21 research outputs found
Predicción de riesgo de quiebra para PYMES en el departamento del Atlántico utilizando análisis discriminante y análisis envolvente de datos (DEA)
En este trabajo se propone el desarrollo de una herramienta que pretenda predecir el riesgo de quiebras de las empresas tipo PYMES ubicadas el departamento del Atlántico. Para ello se propone el uso de las metodologías Análisis Discriminante y el Análisis Envolvente de Datos (DEA) y comparar los resultados obtenidos con las mismas. Para la realización del presente estudio se seleccionaron 144 empresas tipo Pymes ubicadas en el departamento del Atlántico, la información financiera referente a estas empresas ha sido tomada de la Superintendencia de Sociedades. La información con que se trabajó fue obtenida de los boletines estadísticos de los años 2003, 2004, 2005, 2006 y 2007. En los modelos se utilizaron indicadores de liquidez, endeudamiento, rotación y rentabilidad.MaestríaMagister en Ingeniería Industria
Evaluación del comportamiento de los indicadores de productividad y rentabilidad en las Empresas Prestadores de Salud del régimen Contributivo en Colombia
Objetivo: Analizar el comportamiento que han sufrido los indicadores de productividad y rentabilidad financieros en las Empresas Prestadoras de Salud del régimen contributivo en Colombia. Materiales y métodos: Estudio cualitativo, descriptivo propositivo y cuantitativo soportado en un Análisis Discriminante Multivariado (ADM), que permite analizar diferencias significativas durante los periodos 2008 y 2010. Se definen y calculan los indicadores de productividad y rentabilidad financieros analizando las diferencias significativas y medias de los periodos estudiados. Resultados: Se pudo evidenciar y demostrar en el trabajo de investigación que en el análisis de las medias del indicador Utilidad Operacional / Valor agregado (IP2) presentó diferencias significativas. Para el análisis de la función discriminante mejoraron los indicadores Utilidad Bruta / Ingresos Operacionales (MB) y Utilidad Operacional / Valor agregado (IP2) durante los periodos 2008 y 2010 en las Entidades Prestadoras de Salud del régimen contributivo. Conclusiones: Según el trabajo de investigación se pudo concluir por el Análisis Discriminante Multivariado que existe una diferencia significativa en los dos periodos estudiados, el modelo de la función discriminante permite predecir el comportamiento de la población a futuro con un 61,1 % de probabilidad.
Medición de la eficiencia y productividad de los colegios oficiales de Barranquilla
Introducción. En este artículo se presenta una metodología que permite que los colegios públicos (también llamados oficiales) de la ciudad de Barranquilla evalúen su desempeño respecto a otras instituciones oficiales y establezcan planes de mejoras potenciales para su organizaciónObjetivo. Evaluar y analizar, mediante la técnica de análisis envolvente de datos (DEA), la eficiencia relativa y la productividad de acuerdo con el índice de Malmquist en el uso de los recursos de los colegios oficiales del distrito de Barranquilla.Materiales y métodos. Se identificaron las variables de entradas y salidas mediante la metodología multicriterio y la aplicación de encuestas a expertos y se siguieron los lineamientos propuestos por Golany y Roll(1) para la utilización de la técnica DEA.Resultados. Los resultados de este estudio indican que, de los 148 colegios evaluados, 56 presentaron un incremento en su productividad, es decir, el 38% del total de las instituciones. Así mismo, se observó que en los años 2012 y 2013 el número de colegios eficientes fueron 54 y 57, respectivamente.Conclusión. Se evaluó la eficiencia considerando el modelo DEA CCR-O con retornos a escala constantes. El análisis de la eficiencia se efectuó teniendo en cuenta las cinco localidades del distrito de Barranquilla (Riomar, Norte-Centro Histórico, Metropolitana, Suroriente y Suroccidente) y se generaron los valores de eficiencia para los años 2012 y 2013
Predicción de la eficiencia de las instituciones de educación superior colombianas con análisis envolvente de datos y minería de datos.
Este trabajo muestra los resultados de una investigación cuyo propósito es evaluar la eficiencia técnica de las instituciones de educación superior en Colombia durante los años 2011-2013 mediante la aplicación del análisis envolvente de datos y técnicas de minería de datos. Con el análisis envolvente de datos se determinó la eficiencia técnica y la minería de datos permite descubrir información oculta, el resultado de la combinación de estas técnicas permiten establecer reglas de predicción con base a un grupo de indicadores de gestión que pueden ser utilizadas por los diseñadores de políticas educativas para determinar las razones de ineficiencia de las instituciones de educación superior. Como fuente para los datos se utilizó la información provista por el Ministerio de Educación Nacional. Se observó que siete de las treinta y dos instituciones consideradas tienen una eficiencia de 100 % durante el periodo de estudio
Efficiency in the quality of the service of health promotion entities of the colombian subsidized regime
Objetivo: Evaluar la eficiencia en la calidad del servicio de las Entidades Promotoras de Salud del régimen subsidiado durante los períodos comprendidos entre 2011-1 y 2014-1. Materiales y Métodos: Se realizó un estudio descriptivo retrospectivo de la calidad del servicio en las entidades promotoras de salud del régimen subsidiado soportado en la metodología del análisis envolvente de datos (DEA), utilizando el modelo propuesto por Charnes, Cooper y Rhodes orientado a las salidas. Se realiza una selección de un conjunto de variables a partir de la base de datos de la Superintendencia Nacional de Salud. Resultados: Los resultados indican que 14 de las 22 entidades evaluadas tienen una eficiencia superior al 90% durante el periodo de estudio. Conclusiones: El análisis envolvente de datos permitió identificar las entidades promotoras de salud (EPS) del régimen subsidiado que obtuvieron un buen desempeño en el período de estudio así mismo la eficiencia promedio no superó el 70%, lo que muestra que en la actualidad Colombia está pasando por una crisis en el sector de la salud.Objective: To evaluate the efficiency in the quality of Health Promotion Entities service of the subsidized regime between 2011-1 and 2014-1. Materials and Methods: A descriptive retrospective study of the quality in the subsidized regime health promotion entities service was performed supported by the data envelopment analysis (DEA) methodology using the output-oriented model proposed by Charnes, Cooper and Rhodes. A selection of a set of variables was performed from the database of the National Health Board. Results: The results indicate that 14 of the 22 evaluated entities showed efficiency greater than 90% during the study period. Conclusions: The envelopment analysis of data allowed identifying the subsidized regime Health Promotion Entities (EPS) that obtained a good performance in the period of study, as well as the average efficiency that did not exceed 70%, which shows that Colombia is currently undergoing a crisis in the health sector
Definition of Geographic Profiles of car theft. Applied case in Cartagena de Indias
Esta investigación desarrolla un análisis geoespacial del hurto de automóviles ocurridos en la ciudad de Cartagena de Indias - Colombia. En el proceso de definición de perfiles de criminalidad se analizó el delito del hurto en las 5 modalidades consideradas de alto impacto en la generación de percepción de seguridad de los ciudadanos, estas son automotores, motocicletas, residencias, establecimientos comerciales y entidades financieras en el transcurso de los años 2015 y 2016. Los datos utilizados corresponden al informe de criminalidad anual de la Policía Nacional de Colombia. Como resultado se encontraron 7 perfiles geográficos de hurto de automóviles, generando patrones de delitos caracterizados visualizados geográficamente.In the present research a geospatial analysis of the crimes occurred in the city of Cartagena de Indias in Colombia is developed. In the process of definitions of crime profiles, the crime of theft is analyzed in the 5 Modalities considered to have a high impact on the generation of security perception of Citizens, which are motor vehicles, motorcycles, residences, commercial establishments and financial entities during the course of the years 2015 and 2016. The data used corresponds to the annual crime report of the National Police of Colombia. As a result, 7 geographical profiles of car theft were found, generating a patron of characterized crimes displayed geographically
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic
Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world
Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic.
Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality.
Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States.
Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis.
Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries