were available in this country and that there was a dearth of literature with specific reference to the Republic. Thus, it was as a measure of desperation that this thesis was embarked on, in order to satisfy a personal need to learn about the theory of administration and to meet the need for basic research into, and documentation of, hospital administration in South Africa. In view of the necessity to study virtually every aspect of the subject and the fact that so little research had been done on the management of South African hospitals, it was felt that hospital administration should be examined as a totality rather than selecting any single aspect of the subject. General Systems theory which views any open system as a whole, in constant interaction with its environment, provided an appropriate conceptual framework for the general study of hospital administration. The Groote Schuur Hospital Group provided a suitable model within which to l examine the application of general systems theory; for analysis of the environment, resources, organisation and products of a hospital; and upon which to base some general conclusions regarding the administration of hospitals, recommendations for change and for further research. This thesis which is presented in eight chapters with a short summary of the contents at the end of each chapter has examined one teaching hospital group as a whole system. No attempt has been made to study any aspect of hospital administration in great detail, but rather to identify areas where immediate changes can be implemented to improve the effective and efficient utilisation of resources, and those where further research is essential to find better ways of achieving these goals and meeting societal needs. In the words of Tenon - The hospital is the conscience of a civilisation whose worth, in the end will be measured not by articles of faith and lofty doctrines but by the way it nurtures life; succours distress, rights injustices and transforms misery, frailty and want into hope, dignity and sufficiency

    Southwest Research Institute assistance to NASA in biomedical areas of the technology

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    Significant applications of aerospace technology were achieved. These applications include: a miniaturized, noninvasive system to telemeter electrocardiographic signals of heart transplant patients during their recuperative period as graded situations are introduced; and economical vital signs monitor for use in nursing homes and rehabilitation hospitals to indicate the onset of respiratory arrest; an implantable telemetry system to indicate the onset of the rejection phenomenon in animals undergoing cardiac transplants; an exceptionally accurate current proportional temperature controller for pollution studies; an automatic, atraumatic blood pressure measurement device; materials for protecting burned areas in contact with joint bender splints; a detector to signal the passage of animals by a given point during ecology studies; and special cushioning for use with below-knee amputees to protect the integrity of the skin at the stump/prosthesis interface

    Development and Psychometric Evaluation of the Provider Response to Emergency Pandemic (PREP) Tool

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    Background: History and science would suggest that a worldwide influenza pandemic is near and its implications are on the minds of healthcare workers (HCWs). Previous studies revealed that HCW have loss-related fears and concerns associated with working during a disaster, especially one with a biologic component. Most healthcare organizations have well-crafted disaster plans in place; however, these plans often rely on the assumption that HCWs will report to work as usual, which may not be the case. Objective: The purpose of this study was to determine if HCWs\u27 fears and concerns are a predictor of their willingness to report to work (RTW) during a sustained biologic emergency. To achieve this, the Provider Response to Emergency Pandemic (PREP) Tool was developed, piloted, and evaluated. Methods: The 31 PREP Tool items were based on four Loss-subscales plus five exploratory items using a four-point Likert format. In addition, the survey included 11 demographic questions. The PREP Tool was constructed by an expert panel and pretested with a focus group. The instrument was then pilot tested with a cross-sectional convenience sample of 452 HCWs over a 3-month period. Setting: The principle investigator administered the PREP Tool survey during staff meetings at a midsized acute care hospital in the southwestern United States. Data analysis: Descriptive statistics, reliability assessment, correlations, and exploratory factor analysis were used. Results: The Cronbach\u27s alpha reliability coefficient for each Loss-subscale to the total score was between .81 and .85. All items retained demonstrated correlation with the RTW response (Spearman\u27s rho; p \u3c .001) and the ability to distinguish between yes and no RTW responses (Mann-Whitney U; p \u3c .05). Exploratory factor analysis was useful in evaluating item retention. Conclusion: The PREP Tool is a valid instrument for the assessment of HCW RTW concerns and intentions in a biologic emergency. Implications: This study provides new insights into the HCW RTW decision and introduces an instrument designed to evaluate this largely unexplored aspect of healthcare. Results from this research and future PREP Tool-based studies can inform evidence-based disaster planning
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