Transportation costs do matter: simulation study from hospital investment decision

2016 ◽  
Vol 11 (2) ◽  
pp. 560-584 ◽  
Author(s):  
Olli-Pekka Hilmola ◽  
Ville Henttu
Keyword(s):  
Health Care ◽  
Simulation Study ◽  
Public Transportation ◽  
Investment Decision ◽  
Real Life ◽  
Transportation Costs ◽  
Dynamics Simulation ◽  
Ageing Population ◽  
Content Type ◽  
Transportation Modes

Purpose Most OECD countries will have a considerable challenge ahead with an ageing population and necessary health care produced for retired people. Healthcare costs have increased continuously from the mid-1990’s in Finland, and growth is likely to continue in the future, as the amount of older inhabitants is increasing. Furthermore, transportation of patients and their visitors between homes and hospitals is a large component of the total health carehealth care related costs. This paper aims to estimate transport-related costs and develop ways to decrease these costs. Design/methodology/approach A system dynamics simulation model was developed to examine different scenarios for patients and their visitor transportation to hospitals until the year 2040. Model is driven by age distribution of the region and likely by development of the total population. All parameter values were defined based on real-life observations. Findings Patients’ need to travel to hospitals is likely to continue to grow. In addition, quality of travel will change as older retired people are not willing or able to use their own transportation equipment or public transportation modes – this is the main reason for higher transportation costs of patients. Transportation is typically conducted via taxis, private cars and ambulances. Therefore, it is critical that people from the region are able to access hospital services with short proximity. Research limitations/implications Simulation study is limited to one hospital investment decision in Finland. Distances and population densities as well as transportation mode alternatives differ from more populous regions in the world. Practical implications Research findings stressed the importance of keeping their own hospital operations within the region and placing them in a better location. In an alternative case, where a hospital decision would have been abandoned, total transportation costs during 2012-2040 would have increased by at least the same amount that a new hospital is assumed to cost. Originality/value This research is one of the first from the health care sector, where patient transportation modes and ageing is being dealt with in the context of new investments. Patient transportation is often an overlooked issue, which bears significant costs, especially as people age.

Kenneth Fisher’s heuristics

2016 ◽  
Vol 8 (2) ◽  
pp. 130-148
Author(s):  
Carlo Massironi ◽  
Giusy Chesini
Keyword(s):  
Decision Making ◽  
Conceptual Analysis ◽  
Investment Decision ◽  
Real Life ◽  
Human Action ◽  
Theory Of Knowledge ◽  
Constructivist Theory ◽  
Individual Investors ◽  
Content Type ◽  
Radical Constructivist

Purpose The authors are interested in building descriptive – real life – models of successful investors’ investment reasoning and decision-making. Models designed to be useful for trying to replicate and evolve their reasoning and decision-making. The purpose of this paper, a case study, is to take the substantial material – on innovating the investing tools – published in four books (2006/2012, 2010, 2011, 2015) by a US stock investor named Kenneth Fisher (CEO of Fisher Investments, Woodside, California) and sketch Fisher’s investment innovating reasoning model. Design/methodology/approach To sketch Fisher’s investment innovating reasoning model, the authors used the Radical constructivist theory of knowledge, a framework for analyzing human action and reasoning called Symbolic interactionism and a qualitative analytic technique called Conceptual analysis. The authors have done qualitative research applied to the study of investment decision-making of a single professional investor. Findings In the paper, the authors analyzed and described the heuristics used by Fisher to build subsequent generations of investing tools (called by Fisher “Capital Markets Technology”) to try to make better forecasts to beat the stock market. The authors were interested in studying the evolutive dimensions of the tools to make forecasts of a successful investor: the “how to build it” and “how to evolve it” dimension. Originality/value The paper offers an account of Kenneth Fisher’s framework to reason the innovation of investing tools. The authors believe that this paper could be of interest to professional money managers and to all those who are involved in the study and development of the tools of investing. This work is also an example of the use of the Radical constructivist theory of knowledge, the Symbolic interactionist framework and the Conceptual analysis to build descriptive models of investment reasoning of individual investors, models designed to enable the reproduction/approximation of the conceptual operations of the investor.

An integrated DEA-based approach for evaluating and sizing health care supply chains

2019 ◽  
Vol 15 (1) ◽  
pp. 201-231
Author(s):  
Zoubida Chorfi ◽  
Abdelaziz Berrado ◽  
Loubna Benabbou
Keyword(s):  
Health Care ◽  
Supply Chains ◽  
Real Life ◽  
Integrated Approach ◽  
Interval Data ◽  
Pharmaceutical Supply Chain ◽  
Content Type ◽  
Integrated Methodology ◽  
Dea Models ◽  
Health Care Supply

Purpose Evaluating the performance of supply chains is a convoluted task because of the complexity that is inextricably linked to the structure of the aforesaid chains. Therefore, the purpose of this paper is to present an integrated approach for evaluating and sizing real-life health-care supply chains in the presence of interval data. Design/methodology/approach To achieve the objective, this paper illustrates an approach called Latin hypercube sampling by replacement (LHSR) to identify a set of precise data from the interval data; then the standard data envelopment analysis (DEA) models can be used to assess the relative efficiencies of the supply chains under evaluation. A certain level of data aggregation is suggested to improve the discriminatory power of the DEA models and an experimental design is conducted to size the supply chains under assessment. Findings The newly developed integrated methodology assists the decision-makers (DMs) in comparing their real-life supply chains against peers and sizing their resources to achieve a certain level of production. Practical implications The proposed integrated DEA-based approach has been successfully implemented to suggest an appropriate structure to the actual public pharmaceutical supply chain in Morocco. Originality/value The originality of the proposed approach comes from the development of an integrated methodology to evaluate and size real-life health-care supply chains while taking into account interval data. This developed integrated technique certainly adds value to the health-care DMs for modelling their supply chains in today's world.

Improving health care costing with resource consumption accounting

2016 ◽  
Vol 29 (6) ◽  
pp. 646-663
Author(s):  
Hasan Ozyapici ◽  
Veyis Naci Tanis
Keyword(s):  
Health Care ◽  
Real Life ◽  
Resource Consumption ◽  
Selling Price ◽  
Health Care Administrators ◽  
Content Type ◽  
The Difference ◽  
Costing System ◽  
Traditional Costing

Purpose – The purpose of this paper is to explore the differences between a traditional costing system (TCS) and resource consumption accounting (RCA) based on a case study carried out in a hospital. Design/methodology/approach – A descriptive case study was first carried out to identify the current costing system of the case hospital. An exploratory case study was then conducted to reveal how implementing RCA within the case hospital assigns costs differently to gallbladder surgeries than the current costing system (i.e. a TCS). Findings – The study showed that, in contrast to a TCS, RCA considers the unused capacity, which is the difference between the work that can be performed based on current resources and the work that is actually being performed. Therefore, it assigns lower total costs to open and laparoscopic gallbladder surgeries. The study also showed that by separating costs into fixed and variable RCA allows managers to benefit from a pricing strategy based on the difference between the service’s selling price and variable costs incurred in providing that service. Research limitations/implications – The limitation of this study is that, because of time constraints, the implementation was performed in the general surgery department only. However, since RCA is an advanced system that has the same application procedures for any department inside in a hospital, managers need only time gaps to implement this system to all parts of the hospital. Practical implications – This study concluded that RCA is better than a TCS for use in health care settings that have high overhead costs because it accurately assigns overhead costs to services by considering unused capacities incurred by a hospital. Consequently, this study provides insight into both measuring and managing unused capacities within the health care sector. This study also concluded that RCA helps health care administrators increase their competitive advantage by allowing them to determine the lowest service price. Originality/value – Since the literature review found no study comparing RCA with TCS in a real-life health care setting, little is known about differences arising from applying these systems in this context. Thus, the current study fills this gap in the literature by comparing RCA with TCS for both open and laparoscopic gallbladder surgeries.

scholarly journals Exploring health care workers’ perceptions and experiences of communication with ethnic minority elders

2018 ◽  
Vol 19 (3) ◽  
pp. 180-190
Author(s):  
Gloria Likupe ◽  
Carol Baxter ◽  
Mohamed Jogi
Keyword(s):  
Health Care ◽  
Older People ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Health Care Workers ◽  
Care Staff ◽  
Ageing Population ◽  
Care Provision ◽  
Content Type ◽  
Care Workers

Purpose There is a recognition in Europe and in the western world of a demographic shift in the ageing population. While the overall ageing of the general population is growing, the numbers of immigrants getting old in their host countries is also increasing, thereby increasing the racial and ethnic proportion of older people in these countries. This changing landscape calls for understanding of issues related to health care provision, policy and research regarding ethnic minorities. Communication is seen as a key factor in understanding the needs of ethnic minority elders (EMEs). The purpose of this paper is to explore health care workers’ (HCWs) perceptions and experiences of communication with EMEs. In this paper the term HCW includes qualified nurses and health care assistants. Design/methodology/approach A descriptive qualitative study design using semi-structured interviews was employed. Ten HCWs, who had ethnic minorities in their care were individually interviewed to explore their perceptions and experiences of communication when caring for EMEs. Findings Analysis of data revealed that in common with all older people, EMEs experience stereotyped attitudes and difficulties in communication. However, EMEs face particular challenges, including cultural differences, different language and stereotyping of care based on misunderstood needs of EMEs. Facilitators of communication included appropriate training of HCWs and appropriate use of interpreters. Research limitations/implications Only homes willing to take part in the study gave permission for their staff to be interviewed. In addition, the HCWs came from various settings. Therefore, views of staff in homes who did not give permission may not be represented. Practical implications The diversity of older people needing care in nursing homes and the community calls for training in culturally competent communication for effective provision care provision for EMEs. Originality/value Training of health care staff in culturally appropriate communication requires effective practice.

A network flow-based model for operations planning in home health care delivery

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fabián Castaño ◽  
Nubia Velasco
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Care Delivery ◽  
Real Life ◽  
Home Health ◽  
Planning Problem ◽  
Multiple Time ◽  
Content Type ◽  
Proposed Model ◽  
Care Workers

PurposeTo solve the problem, a mathematical model is proposed; it relies on a directed acyclic graph (DAG), in which arcs are used to indicate whether a pair of appointments can be assigned to the same route or not (and so to the same care worker). The proposed model aims at minimizing the personnel required to meet daily demand and balancing workloads among the workers while considering the varying traffic patterns derived from traffic congestion.Design/methodology/approachThis paper aims at providing solution approaches for addressing the problem of assigning care workers to deliver home health-care (HHC) services, demanding different skills each. First, a capacity planning problem is considered, where it is necessary to define the number of workers required to satisfy patients' requests and then, patients are assigned to the care workers along with the sequence followed to visit them, thus solving a scheduling problem. The benefits obtained by permitting patients to propose multiple time slots where they can be served are also explored.FindingsThe results indicate that the problem can be efficiently solved for medium-sized instances, that is, up to 100 daily patient requests. It is also indicated that asking patients to propose several moments when they can receive services helps to minimize the need for care workers through more efficient route allocations without affecting significantly the balance of the workloads.Originality/valueThis article provides a new framework for modeling and solving a HHC routing problem with multiskilled personnel. The proposed model can be used to identify efficient daily plans and can handle realistic characteristics such as time-dependent travel times or be extended to other real-life applications such as maintenance scheduling problems.

Resilience of hospital facilities in Singapore’s healthcare industry: a pilot study

2017 ◽  
Vol 8 (5) ◽  
pp. 537-554 ◽  
Author(s):  
Sui Pheng Low ◽  
Shang Gao ◽  
Gina Qi Er Wong
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Health Care Professionals ◽  
Questionnaire Survey ◽  
Health Care Industry ◽  
Ageing Population ◽  
Content Type ◽  
The Public ◽  
Care Industry ◽  
Survey Results

Purpose Singapore’s health-care infrastructure is suffering from increasing pressure due to population growth and a rapidly ageing population. This paper aims to assess the resilience of hospital facilities in Singapore’s health-care industry. The main attribute of resilience is adaptive capacity, which is also associated with vulnerability. Vulnerability is defined as the system’s susceptibility to threats that cause damage and affect its normal performance, while resilience is defined as the ability to anticipate and the capacity to change before a setback becomes obvious. Design/methodology/approach A questionnaire survey was adopted for the study, with respondents drawn randomly from both the health-care professionals as well as the public. The questionnaire survey results from 83 respondents, consisting of 31 health-care professionals and 52 members of the public, are analysed in this pilot study. Findings Ninety-one per cent of the respondents perceived bed shortage as an indication of vulnerability. The survey results showed that bed shortages, high bed-occupancy and long waiting hours were perceived as indications of vulnerability. The top three vulnerabilities identified were Singapore’s ageing population, the fast-growing population and the increasing trend of chronic diseases in its population. From the results, respondents appeared doubtful about the resilience of Singapore’s public hospitals. On a positive note, Singapore residents are still, relatively speaking, confident of the quality of Singapore’s health-care delivery system, which can be translated as one with relatively strong community resilience. Originality/value In conclusion, it appears fair to say that the public perceive hospital facilities in Singapore’s health-care industry to be reasonably resilient, but expect further improvements to ensure continuous delivery of quality health-care services.

Student-led leadership training for undergraduate healthcare students

2017 ◽  
Vol 30 (4) ◽  
pp. 428-431 ◽  
Author(s):  
Ibrahim Hasanyn Naim Sheriff ◽  
Faheem Ahmed ◽  
Naheed Jivraj ◽  
Jonathan C.M. Wan ◽  
Jade Sampford ◽  
...  
Keyword(s):  
Health Care ◽  
Leadership Training ◽  
Real Life ◽  
Life Quality ◽  
Content Type ◽  
Health Care Students ◽  
Cost Constraints ◽  
Care Workers ◽  
Health Care Leaders ◽  
The Impact

Purpose Effective clinical leadership is crucial to avoid failings in the delivery of safe health care, particularly during a period of increasing scrutiny and cost-constraints for the National Health Service (NHS). However, there is a paucity of leadership training for health-care students, the future leaders of the NHS, which is due in part to overfilled curricula. The purpose of this study was to assess the impact of student-led leadership training for the benefit of fellow students. Design/methodology/approach To address this training gap, a group of multiprofessional students organised a series of large-group seminars and small-group workshops given by notable health-care leaders at a London university over the course of two consecutive years. Findings The majority of students had not previously received any formal exposure to leadership training. Feedback post-events were almost universally positive, though students expressed a preference for experiential teaching of leadership. Working with university faculty, an inaugural essay prize was founded and student members were given the opportunity to complete internships in real-life quality improvement projects. Originality/value Student-led teaching interventions in leadership can help to fill an unmet teaching need and help to better equip the next generation of health-care workers for future roles as leaders within the NHS.

“It’s real life, isn’t it?” Integrated simulation teaching in undergraduate psychiatry education – a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Harriet Greenstone ◽  
Katie Wooding
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Professional Education ◽  
Health Care Professionals ◽  
Student Attitudes ◽  
Real Life ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Content Type ◽  
Integrated Simulation

Purpose High-fidelity simulation has well-established educational value. However, its use in psychiatry remains underexplored. This study explores medical students’ experiences of high-fidelity simulation teaching during their psychiatry placements. A session was delivered on “psychiatric emergencies”, set in a simulated emergency department, with equal emphasis on the management of physical and psychiatric aspects of patient care. This paper aims to report on student attitudes to high-fidelity simulation teaching in psychiatry, as well as student attitudes to “integrated” teaching (i.e. covering both physical and psychiatric knowledge). Design/methodology/approach Semi-structured focus groups were conducted with medical students at a UK university. This exploratory approach generated rich qualitative data. Thematic analysis was used. Findings High-fidelity simulation teaching in psychiatry is well regarded by medical students, and helps students recognise that psychiatric problems can present in any clinical setting. This study has demonstrated that students value this type of “integrated” teaching, and there is potential for this approach to be more widely adopted in undergraduate health-care professional education. High-fidelity simulation could also be considered for incorporation in undergraduate examinations. Originality/value To the best of their knowledge, the authors are the first to conduct an in-depth exploration of attitudes to simulation teaching specifically in psychiatry. The authors are also the first to directly explore student attitudes to “integrated” teaching of psychiatry and physical health topics. The results will support the effective planning and delivery of simulation teaching in psychiatry, the planning of undergraduate summative assessments and will likely be of interest to health-care professionals, educational leads, simulation practitioners and students.

Overview of challenges faced by refugees following resettlement in Houston, Texas: a qualitative study at five refugee resettlement agencies

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Julika Kaplan ◽  
Natalie Lazarescou ◽  
Sally Huang ◽  
Sarah Ali ◽  
Sophia Banu ◽  
...  
Keyword(s):  
Health Care ◽  
Public Schools ◽  
Public Transportation ◽  
Formal Education ◽  
Qualitative Interviews ◽  
Refugee Children ◽  
Refugee Resettlement ◽  
Content Type ◽  
Staff Members ◽  
Time To Learn

Purpose This paper aims to conduct a qualitative needs assessment to explore the effectiveness of Houston’s refugee resettlement efforts in the areas of employment, health care and education. Design/methodology/approach Using referral sampling, the authors identified refugee community leaders and staff members at the five refugee resettlement agencies in Houston. The authors conducted 29 qualitative interviews with these contacts from February–August 2017. Findings Recently resettled refugees may struggle to find and maintain employment in Houston due to difficulty accessing public transportation. Refugees seeking medical care in Houston often have difficulty navigating the complexities of the health-care system and communicating with their physicians due to language barriers. Finally, refugee children may have trouble adapting to Houston public schools, sometimes because they have limited experience with formal education. This study provided insights into the challenges Houston refugees face during resettlement and these barriers can be mitigated with policies designed specifically to address them. Practical implications The authors recommend decreasing public transportation fees for refugees, supporting programs that donate used vehicles to refugees, expanding access to English as a Second Language classes for refugee children and adults and giving refugees designated time to learn English upon arrival. Originality/value Houston welcomes more resettled refugees than any other American city. However, few studies have explored the barriers refugees face during the resettlement process.

Sustainable transportation strategies for decoupling road vehicle transport and carbon dioxide emissions

2015 ◽  
Vol 26 (3) ◽  
pp. 373-388 ◽  
Author(s):  
Luis Velazquez ◽  
Nora E Munguia ◽  
Markus Will ◽  
Andrea G Zavala ◽  
Sara Patricia Verdugo ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Public Transportation ◽  
Carbon Dioxide Emissions ◽  
Transportation System ◽  
Sustainable Transportation ◽  
Sustainable Transport ◽  
Content Type ◽  
Transportation Modes ◽  
Transport Modes ◽  
Motorized Transport

Purpose – The purpose of this paper is to identify research priorities to guide transportation stakeholders in their practice, education, and research. Design/methodology/approach – A literature review of published, conference proceedings, agency reports, books, and web site documents was conducted, aiming at the identification of the diverging strategies and practices undertaken by transportation stakeholders in order to be able to generate initial meaningful insights about a sustainable transportation system. Findings – Sustainable transportation systems are in certain way a new paradigm where a business-as-usual approach is not possible. Vehicle makers produce more energy efficient vehicles. Nevertheless, fossil fuel is still the predominant source of energy. Regarding the level of carbon dioxide (CO2) emissions, non-motorized transport modes are preferable over motorized transport modes, and public transportation modes preferable to private transportation modes. It is also import to include environmental consideration along the design, construction, maintenance, and operation of the transportation infrastructure. While vehicles powered by alternate fuel such as biofuel, electricity, and/or fuel cell are becoming more popular, shifting to more sustainable transport modes would also require changes on commuter behaviors and individual preferences. Practical implications – The paper discusses the efforts that are underway for decoupling transport and CO2 emissions, being useful for transportation stakeholders to implement or improve the effectiveness of their potential or current sustainability transport initiatives through the identification of strategies, opportunities, and barriers. Originality/value – Although there is plenty of good information about sustainability and transportation modes in literature, most of the articles analyzed focus on specific factors of the whole transportation system. The originality/value of this paper is found in the holistic perspective, here presented, of the state of the art issues that a sustainable transport system would encompass.

Sign in / Sign up

Export Citation Format

Share Document