Payments and quality of care in private for-profit and public hospitals in Greece

<p>Abstract</p> <p>Background</p> <p>Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged.</p> <p>Methods</p> <p>Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003.</p> <p>Results</p> <p>PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities.</p> <p>Conclusions</p> <p>In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.</p

Bile acids and colon cancer: Solving the puzzle with nuclear receptors

Colorectal cancer is the third most common malignancy worldwide and is often linked to obesity, a sedentary lifestyle, carbohydrate- and fat-rich diets and elevated fecal excretion of secondary bile acids. Accumulation of toxic bile acids triggers oxidative damage, mitochondrial dysfunction and tumor progression. Nuclear receptors are transcription factors crucially involved in the regulation of bile acid metabolism and detoxification, and their activation may confer protection from bile acid tumor-promoting activity. In this review, we explore the tangled relationships among bile acids, nuclear receptors and the intestinal epithelium, with particular emphasis on the role of the farnesoid X receptor in colorectal cancer prevention and on novel nuclear receptor-based approaches to expand the portfolio of chemotherapeutic agent

Elastic Extension of a CMS Computing Centre Resources on External Clouds

After the successful LHC data taking in Run-I and in view of the future runs, the LHC experiments are facing new challenges in the design and operation of the computing facilities. The computing infrastructure for Run-II is dimensioned to cope at most with the average amount of data recorded. The usage peaks, as already observed in Run-I, may however originate large backlogs, thus delaying the completion of the data reconstruction and ultimately the data availability for physics analysis. In order to cope with the production peaks, CMS - along the lines followed by other LHC experiments - is exploring the opportunity to access Cloud resources provided by external partners or commercial providers. Specific use cases have already been explored and successfully exploited during Long Shutdown 1 (LS1) and the first part of Run 2. In this work we present the proof of concept of the elastic extension of a CMS site, specifically the Bologna Tier-3, on an external OpenStack infrastructure. We focus on the “Cloud Bursting” of a CMS Grid site using a newly designed LSF configuration that allows the dynamic registration of new worker nodes to LSF. In this approach, the dynamically added worker nodes instantiated on the OpenStack infrastructure are transparently accessed by the LHC Grid tools and at the same time they serve as an extension of the farm for the local usage. The amount of resources allocated thus can be elastically modeled to cope up with the needs of CMS experiment and local users. Moreover, a direct access/integration of OpenStack resources to the CMS workload management system is explored. In this paper we present this approach, we report on the performances of the on-demand allocated resources, and we discuss the lessons learned and the next steps