4 research outputs found
Transbronchial Needle Aspiration in the Staging of Bronchogenic Carcinoma
To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNA) for the
diagnosis of mediastinal involvement, we have prospectively examined 316 patients with
morphologically verified bronchogenic carcinoma. The percentage of positive aspirations
(149 of 316) from the three basic lymph node groups in the mediastinum was not significantly
different. Tumor cells were aspirated from the mediastinum in 75 of 112 patients
with radiologically positive findings and in patients with 74 of 204 radiologically negative
findings. Mediastinal involvement was verified even in 61 of 196 patients with a normal
endoscopic picture. Metastases were proved in 14 of 39 patients with peripheral versus
135 of 277 patients with central carcinoma. Tumor cells were aspirated in 47 of 76
patients with undifferentiated small cell carcinoma, 92 of 227 patients with squamous cell
carcinoma, and 10 of 13 patients with adenocarcinoma. Our results suggest that TBNA
being a highly diagnostic and less invasive method, will prove its clinical importance
Non-parametric Estimation of Elliptical Copulae with Application to Credit Risk
This paper develops a method for statistical estimation of the dependence structure of financial assets. As we are interested mainly in applications to credit risk, our approach focuses directly on the copula function of a random vector and works independently of any marginal assumptions. We use the class of elliptical copulas, which provide a natural extension to the standard for the practice Gaussian copula and a flexible model for joint extreme events. We calibrate the linear correlation coe#cients using the whole sample of observations and the non-linear (tail) dependence coe#cients using only the extreme observations. We provide theoretical as well as numerical support for our method
Outcomes analysis of hospital management model in restricted budget conditions
Facing conditions of market economy and financial crisis, the head of any healthcare facility has to take adequate decisions about the cost-effective functioning of the hospital. Along with cost reduction, the main problem is how to maintain a high level of health services. The aim of our study was to analyse the quality of healthcare services after the implementation of control over expenses due to a reduction in the budgetary resources in Military Medical Academy (MMA, Sofia, Bulgaria). Data from the hospital information system and the Financial Department about the incomes and expenditures for patient treatment were used. We conducted a retrospective study on the main components of clinical indicators in 2013 to reveal the main problems in the hospital management. In 2014, control was imposed on the use of the most expensive medicines and consumables. Comparative analysis was made of the results of the medical services in MMA for 2013 and 2014. Our results showed that despite the limited budget in MMA over the last year, the policy of control over operational costs succeeded in maintaining the quality of healthcare services. While reducing the expenses for medicines, consumables and laboratory investigations by ∼26%, some quality criteria for healthcare services were observed to be improved by ∼9%. Financial crisis and budget reduction urge healthcare economists to create adequate economical instruments to assist the normal functioning of hospital facilities. Our analysis showed that when a right policy is chosen, better results may be achieved with fewer resources