Hospital specialists' private practice and its impact on the number of NHS patients treated and on the delay for elective surgery.

This paper analyses UK NHS waiting times and waiting lists for elective surgery looking at the hospital specialists' behaviour and the conflict of interest these may face when allowed to practice privately. We look at the relationship between the government as the health care purchaser and principal of a two-tier hierarchy, and two hospital specialists, the agents, that deal with elective and emergency treatement. Specialists are organised in a separated structure, each responsible for only one type of surgery (either elective or emergency). We formalise specialists' preferences when dealing with the two activities. We see how specialists' interest in the income obtained with private practice (and altruism) affects negatively (positively) the optimal NHS numbers treated and increases the waiting time for elective surgery. Asymmetry of information also has a negative impact on the NHS leading to fewer patients treated or higher transfers paid. If remuneration is based on performance, transfers have to take private practice into account. As a result, there may be benefits from extra investment so as to improve information systems as well as seeking out instruments for nurturing more altruistic behaviour on the part of the specialistswaiting times and lists; elective surgery; hospital specialists

The Number and Size of Firms: Why So Big a Difference?

The number of firms and their size are analysed for the Slovenian manufacturing sector on the basis of the firm-level evidence of the Business Register of Slovenia virtually representing all the firms in activity. A remarkable difference is found between the number of the registered manufacturing firms and the number of firms with employment. The increase in the number of all registered firms is remarkable, but it is less so for the number of firms with employment, suggesting that many more firms were being registered than were in reality economically active. The large majority of newly registered firms during the 1990s were firms without any recorded employment. Whilst the number of firms increased, the number of employees declined, the average manufacturing firm size measured by employees per firm declined. Private firms constitute the vast majority of the firms in activity at end of the 1990s and afterwards.

Firm Performance and Selection in an emerging Economy: Micro Evidence from Slovenia

We investigate the determinants of firm survival and growth (employment and sales), in the context of transition from plan to market, using firm data from Slovenia spanning from 1994 to 1998 and OLS and Heckman selection models. Firm and industry pre-transition conditions including size, ownership, financial constraints, trade and market structure are used to understand what firms best performed in the Slovenian transition. Small, private, exporting and capital intensive firms grew the fastest. Large firms with positive profits and higher sunk costs were more likely to survive compare to firms with harder financial constraints, high costs or trading abroad.firm growth and survival, owndership, competition, financial constraints

Firm growth and survival in a transition country: Micro evidence from Slovenia.

Country; Firm growth; Growth;

Unofficial payments for acute state hospital care in Kazakhstan. A model of physician behaviour with price discrimination and vertical service differentiation

We consider a discriminatory pricing and service differentiation model where: a)state physicians exploit their monopoly position and adjust quality to the unofficial payment made, and b)patients, perceiving state provision as poor, pay unofficially to improve it. Applying OLS and probit analysis to survey data on patients discharged from Almaty City hospitals, and using admission wait, length of stay (LOS) and a subjective categorical variable as quality measures. Unofficial payments are positively associated with surgical admission wait and the subjective quality of care while negatively associated with hospital LOS. Evidence suggests that price discrimination and service differentiation takes place in Kazakhstan.transition economies, unofficial or informal payments for health care, length of stay, ordered probit and marginal effects

Modelling the Demand for and Supply of Elective Surgery: A Duopoly Model

In this paper I model the demand for and supply of elective surgery using a modified Hotelling framework in which waiting time, money and distance costs are determinants of the demand for hospital care. Hospitals compete with each other by varying supply and hence their waiting times. I consider both the situation where GPs do not hold a budget (and thus Health Authorities pay for health care), and the situation where they are given budgets to buy care for their patients. Waiting time increases when production of care becomes more expensive, when the benefit obtained from treatment increases, when the unit cost of distance decreases, and when the importance given to the delay by the hospitals decreases. Moreover, the higher the money price (and if greater than the marginal cost of producing hospital care) the lower the waiting time. If the money price paid by GP fundholders is higher than that paid by HAs, fundholding patients pay a lower time price.

Implementação de um plano de segurança de águas num hospital

Dissertação de Natureza Científica para obtenção do grau de Mestre em Engenharia CivilO sistema de distribuição predial (SDP) de água de um hospital apresenta determinados componentes, que caso não sejam devidamente instalados, operados e alvo de uma manutenção e monitorização adequada, podem constituir um foco de contaminação da água. A implementação de um plano de segurança de águas (PSA) constitui uma ferramenta importante na avaliação e na gestão de risco de um SDP, que permite garantir uma maior qualidade da água, constituindo um elemento importante das políticas de saúde. O PSA é uma abordagem de avaliação e gestão de risco onde são identificados potenciais riscos microbiológicos (nomeadamente, bactérias e vírus), químicos, radiológicos e físicos. Num SDP o PSA é implementado desde o contador (local onde cessa a responsabilidade da entidade gestora do sistema de distribuição público) até ao dispositivo de utilização. A OMS (2004, 2007 e 2011a)) estende a implementação de PSA’s a hotéis, navios de cruzeiro, urbanizações, entre outros. A implementação de uma avaliação de riscos já é uma recomendação da atual legislação nacional em vigor (Decreto Lei 307/2006, de 27 de agosto) verificando-se a suaimplementação em várias entidades gestoras de sistemas de abastecimento. É importante referir que atualmente já existem PSA em sistemas de abastecimento público de águas. A Diretiva (EU) nº 1787/2015, de 6 Outubro, que altera os anexos II e III da Diretiva 98/83/CE relativa à qualidade da água destinada ao consumo humano, de modo a incorporar o progresso científico e técnico, vem reforçar a importância da implementação de um PSA, recomenda a incorporação de aspetos relativos à avaliação de risco segundo a norma europeia EN 15975-1-2011, Security of drinking water supply – Guidelines for risk and crisis management. A implementação de um PSA num hospital deve ter em conta não só as recomendações por parte da OMS (referenciadas nas Guidelines for DrinkingWater Quality (2004), Legionella and the Prevention of Legionellosis (2007), Water Safety in Buildings (2011) e Water Safety in Distribution Systems (2014)) e a norma europeia (Security of drinking water supply – Guidelines for risk and crisis management (2013)), mas também a legislação portuguesa e outras recomendações nacionais. Para implementar com sucesso um PSA devem-se considerar as seguintes etapas: - etapas preliminares, que engloba a constituição da equipa e a descrição do sistema; - avaliação do sistema, onde são avaliados e caracterizados os riscos; - monitorização do sistema, com o detalhe dos diferentes procedimentos; - elaboração de procedimentos, implementando uma gestão de rotina em condições normais e excecionais, e a documentação e protocolos de comunicação; - validação e verificação do PSA. O objetivo deste trabalho final de mestrado é desenvolver um PSA num hospital, contribuindo para o abastecimento seguro e com qualidade da água para todos os usos e atividades a desenvolver. O hospital selecionado foi o Hospital Beatriz Ângelo (HBA), um hospital recente, com três anos de funcionamento, situado no concelho de Loures.Abstract: The building distribution system (BDS) of water in a hospital presents certain components, if not correctly installed, operated, maintained and monitored, can be a focus of water contamination. The implementation of a water safety plan (WSP) is an important tool to evaluate and manage the risk of a BDS, it allows to guarantee a bigger water quality, allowing to guarantee a better water quality constituting an important element in health politics. A WSP is an assessment and risk management approach where the potentialrisks are identified: microbiologic (such as bacteria and virus), chemical, radiological and physical. In a BDS the WSP is implemented from the counter (local where the responsability of the management entity of the public distribution system ends) to the user device. WHO (2004, 2007 and 2011a)) extends WSPs implementations to hotels, cruise ships, urbanizations, etc. The risk management implementation is currently a recommendation of an existing national legislation (Decreto Lei 307/2006, de 27 de agosto), verifying their implementation in many management companies of supply systems. It is important to note that currently there are already WSP in water for public supply systems. The directive (EU) nº 1787/2015, of October 6th, that changes the annexes II and III of the directiva 98/83/CE related to water quality to human consumption, to incorporate the scientific and technical progress, reinforcing the importance of implementing a WSP, it recommends the incorporation of aspects such as risk assessment in accordance with the European Norm EN 15975-1-2011, Security of drinking water supply – Guidelines for risk and crisis management. The implementation of a WSP in a hospital should have in consideration not only the recommendations by WHO referenced in Guidelines for Drinking-Water Quality (2004), Legionella and the Prevention of Legionellosis (2007), Water Safety in Buildings (2011) and Water Safety in Distribution Systems (2014), but also Portuguese legislation and other national recommendations. To implement a WSP with success the following steps should be considered: • preliminary step, where it is considered the team constitution and the system description; - system evaluation, where the risks are identified and characterized; - system monitorization, with the different procedures; - procedures elaboration, related with routine management procedures in normal and exceptional conditions, and documents and communicationprotocols; - WSP validation and verification. The objective of this final work of master degree is to implement a WSP in a hospital, contributing for a safe supply with a water quality for all uses and activities developed. The selected hospital was Hospital Beatriz Ângelo (HBA), a recent hospital, with three years of operation, located in the municipality of Loures

Digital analytics: an approach for data quality control

Internship Report presented as the partial requirement for obtaining a Master's degree in Data Science and Advanced Analytics, specialization in Data ScienceWith the emergence of the Digital Era, a new way of analyzing customers' behavior also emerged. It's not only about analyzing data from traditional data warehouses but also about measuring users' digital footprint on websites, mobile applications, and other digital data sources. Nowadays, companies collect data on their digital channels to improve website design and user experience, optimize e-commerce, track, and measure the success of actions and programs, identify problems, and improve the digital channels' performance. But the question that arises is how valid, accurate, and complete the data is. Do digital analysts understand each data point they have at their disposal? In this internship report will be given a detailed view of the critical points of digital analytics data quality, the adjacent problems and a solution will be presented to support and help the digital analysts overcome some of the challenges in this area