The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results?

2014 ◽  
Vol 17 (4) ◽  
pp. 365-378 ◽  
Author(s):  
Ivonne Lindlbauer ◽  
Jonas Schreyögg
Keyword(s):  
Hospital Efficiency ◽  
Hospital Specialization ◽  
The Relationship

scholarly journals Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market

2020 ◽  
Vol 23 (4) ◽  
pp. 649-660
Author(s):  
Annika Maren Schneider ◽  
Eva-Maria Oppel ◽  
Jonas Schreyögg
Keyword(s):  
Healthcare Expenditure ◽  
Negative Relationship ◽  
Hospital Efficiency ◽  
Data Envelopment ◽  
Truncated Regression ◽  
Hospital Market ◽  
Double Bootstrap ◽  
Linear Effects ◽  
The Relationship ◽  
Urgency Score

AbstractWith hospital budgets remaining tight and healthcare expenditure rising due to demographic change and advances in technology, hospitals continue to face calls to contain costs and allocate their resources more efficiently. In this context, efficiency has emerged as an increasingly important way for hospitals to withstand competitive pressures in the hospital market. Doing so, however, can be challenging given unpredictable fluctuations in demand, a prime example of which are emergencies, i.e. urgent medical cases. The link between medical urgency and hospitals’ efficiency, however, has been neglected in the literature to date. This study therefore aims to investigate the relationship between hospitals’ urgency characteristics and their efficiency. Our analyses are based on 4094 observations from 1428 hospitals throughout Germany for the years 2015, 2016, and 2017. We calculate an average urgency score for each hospital based on all cases treated in that hospital per year and also investigate the within-hospital dispersion of medical urgency. To analyze the association of these urgency measures with hospitals’ efficiency we use a two-stage double bootstrap data envelopment analysis approach with truncated regression. We find a negative relationship between the urgency score and hospital efficiency. When testing for non-linear effects, the results reveal a u-shaped association, indicating that having either a high or low overall urgency score is beneficial in terms of efficiency. Finally, our results reveal that higher within-hospital urgency dispersion is negatively related to efficiency.

scholarly journals The Impact of Hospital Specialization on Congestion and Efficiency

2019 ◽  
Vol 11 (5) ◽  
pp. 1475
Author(s):  
Sung-hun Park ◽  
Joong Ko ◽  
Eun-song Bae ◽  
Meehyang Chang ◽  
Daecheol Kim
Keyword(s):  
The Other ◽  
Efficiency Improvement ◽  
Hospital Size ◽  
Other Hand ◽  
Hospital Beds ◽  
Negative Effect ◽  
Hospital Specialization ◽  
The Impact ◽  
The Relationship ◽  
Positive Effect

The purpose of this study is to verify the existence of congestion in Korean hospitals, to identify the causes of congestion, and to suggest directions for efficiency improvement of hospitals. The result showed that congestion occurred in 71.90% of 1185 hospitals. In addition, it was found that hospital specialization has a negative effect on congestion. In other words, the higher the hospital specialization, the lower the overall congestion rate of the hospital. More specifically, the specialization of hospitals also showed a negative effect on congestion of nurses. On the other hand, hospital specialization was found to have a positive effect on the congestion of the number of doctors, but it does not have a significant effect on the congestion of hospital beds. It was also found that hospital size has an effect on the relationship between hospital specialization and congestion, but the location of the hospital and the type of ownership did not act as a moderator.

scholarly journals COMPARISON BETWEEN A MULTI-PAVILION HOSPITAL AND A SINGLE PAVILION HOSPITAL

2016 ◽  
Vol 89 (3) ◽  
pp. 402-409
Author(s):  
Mihai Mleșnițe ◽  
Ioan Stelian Bocșan
Keyword(s):  
Mortality Rate ◽  
Hospital Efficiency ◽  
Steady Increase ◽  
Hospital Level ◽  
Clinical Hospital ◽  
Rehabilitation Hospital ◽  
The Relationship

Background and aim: Defining and measuring hospital efficiency is a hard task, in spite of the agreement that hospitals need to be efficient. Thus, while research might focus on the relationship between costs and outcomes, measurements differ significantly across studies.The aim of the present study is to compare a multi-pavilion hospital with a single hospital from Cluj-Napoca, Romania.Methods: Statistical and financial (effective expenses, salaries, drugs, materials, reagents, food) indicators were used to compare two hospitals from Cluj-Napoca: the Adults’ Clinical Hospital in Cluj-Napoca, and the Rehabilitation Hospital from Cluj-Napoca respectively. Data related to these indicators were collected at each hospital level, between 2004 and 2010.Results: When investigating the expenses on medicine, data showed the two hospitals had similar values in 2004, 13.09% and 14.43% for the multi-pavilion hospital and single hospital, respectively. After 2004, the expenses started to drop simultaneously, being around 11% in 2006 and 2007 for both hospitals. The mortality rate was significantly different for the two hospitals. The multi-pavilion had a much higher mortality rate, when compared to the single hospital. From 2004 until 2007 a steady increase was observed for the multi-pavilion hospital, from 1.09 to 2.57 respectively.Conclusion: The significant differences found between the two hospitals look being unavoidable, as long as they seem to stem from the hospitals’ ownership, their addressability and their targeted diseases and associated procedures. 

Interstellar gas in the central region of the Galaxy

1967 ◽  
Vol 31 ◽  
pp. 239-251 ◽  
Author(s):  
F. J. Kerr
Keyword(s):  
Central Region ◽  
Galactic Plane ◽  
Neutral Hydrogen ◽  
Continuum Emission ◽  
Galactic Centre ◽  
Interstellar Gas ◽  
Hydrogen Recombination ◽  
The Galaxy ◽  
Centre Region ◽  
The Relationship

A review is given of information on the galactic-centre region obtained from recent observations of the 21-cm line from neutral hydrogen, the 18-cm group of OH lines, a hydrogen recombination line at 6 cm wavelength, and the continuum emission from ionized hydrogen.Both inward and outward motions are important in this region, in addition to rotation. Several types of observation indicate the presence of material in features inclined to the galactic plane. The relationship between the H and OH concentrations is not yet clear, but a rough picture of the central region can be proposed.

The relationship of the scleractinian corals to the rugose corals

Paleobiology ◽  
1980 ◽  
Vol 6 (02) ◽  
pp. 146-160 ◽  
Author(s):  
William A. Oliver
Keyword(s):  
Critical Points ◽  
Scleractinian Corals ◽  
Convincing Evidence ◽  
Early Triassic ◽  
Rugose Corals ◽  
History Of ◽  
The Subject ◽  
Relationship Of ◽  
The Relationship ◽  
Biologic Factors

The Mesozoic-Cenozoic coral Order Scleractinia has been suggested to have originated or evolved (1) by direct descent from the Paleozoic Order Rugosa or (2) by the development of a skeleton in members of one of the anemone groups that probably have existed throughout Phanerozoic time. In spite of much work on the subject, advocates of the direct descent hypothesis have failed to find convincing evidence of this relationship. Critical points are:(1) Rugosan septal insertion is serial; Scleractinian insertion is cyclic; no intermediate stages have been demonstrated. Apparent intermediates are Scleractinia having bilateral cyclic insertion or teratological Rugosa.(2) There is convincing evidence that the skeletons of many Rugosa were calcitic and none are known to be or to have been aragonitic. In contrast, the skeletons of all living Scleractinia are aragonitic and there is evidence that fossil Scleractinia were aragonitic also. The mineralogic difference is almost certainly due to intrinsic biologic factors.(3) No early Triassic corals of either group are known. This fact is not compelling (by itself) but is important in connection with points 1 and 2, because, given direct descent, both changes took place during this only stage in the history of the two groups in which there are no known corals.

Choosing a Markov blanket

2020 ◽  
Vol 43 ◽  
Author(s):  
Thomas Parr
Keyword(s):  
Markov Blanket ◽  
Target Article ◽  
The Relationship

Abstract This commentary focuses upon the relationship between two themes in the target article: the ways in which a Markov blanket may be defined and the role of precision and salience in mediating the interactions between what is internal and external to a system. These each rest upon the different perspectives we might take while “choosing” a Markov blanket.

Tinkering with cognitive gadgets: Cultural evolutionary psychology meets active inference

2019 ◽  
Vol 42 ◽  
Author(s):  
Paul Benjamin Badcock ◽  
Axel Constant ◽  
Maxwell James Désormeau Ramstead
Keyword(s):  
Evolutionary Psychology ◽  
Research Program ◽  
Active Inference ◽  
Innovative Research ◽  
Cognitive Faculties ◽  
Cultural Evolutionary ◽  
The Relationship

Abstract Cognitive Gadgets offers a new, convincing perspective on the origins of our distinctive cognitive faculties, coupled with a clear, innovative research program. Although we broadly endorse Heyes’ ideas, we raise some concerns about her characterisation of evolutionary psychology and the relationship between biology and culture, before discussing the potential fruits of examining cognitive gadgets through the lens of active inference.

Radiation Damage, Contrast and Statistics in High Resolution Biological Electron Microscopy

1970 ◽  
Vol 28 ◽  
pp. 260-261
Author(s):  
Robert M. Glaeser
Keyword(s):  
High Resolution ◽  
Particle Flux ◽  
Unit Area ◽  
Signal To Noise ◽  
Resolution Image ◽  
High Resolution Image ◽  
Pass Through ◽  
Counting Statistics ◽  
The Relationship ◽  
Picture Element

It is well known that a large flux of electrons must pass through a specimen in order to obtain a high resolution image while a smaller particle flux is satisfactory for a low resolution image. The minimum particle flux that is required depends upon the contrast in the image and the signal-to-noise (S/N) ratio at which the data are considered acceptable. For a given S/N associated with statistical fluxtuations, the relationship between contrast and “counting statistics” is s131_eqn1, where C = contrast; r2 is the area of a picture element corresponding to the resolution, r; N is the number of electrons incident per unit area of the specimen; f is the fraction of electrons that contribute to formation of the image, relative to the total number of electrons incident upon the object.

Skeletal elements of crinoid echinoderms: High-resolution structural and microanalytical results

1983 ◽  
Vol 41 ◽  
pp. 194-195
Author(s):  
D. F. Blake ◽  
L. F. Allard ◽  
D. R. Peacor
Keyword(s):  
High Resolution ◽  
Marine Invertebrates ◽  
Sea Urchins ◽  
Structural Features ◽  
Sea Stars ◽  
High Resolution Tem ◽  
Relationship Of ◽  
The Relationship ◽  
Insight Into

Echinodermata is a phylum of marine invertebrates which has been extant since Cambrian time (c.a. 500 m.y. before the present). Modern examples of echinoderms include sea urchins, sea stars, and sea lilies (crinoids). The endoskeletons of echinoderms are composed of plates or ossicles (Fig. 1) which are with few exceptions, porous, single crystals of high-magnesian calcite. Despite their single crystal nature, fracture surfaces do not exhibit the near-perfect {10.4} cleavage characteristic of inorganic calcite. This paradoxical mix of biogenic and inorganic features has prompted much recent work on echinoderm skeletal crystallography. Furthermore, fossil echinoderm hard parts comprise a volumetrically significant portion of some marine limestones sequences. The ultrastructural and microchemical characterization of modern skeletal material should lend insight into: 1). The nature of the biogenic processes involved, for example, the relationship of Mg heterogeneity to morphological and structural features in modern echinoderm material, and 2). The nature of the diagenetic changes undergone by their ancient, fossilized counterparts. In this study, high resolution TEM (HRTEM), high voltage TEM (HVTEM), and STEM microanalysis are used to characterize tha ultrastructural and microchemical composition of skeletal elements of the modern crinoid Neocrinus blakei.

Ultrastructural Correlations between Clonal Human Tumor Colonies and in Vivo Neoplasms

1982 ◽  
Vol 40 ◽  
pp. 210-211
Author(s):  
M.J. Murphy ◽  
R.R. Price ◽  
J.C. Sloman
Keyword(s):  
Cultured Cells ◽  
Human Tumor ◽  
Cell Type ◽  
Tumor Mass ◽  
Initial Cell ◽  
Cloning Assay ◽  
Human Tumor Cloning ◽  
The Relationship

The in vitro human tumor cloning assay originally described by Salmon and Hamburger has been applied recently to the investigation of differential anti-tumor drug sensitivities over a broad range of human neoplasms. A major problem in the acceptance of this technique has been the question of the relationship between the cultured cells and the original patient tumor, i.e., whether the colonies that develop derive from the neoplasm or from some other cell type within the initial cell population. A study of the ultrastructural morphology of the cultured cells vs. patient tumor has therefore been undertaken to resolve this question. Direct correlation was assured by division of a common tumor mass at surgical resection, one biopsy being fixed for TEM studies, the second being rapidly transported to the laboratory for culture.

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