The impact of the 2017 kidney allocation policy change on simultaneous liver kidney utilization and outcomes

2021 ◽  
Author(s):  
Mariya L. Samoylova ◽  
Kara Wegermann ◽  
Brian I. Shaw ◽  
Samuel J. Kesseli ◽  
Sandra Au ◽  
...  
Water Policy ◽  
2006 ◽  
Vol 8 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Ramesh Bhatia ◽  
John Briscoe ◽  
R. P. S. Malik ◽  
Lindy Miller ◽  
Smita Misra ◽  
...  

The state of Tamil Nadu, India, is in the grips of a water crisis, with demand far outstripping supply. As the economy of the state grows, this crisis is going to become ever more serious. To date the focus of state water policy has been on trying to augment supplies, from within the state (even from desalinization) and from neighboring states. In addition, the water use is regulated in a way that does not encourage the highest value uses. International experience shows that supply-side measures must be complemented by demand-side measures and that practice must move away from fixed, command-and-control allocation policies towards flexible allocation mechanisms, which facilitate the voluntary movement of water from low to high-value uses. This study addresses the question of whether such a change in allocation policies is worth doing. It addresses this question by developing optimization models for each of the 17 river basins in Tamil Nadu (including an assessment of the economic value of water in different end-uses – agriculture, domestic and industry), then using an input–output model embedded in a social accounting matrix (SAM), to assess the impact of these changes on the state economy and on different rural and urban employment groups. The results suggest that a shift to a flexible water allocation system would bring major environmental, economic and social benefits to the state. Compared with the current “fixed sectoral allocation” policy, a flexible allocation policy would, in 2020, result in 15% less overall water used; 24% less water pumped from aquifers; 20% higher state income; with all strata, rich and poor, benefiting similarly, with one important exception, that of agricultural laborers.


2021 ◽  
Vol 40 (4) ◽  
pp. S224
Author(s):  
K. Bradbrook ◽  
K. Lindblad ◽  
R.R. Goff ◽  
R. Daly ◽  
S. Hall

Author(s):  
Laura Broeker ◽  
Harald Ewolds ◽  
Rita F. de Oliveira ◽  
Stefan Künzell ◽  
Markus Raab

AbstractThe aim of this study was to examine the impact of predictability on dual-task performance by systematically manipulating predictability in either one of two tasks, as well as between tasks. According to capacity-sharing accounts of multitasking, assuming a general pool of resources two tasks can draw upon, predictability should reduce the need for resources and allow more resources to be used by the other task. However, it is currently not well understood what drives resource-allocation policy in dual tasks and which resource allocation policies participants pursue. We used a continuous tracking task together with an audiomotor task and manipulated advance visual information about the tracking path in the first experiment and a sound sequence in the second experiments (2a/b). Results show that performance predominantly improved in the predictable task but not in the unpredictable task, suggesting that participants did not invest more resources into the unpredictable task. One possible explanation was that the re-investment of resources into another task requires some relationship between the tasks. Therefore, in the third experiment, we covaried the two tasks by having sounds 250 ms before turning points in the tracking curve. This enabled participants to improve performance in both tasks, suggesting that resources were shared better between tasks.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.


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