What cases on lean hospital transformation tell us?

The scientific knowledge about the lean transformation of hospital processes is at best in its “emerging” phase; neither related international, nor Hungarian literature offers a systematic, comprehensive description of the phenomenon (Brandao de Souza, 2009). In this paper empirical evidences concerning the lean transformation of hospital processes are researched and systemized. Thus it provides a new insight of existing knowledge in order to provide solid base for further researches and practical actions

A post-accession crisis? Political developments and public sector modernization in Hungary

The paper examines the relationship between the political system and the public administration modernization in the Hungarian transition. Its intention is to point out that there are various shortcuts and bottlenecks of the Hungarian modernization and the cumulative impacts of these deficiencies have caused characteristic difference of the Hungarian modernization trajectory from the typical Western trajectories. --Hungarian incomplete modernization trajectory,phases of modernization and their international contexts,politization,Neo-patrimonialism versus Neo-weberian synthesis

Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public

A novel extension of assisted history matching to honour geological constraints

Most gradient-based history matching (HM) tools consider only the minimum and maximum geological constraints in the algorithm and the applied calculations. As a result, the crucial link connecting geological, petrophysical and reservoir engineering data is diminished or, at times, completely lost. Therefore, an iteratively created model suffers significantly from the subsequent inconsistencies, e.g., porosity/permeability relations do not honour their petrophysical constraints. This leads to questionable admissibility of the entire model and, thus, calls for the necessity of removing or minimalising these inconsistencies. This dissertation focuses on finding an innovative solution to suggest better and plausible results. It investigates a new workflow that improves the geological consistency and suggests automation of the process of assisted history matching with a strong consideration of different geological constraints with respect to the different rock type definitions. The new workflow is provided as an external tool using available libraries in Python that can be applied as an extension for existing assisted history matching workflows. The rock typing coupled with the adjoint method is proposed to maintain the relationship between model parameters to different rock types, which are then iteratively updated during the history matching procedure. The rock types have different porosity and permeability ranges, relative permeability curves, and different connate water and residual oil saturation. The rock type is changed with corresponding parameters at the grid-block level based on the porosity and horizontal permeability change. The so-called rock-typing extension of the history matching workflow allows parameters to be modified co-dependently according to the rock type definition after the permeability adjustment suggested by adjoint-based sensitivity calculations. As proof of the concept, the simulation was carried out for the synthetic model with the same parameter distribution with and without the extended workflow. The results show obvious improvements in history matching quality in terms of geological consistency with fewer iterations or within the same amount of iterations with favourable objective function (OF) values. The simulation output achieves the target observed production profiles driven by the automatic joint correction of the saturation functions, including the initial saturations due to the rock type adjustments. Properly including the porosity-permeability correlations, priorities and model-specific details, the rock type can bind all the geological properties together, allowing consistent parameter changes for an improved history matching process. Since the base case is a product of geostatistical modelling, the level of certainty needs to be accounted for. Therefore a statistical distance is applied, which is the Mahalanobis distance. The Mahalanobis distance is associated with each rock type; it helps to guide the validation and correction step and determines the appropriate rock type based on the underlying statistical information. It also serves as the basis for the calculation to prove the concept. Overall, the novel approach has successfully managed to improve the geological consistency of the models during the history matching process, thereby improving the quality and reliability of the reverse simulation. Moreover, this extension includes workflow automation. It is an excellent practical standalone achievement that can potentially reduce the previously required work hours for the iterations to find the right set of data

Közintézményi reformok szemléleti háttere és fejlődési pályái az ezredfordulón

A cikk a közszolgáltatások szempontjából elemzi az állam szerepét a XXI. században. Megállapítja, hogy a modern demokráciát nemcsak a jogszerűség, hanem az eredményesség is legitimálja. Ennek érdekében a 90-es években a fejlett nyugati államokban elkezdődött az állami-közszolgáltató rendszerek reformja. Ezek közös jellemzője volt, hogy menedzsmentreformokkal kezdődtek, amelyek kiegészültek közpolitikai reformokkal és közigazgatási jogi innovációkkal. A reformlépések sorozatának lényegi törekvése a közszolgáltató rendszerek és szervezetek olyan alapvető átalakítása, amely jelentősen megnöveli a hatékonyságot, az eredményességet, az alkalmazkodóképességet és az innovációs kapacitásokat. Megtöri a szolgáltatási monopóliumokat olyan versenykörülmények kialakításával, amelyben az állami, a magán és a civil társadalom szolgáltató szervezetei versenyeznek. A közszolgálati menedzsment megújítása a modern polgári demokráciák állampolgáraihoz, mint igényes közszolgáltatási fogyasztókhoz közelít