Estimating Times of Surgeries with Two Component Procedures

2003 ◽  
Vol 98 (1) ◽  
pp. 232-240 ◽  
Author(s):  
David P. Strum ◽  
Jerrold H. May ◽  
Allan R. Sampson ◽  
Luis G. Vargas ◽  
William E. Spangler
Keyword(s):  
Goodness Of Fit ◽  
Normal Model ◽  
Factors Affecting ◽  
Lognormal Model ◽  
Time Estimates ◽  
Surgical Scheduling ◽  
Large Teaching Hospital ◽  
Two Component ◽  
The Impact ◽  
Component Procedure

Background Variability inherent in the duration of surgical procedures complicates surgical scheduling. Modeling the duration and variability of surgeries might improve time estimates. Accurate time estimates are important operationally to improve utilization, reduce costs, and identify surgeries that might be considered outliers. Surgeries with multiple procedures are difficult to model because they are difficult to segment into homogenous groups and because they are performed less frequently than single-procedure surgeries. Methods The authors studied, retrospectively, 10,740 surgeries each with exactly two CPTs and 46,322 surgical cases with only one CPT from a large teaching hospital to determine if the distribution of dual-procedure surgery times fit more closely a lognormal or a normal model. The authors tested model goodness of fit to their data using Shapiro-Wilk tests, studied factors affecting the variability of time estimates, and examined the impact of coding permutations (ordered combinations) on modeling. Results The Shapiro-Wilk tests indicated that the lognormal model is statistically superior to the normal model for modeling dual-procedure surgeries. Permutations of component codes did not appear to differ significantly with respect to total procedure time and surgical time. To improve individual models for infrequent dual-procedure surgeries, permutations may be reduced and estimates may be based on the longest component procedure and type of anesthesia. Conclusions The authors recommend use of the lognormal model for estimating surgical times for surgeries with two component procedures. Their results help legitimize the use of log transforms to normalize surgical procedure times prior to hypothesis testing using linear statistical models. Multiple-procedure surgeries may be modeled using the longest (statistically most important) component procedure and type of anesthesia.

Modeling the Uncertainty of Surgical Procedure Times

2000 ◽  
Vol 92 (4) ◽  
pp. 1160-1167 ◽  
Author(s):  
David P. Strum ◽  
Jerrold H. May ◽  
Luis G. Vargas
Keyword(s):  
Surgical Procedure ◽  
Goodness Of Fit ◽  
Statistical Tests ◽  
Current Procedural Terminology ◽  
Normal Model ◽  
Rounding Errors ◽  
Goodness Of Fit Tests ◽  
Time Estimates ◽  
Surgical Scheduling ◽  
Log Normal

Background Medical institutions are under increased economic pressure to schedule elective surgeries efficiently to contain the costs of surgical services. Surgical scheduling is complicated by variability inherent in the duration of surgical procedures. Modeling that variability, in turn, provides a mechanism to generate accurate time estimates. Accurate time estimates are important operationally to improve operating room utilization and strategically to identify surgeons, procedures, or patients whose duration of surgeries differ from what might be expected. Methods The authors retrospectively studied 40,076 surgical cases (1,580 Current Procedural Terminology-anesthesia combinations, each with a case frequency of five or more) from a large teaching hospital, and attempted to determine whether the distribution of surgical procedure times more closely fit a normal or a log-normal distribution. The authors tested goodness-of-fit to these data for both models using the Shapiro-Wilk test. Reasons, in practice, the Shapiro-Wilk test may reject the fit of a log-normal model when in fact it should be retained were also evaluated. Results The Shapiro-Wilk test indicates that the log-normal model is superior to the normal model for a large and diverse set of surgeries. Goodness-of-fit tests may falsely reject the log-normal model during certain conditions that include rounding errors in procedure times, large sample sizes, untrimmed outliers, and heterogeneous mixed populations of surgical procedure times. Conclusions The authors recommend use of the log-normal model for predicting surgical procedure times for Current Procedural Terminology-anesthesia combinations. The results help to legitimize the use of log transforms to normalize surgical procedure times before hypothesis testing using linear statistical models or other parametric statistical tests to investigate factors affecting the duration of surgeries.

Structural Model of Service Quality Factors Affecting Loyalty Sustainability

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Eman Al-erqi ◽  
◽  
Mohd Lizam Mohd Diah ◽  
Najmaddin Abo Mosali ◽  
◽  
...  
Keyword(s):  
International Students ◽  
Service Quality ◽  
Goodness Of Fit ◽  
Structural Model ◽  
Quality Factors ◽  
Factors Affecting ◽  
Measurement Models ◽  
Confirmatory Factor ◽  
The University ◽  
The Impact

This study seeks to address the impact of service quality affecting international student's satisfaction towards loyalty tothe Universiti Tun Hussein Onn Malaysia(UTHM). The aim of thestudy is to develop relationship between service quality factor and loyalty to the university from the international students’ perspectives. The study adopted quantitative approach where data was collected through questionnaire survey and analysed statistically. A total of 246 responses were received and found to be valid. The model was developed and analysed using AMOS-SEM software. Confirmatory factor analysis (CFA) function of the software was to assessed the measurement models and found that all the models achieved goodness of fit. Then path analysis function was used to assessed structural model and found that service qualityfactors have a significant effect on the students’ satisfaction and thus affecting the loyaltyto the university. Hopefully the outcome form this study will benefit the university in providing services especially to the international students.

scholarly journals Comprehensive Evaluation of a Sparse Dataset, Assessment and Selection of Competing Models

Signals ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 157-169
Author(s):  
Mahdi Rezapour ◽  
Khaled Ksaibati
Keyword(s):  
Goodness Of Fit ◽  
Negative Binomial ◽  
Comprehensive Evaluation ◽  
Binary Logistic Regression ◽  
Parameter Estimates ◽  
Hurdle Model ◽  
Factors Affecting ◽  
Equivalent Property ◽  
The Right ◽  
The Impact

With tremendous associated economic and social costs of crashes, researchers have been trying not only to identify the factors affecting crashes, but also to estimate those coefficients in the most accurate ways. Estimating model coefficients without accounting for a correct distribution would result in biased and erroneous results. This risk especially holds true when modeling skewed equivalent property damage only (EPDO) crashes with a preponderance of zeroes. The distribution of EPDO is known for not being modeled with known distributions such as Poisson or negative binomial distributions. This issue is highlighted in particular for a mountainous state like Wyoming that has very low traffic levels and a severely high crash rate. In addition, we included barriers in the model that did not experience any crashes but did suffer from being under-designed by geometric architects, thereby adding to the number of zero count observations. Various models with different distributional characteristics were considered and compared in this study. Comparisons were not just made across models in terms of their goodness of fit, but the estimated coefficients were also compared to see the impact of considering the wrong distributional assumptions on model parameter estimates. As the objectives of this study are to implement the identified results for optimization purposes and locate hazardous locations that could host future crashes, the results highlight accurate model estimations and the consequences of a failure to account for the right distributions. After conducting different goodness-of-fit measures, a hurdle model was proposed in this study to accommodate observations with zero crashes, and to account for a sparse distribution of EPDO crashes in the state of Wyoming. For the hurdle model, binary logistic regression was used to account for observations with zero crashes, while the negative binomial method was considered for non-zero observations. The findings of this study have direct implications on the allocation of limited funds for policymakers in Wyoming, as optimization could be conducted on the geometric characteristics of traffic barriers in future studies.

DAMPAK KEBIJAKAN FISKAL TERHADAP KINERJA SEKTOR PERTANIAN DI SULAWESI TENGGARA

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
La Ode Jabuddin ◽  
Ayub M Padangaran ◽  
Azhar Bafadal Bafadal
Keyword(s):  
Fiscal Policy ◽  
Interest Rates ◽  
Agricultural Sector ◽  
Simultaneous Equations ◽  
Poor People ◽  
Land Area ◽  
Factors Affecting ◽  
Historical Simulation ◽  
The Impact ◽  
Direct Expenditure

This study aims to: (1) Knowing the dynamics of fiscal policy and the performance of the agricultural sector, (2) Analyze the factors that influence fiscal policy and the performance                   of the agricultural sector, and (3) Analyzing the impact of fiscal policy on the performance of the agricultural sector. The data used in this study were pooled 2005-2013 data in the aggregate. Econometric model the impact of fiscal policy on the performance of the agricultural sector is built in the form of simultaneous equations, consisting of 7 equations with 25 total variables in the model, 7 endogenous variables, 12 exogenous variables, and 6 variables lag. The model is estimated by 2SLS method SYSLIN procedures and historical simulation with SIMNLIN procedure.The results showed that: (1) The development of fiscal policy in Southeast Sulawesi from year to year tends to increase, (2) The performance of the agricultural sector from the aspect of GDP has decreased, from the aspect of labor is still consistent, in terms of investment to grow positively, and assign roles which means to decrease the number of poor people, (3) factors affecting fiscal policy is local revenues, equalization funds, other revenues, as well as the lag fiscal policy, (4) the factors that affect the performance of the agricultural sector from the aspect GDP is labor, direct expenditure and GDP lag; from the aspect of labor is the total labor force, investment, land area, direct expenditure, as well as the lag of labor; from the aspect of investment is influenced by GDP per capita, land area, interest rates and investment lag; as well as from the aspect of poor people, are affected by population, investments, direct expenditure and poverty lag, (5). Fiscal policy impact on the agricultural sector GDP increase, a decrease in the number of poor, declining agricultural laborers, and a decrease in the amount of investment in the agricultural sector.Keywords: Fiscal policy, the performance of the agricultural sector, the simultaneous equations

Influence of the ICCPR in Asia

2018 ◽  
Author(s):  
Yogesh Tyagi
Keyword(s):  
Human Rights ◽  
Political Rights ◽  
International Human Rights ◽  
Factors Affecting ◽  
Judicial Discourse ◽  
International Human ◽  
Golden Jubilee ◽  
Civil And Political Rights ◽  
The Impact

The golden jubilee of the International Covenant on Civil and Political Rights (ICCPR) coincides with the emergence of Asia as a centre of global attention. However, greater attention to Asia has been accompanied by some scepticism over its attitude towards human rights. The chapter provides an overall assessment of the impact of the ICCPR on the major Asian States, with an analysis of the factors affecting such influence. The chapter considers the involvement in, observance of, and compliance with the provisions of the ICCPR by these States. It further delves into the academic and judicial discourse on the ICCPR within these States, recording the domestic disposition towards judgments of foreign courts, the output of the Human Rights Committee, and the work of other international human rights bodies. It makes suggestions for developing mechanisms to improve the effectiveness of the ICCPR and for creating databases to perform further research in the area.

scholarly journals Assessing the Impact of Bank Concentration and Liquidity of Refah Bank Branches on Profitability during the Period1383-190

2014 ◽  
Vol 4 (1) ◽  
pp. 248
Author(s):  
Hossin Ostadi ◽  
Nastran Monsef
Keyword(s):  
Commercial Banks ◽  
Bank Capital ◽  
Factors Affecting ◽  
Bank Branches ◽  
Independent Variables ◽  
Bank Deposits ◽  
The Impact ◽  
Bank Concentration ◽  
Research Period

Profitability is an important factor to show this articledoeswhat is the role of the intermediary bank to collect your savings and allocation of loans.  Given the importance of profitability indicators in this study, the factors affecting the profitability of commercial banks in Iranare analyzedwith emphasis on the degree of centralization and bank deposits. Dependent variable is indicators of profitability (ROE, ROA) and bank deposits, bank size, bank capital, focus on liquidity and banking requirements are independent variables. Correlation analysis and OLS regression are used and the research period is 1381 to 1390 that the country's territory where bank branches.Our results indicate that the effect of bank size on profitability is positive and the increase in bank size on profitability is increased. Impact on the profitability of bank deposits is positive, ie increasing the profitability of bank deposits increased. Finally, the impact of bank concentration on profitability is positive. Increasing the bank's focus profitability increases. Moreover, the results adversely affect the liquidity of the index is profit. 

scholarly journals THE FUTURE OF PASSENGER AIR TRANSPORT – VERY LARGE AIRCRAFT AND OUT KEY HUMAN FACTORS AFFECTING THE OPERATION AND SAFETY OF PASSENGER AIR TRANSPORT

2017 ◽  
Vol 12 ◽  
pp. 104
Author(s):  
Petra Skolilova
Keyword(s):  
Human Factors ◽  
Human Error ◽  
Operating Cost ◽  
Aircraft Design ◽  
Air Transport ◽  
Final Decision ◽  
Factors Affecting ◽  
Fuel Burn ◽  
The Future ◽  
The Impact

The article outlines some human factors affecting the operation and safety of passenger air transport given the massive increase in the use of the VLA. Decrease of the impact of the CO2 world emissions is one of the key goals for the new aircraft design. The main wave is going to reduce the burned fuel. Therefore, the eco-efficiency engines combined with reasonable economic operation of the aircraft are very important from an aviation perspective. The prediction for the year 2030 says that about 90% of people, which will use long-haul flights to fly between big cities. So, the A380 was designed exactly for this time period, with a focus on the right capacity, right operating cost and right fuel burn per seat. There is no aircraft today with better fuel burn combined with eco-efficiency per seat, than the A380. The very large aircrafts (VLAs) are the future of the commercial passenger aviation. Operating cost versus safety or CO2 emissions versus increasing automation inside the new generation aircraft. Almost 80% of the world aircraft accidents are caused by human error based on wrong action, reaction or final decision of pilots, the catastrophic failures of aircraft systems, or air traffic control errors are not so frequent. So, we are at the beginning of a new age in passenger aviation and the role of the human factor is more important than ever.

scholarly journals Public reporting of performance measures in long-term care in Canada: does it make a difference?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poldrugovac ◽  
J E Amuah ◽  
H Wei-Randall ◽  
P Sidhom ◽  
K Morris ◽  
...  
Keyword(s):  
Performance Measures ◽  
Performance Indicators ◽  
Long Term Care ◽  
Public Reporting ◽  
Policy Implications ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
The Impact

Abstract Background Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication. Methods We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication. Results Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed. Conclusions Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication. Key messages Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.

Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker

2021 ◽  
Author(s):  
Micaella Sotera Hansen ◽  
Wubshet Tesfaye ◽  
Beena Sewlal ◽  
Bharati Mehta ◽  
Kamal Sud ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Psychosocial Factors ◽  
Social Worker ◽  
End Stage Kidney Disease ◽  
Factors Affecting ◽  
The Social ◽  
End Stage ◽  
The Impact

What Drives Banking Profitability During Financial Crisis and Political Turmoil? Evidence from the MENA Region

2021 ◽  
pp. 097491012110311
Author(s):  
Salma Zaiane ◽  
Fatma Ben Moussa
Keyword(s):  
Financial Crisis ◽  
Political Instability ◽  
Generalized Method Of Moments ◽  
Bank Performance ◽  
Net Income ◽  
Mena Region ◽  
Factors Affecting ◽  
Mena Countries ◽  
Conventional Banks ◽  
The Impact

The purpose of the study is to identify bank specific, macroeconomic, and stability determinants of both conventional and Islamic bank performance. We also try to identify evidence on the impact of financial crisis and political instability during the Arab Spring (AS) period. The study covers a sample of 123 banks (34 Islamic banks and 89 conventional banks from 13 Middle East and North Africa [MENA] countries) over the period 2000–2013. We use different proxies of performance as dependent variables: return on asset (ROA), return on equity (ROE), net income margin (NIM), and estimate several regressions using the dynamic generalized method of moments. Our results reveal that bank size, asset quality, specialization, and diversification are the major bank specific factors affecting performance of Islamic and conventional banks. Besides, macroeconomic indicators (GDP and inflation) and regulatory quality influence both types of banks differently. Finally, both the financial crisis and political instability negatively affect bank performance.

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