VP135 Clustering Surgical Indicators And Predictors Of Catastrophic Expenses

2017 ◽  
Vol 33 (S1) ◽  
pp. 210-211
Author(s):  
Songul Cinaroglu ◽  
Onur Baser
Keyword(s):  
Medical Imaging ◽  
General Health ◽  
Surgical Care ◽  
The Third ◽  
Surgical Workforce ◽  
Silhouette Index ◽  
The World ◽  
Country Differences ◽  
Cross Country ◽  
Risk Predictors

INTRODUCTION:Increasing access to surgical care is crucial in improving the general health status of a population. Despite studies indicating the cross-country differences of general health indicators, there is a scarcity of knowledge focusing on the cross-country differences of surgical indicators. This study aims to classify countries according to surgical care indicators and identify risk predictors of catastrophic surgical care expenditures.METHODS:For this study, data were used from the World Health Organization and the World Bank on 177 countries. The following variable groups were chosen: total density of medical imaging technologies, surgical workforce distribution, number of surgical procedures, and risk of catastrophic surgical care expenditures. The k-means clustering algorithm was used to classify countries according to the surgical indicators. The optimal number of clusters was determined with a within-cluster sum of squares and a scree plot. A Silhouette index was used to examine clustering performance, and a random forest decision tree approach was used to determine risk predictors of catastrophic surgical care expenditures.RESULTS:The surgical care indicator results delineated the countries into four groups according to each country's income level. The cluster plot indicated that most high-income countries (for example, United States, United Kingdom, Norway) are in the first cluster. The second cluster consisted of four countries: Japan, San Marino, Marshall Islands, and Monaco. Low-income countries (for example, Ethiopia, Guatemala, Kenya) and middle-income countries (for example, Brazil, Turkey, Hungary) are represented in the third and fourth clusters, respectively. The third cluster had a high Silhouette index value (.75). The densities of both surgeons and medical imaging technology were risk determiners of catastrophic surgical care expenditures (Area Under Curve = .82).CONCLUSIONS:Our results demonstrate a need for more effective health plans if the differences between countries surgical care indicators are to be overcome. We recommend that health policymakers reconsider distribution strategies for the surgical workforce and medical imaging technology in the interest of accessibility and equality.

scholarly journals Worldwide clustering of surgical indicators and predictors of risk of catastrophic expenditure for surgical care

2017 ◽  
Vol 7 (3) ◽  
pp. 188-195
Author(s):  
Songul Cinaroglu ◽  
Onur Baser
Keyword(s):  
Medical Imaging ◽  
Low Income ◽  
General Health ◽  
Surgical Care ◽  
Low Income Countries ◽  
Total Density ◽  
Catastrophic Expenditure ◽  
Imaging Technologies ◽  
Study Results ◽  
Silhouette Index

Introduction: Better access to surgical care is crucial to improve general health status of the population. Despite studies indicate cross country differences according to the general health indicators, there is a scarcity of knowledge about the differences between countries according to the surgical indicators. This study aims to classify countries according to the surgical care indicators and to identify predictors of risk of catastrophic health expenditure for surgical care. Methods: Data came from WHO and WB statistics and totally 177 countries were selected for this study. Variable groups are determined as; total density of medical imaging technologies, workforce distribution in surgical care, number of surgical prodecures and risk of catastrophic expenditure for surgical care. K-means clustering algorithm was used to classify countries according to the surgical indicators. Optimal number of clusters determined by using within cluster sum of squares and scree plot. Silhouette index was used to examine clustering performance. Random Forest decision tree approach was used to determine predictors of the risk for catastrophic expenditure for surgical care. Results: Study results shows that there are four country groups exists according to their surgical care indicators. High and low income countries are in different clusters. The third cluster which consists of low income countries has high Silhouette index value (0.75). Surgeon density and density of the medical imaging technologies are determinators of the risk for catastrophic expenditure for surgical care (AUC=0.82). Conclusions: Study results pose that there is a need for more effective health plans to overcome the differences between countries in terms of surgical care indicators. Determining strategies about distribution of surgical workforce and medical imaging technologies considering accessibility and equality are recommendated for health policy makers.

scholarly journals Cross-Country Differences in Intergenerational Earnings Mobility

2002 ◽  
Vol 16 (3) ◽  
pp. 59-66 ◽  
Author(s):  
Gary Solon
Keyword(s):  
United States ◽  
Intergenerational Transmission ◽  
Intergenerational Mobility ◽  
Economic Status ◽  
The United States ◽  
International Studies ◽  
The Third ◽  
Income Status ◽  
Country Differences ◽  
Cross Country

International studies of the extent to which economic status is passed from one generation to the next are important for at least two reasons. First, each study of a particular country characterizes an important feature of that country's income inequality. Second, comparisons of intergenerational mobility across countries may yield valuable clues about how income status is transmitted across generations and why the strength of that intergenerational transmission varies across countries. The first section of this paper explains a benchmark measure of intergenerational mobility commonly used in U.S. studies. The second section summarizes comparable empirical findings that have accumulated so far for countries other than the United States. The third section sketches a theoretical framework for interpreting cross-country differences in intergenerational mobility.

scholarly journals Medical Imaging in Guyana, development and status

2019 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
Ramona Chanderballi
Keyword(s):  
Medical Imaging ◽  
Urban Areas ◽  
Health Indicators ◽  
Tropical Rainforests ◽  
Young Population ◽  
Basic Health ◽  
Cultural Divide ◽  
The Third ◽  
The World ◽  
The Uk

Medical imaging services have been rapidly advancing in Guyana over the last decade. It is time to look back, and state the todays’ situation.With a population, under 1 million, Guyana, according to the World Factbook (1), is the third smallest country in South America. Guyana was originally a Dutch colony in the 17th century, by 1815 had become a British possession. The abolition of slavery led to settlement of urban areas by former slaves and the importation of indentured servants from India to work the sugar plantations. Tropical rainforests cover over 80 percent, and its agricultural lands are fertile. A resulting ethno-cultural divide has persisted and has led to turbulent politics. Guyana achieved independence from the UK in 1966. In 1992, the country is first free and fair election since independence. The economy is growing; still at a high unemployment. According to the World Factbook, it is (per 2018) a young population; mean age for both females and males are 28 years, and life expectancy 68y. Compared with other neighboring countries, Guyana ranks poorly concerning basic health indicators (2), basic health services in the interior are primitive to non-existent.

scholarly journals The experiences of female surgeons around the world: a scoping review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Meredith D. Xepoleas ◽  
Naikhoba C. O. Munabi ◽  
Allyn Auslander ◽  
William P. Magee ◽  
Caroline A. Yao
Keyword(s):  
Gender Equity ◽  
Gender Gap ◽  
Low Income ◽  
Critical Mass ◽  
Surgical Care ◽  
Child Rearing ◽  
Lower Income ◽  
Surgical Workforce ◽  
The World ◽  
Female Surgeons

Abstract Introduction The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons’ experiences globally to identify strategies to increase surgical capacity through women. Methods Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). Results Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. Conclusion The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons’ experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons’ experiences and promote gender equity in increasing the number of surgical providers.

scholarly journals The Global Neurosurgery and the WFNS

2021 ◽  
Vol 1 (1) ◽  
pp. 13-14
Author(s):  
Franco Servadei ◽  
Maria Pia Tropetano
Keyword(s):  
Surgical Care ◽  
Critical Factor ◽  
World Health ◽  
Easy Access ◽  
World Federation ◽  
Middle Income ◽  
Global Improvement ◽  
Surgical Workforce ◽  
The World ◽  
Health Organization

In 2015, the Lancet Commission on Global Surgery highlighted surgical care disparities worldwide [1]. No one could ever imagine that Global Neurosurgery would become a real movement, a source of inspiration for others surgical specialties [2]. Over the years, Global Neurosurgery allowed the realization of a collective awareness of surgery as a global health priority. The Neurosurgical community accepted the challenge of delivering timely, safe, and affordable neurosurgical care to all who need it. Multiple efforts have been made to address this need to promote national surgical policies, improve surgical education and training, build quality research, and advocate for the surgical workforce. The critical factor has been the relationship between the World Health Organization (WHO) and the World Federation of Neurosurgical Societies (WFNS). Since 1955, the WFNS has promoted global improvement in neurosurgical care, building neurosurgical capacity through education, training, technology, and research. The goals are ambitious. By creating international partnerships, the WFNS has established multiple training programs in neurosurgical centers in Africa and other countries with limited facilities, allowing residents to work first in the host countries to learn and improve their skills and return to their country of origin [3,4,5]. Furthermore, the WFNS is working on sustainable surgical programs within Low-and Middle-income countries (LMICs) using digital technology [6]. Internet availability allows fast and easy access to digital resources, and digital education has become an emerging tool to bridge the gap between surgeons from High-Income Countries (HICs) and LMICs.

scholarly journals Crop Selection and International Differences in Aggregate Agricultural Productivity

2019 ◽  
Vol 19 (179) ◽  
Author(s):  
Jorge Alvarez ◽  
Claudia Berg
Keyword(s):  
Agricultural Productivity ◽  
Large Share ◽  
World Data ◽  
International Differences ◽  
Crop Selection ◽  
The World ◽  
Comparative Advantages ◽  
Country Differences ◽  
Specific Potential ◽  
Cross Country

A large share of cross-country differences in productivity is explained by differences in agricultural productivity. Using a combination of sub-national agricultural statistics and geospatial datasets on crop-specific potential yields, we study the main drivers of this variation from a macroeconomic perspective. We find that differences in geographically-induced crop-specific comparative advantages can explain a substantial share of the variation in yields across the world. Data reveal substantial gaps between potential and observed yields in most countries. When decomposing these within country gaps, we find that crop selection gaps are on average larger than those induced by input usage alone. The results highlight the importance of understanding the interaction of geography and crop selection drivers in assessing aggregate agricultural productivity differences.

ARTIFICIAL INTELLIGENCE IN ECONOMY AND POLICY NOWADAYS. ARTICLE 3. ARTIFICIAL INTELLIGENCE IN RUSSIAN AND FOREIGN PUBLIC POLICY

2021 ◽  
pp. 3-32
Author(s):  
V.N. Leksin
Keyword(s):  
Artificial Intelligence ◽  
United States ◽  
Public Policy ◽  
The United States ◽  
The Third ◽  
China And India ◽  
The World ◽  
Final Article ◽  
Country Differences

The third and final article of the three-part series of articles «Artificial intelligence in the economy and politics of our time» (the first and second articles of the series were published in the fourth and fifth issues of the journal for this year, respectively) presents the results of a study of the goals, motivations and specifics of the adoption of national strategies to support the development of artificial intelligence in different countries. It is shown that such a strategy in Russia is based on the idea of the most important role of using artificial intelligence in solving the most complex economic, social, and military-political problems of the country. Differences in conceptual approaches to the development of research and practical use of artificial intelligence developments in the national strategies of the largest countries of the world — the United States, China and India.

scholarly journals The Creation of a Sustainable Otolaryngology Department in Malawi

2019 ◽  
Vol 99 (8) ◽  
pp. 501-502
Author(s):  
Nathan Douglas Vandjelovic ◽  
Eric Masao Sugihara ◽  
Wakisa Mulwafu ◽  
David Nathan Madgy
Keyword(s):  
Continuity Of Care ◽  
International Collaboration ◽  
Surgical Care ◽  
Medically Underserved ◽  
Surgical Services ◽  
Surgical Workforce ◽  
The World ◽  
Complete Access

There is a significant lack of surgeons in the developing world. Malawi Africa is one of the poorest and medically underserved countries in the World, with surgical care particularly lacking. Providing surgical services has numerous barriers, such as availability of well-trained surgeons, infrastructure, continuity of care, and access to care. There is currently one otolaryngologist in Malawi who provides complete access to this subspecialty. The development of the otolaryngology department was successful through institutional, local, national, and international collaboration, with a long-term goal of sustainability. An established department can train the next generation of surgeons for the preservation and growth of the surgical workforce. Once the department approaches independence, the role of outside collaboration transforms primarily from financial to a bi-directional partnership encompassing education, training, and leadership.

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