scholarly journals How New Mexico Leveraged a COVID-19 Case Forecasting Model to Preemptively Address the Health Care Needs of the State: Quantitative Analysis (Preprint)

2021 ◽  
Author(s):  
Lauren A Castro ◽  
Courtney D Shelley ◽  
Dave Osthus ◽  
Isaac Michaud ◽  
Jason Mitchell ◽  
...  
Keyword(s):  
Health Care ◽  
New Mexico ◽  
Hospital Admissions ◽  
State Level ◽  
Health Care Resource ◽  
The State ◽  
Forecast Horizon ◽  
Resource Needs ◽  
The Future ◽  
Made In

BACKGROUND Prior to the COVID-19 pandemic, US hospitals relied on static projections of future trends for long-term planning and were only beginning to consider forecasting methods for short-term planning of staffing and other resources. With the overwhelming burden imposed by COVID-19 on the health care system, an emergent need exists to accurately forecast hospitalization needs within an actionable timeframe. OBJECTIVE Our goal was to leverage an existing COVID-19 case and death forecasting tool to generate the expected number of concurrent hospitalizations, occupied intensive care unit (ICU) beds, and in-use ventilators 1 day to 4 weeks in the future for New Mexico and each of its five health regions. METHODS We developed a probabilistic model that took as input the number of new COVID-19 cases for New Mexico from Los Alamos National Laboratory’s COVID-19 Forecasts Using Fast Evaluations and Estimation tool, and we used the model to estimate the number of new daily hospital admissions 4 weeks into the future based on current statewide hospitalization rates. The model estimated the number of new admissions that would require an ICU bed or use of a ventilator and then projected the individual lengths of hospital stays based on the resource need. By tracking the lengths of stay through time, we captured the projected simultaneous need for inpatient beds, ICU beds, and ventilators. We used a postprocessing method to adjust the forecasts based on the differences between prior forecasts and the subsequent observed data. Thus, we ensured that our forecasts could reflect a dynamically changing situation on the ground. RESULTS Forecasts made between September 1 and December 9, 2020, showed variable accuracy across time, health care resource needs, and forecast horizon. Forecasts made in October, when new COVID-19 cases were steadily increasing, had an average accuracy error of 20.0%, while the error in forecasts made in September, a month with low COVID-19 activity, was 39.7%. Across health care use categories, state-level forecasts were more accurate than those at the regional level. Although the accuracy declined as the forecast was projected further into the future, the stated uncertainty of the prediction improved. Forecasts were within 5% of their stated uncertainty at the 50% and 90% prediction intervals at the 3- to 4-week forecast horizon for state-level inpatient and ICU needs. However, uncertainty intervals were too narrow for forecasts of state-level ventilator need and all regional health care resource needs. CONCLUSIONS Real-time forecasting of the burden imposed by a spreading infectious disease is a crucial component of decision support during a public health emergency. Our proposed methodology demonstrated utility in providing near-term forecasts, particularly at the state level. This tool can aid other stakeholders as they face COVID-19 population impacts now and in the future.

What's the matter by Kansas? Legislative debates over stem cell research in Kansas and Massachusetts

2009 ◽  
Vol 28 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Bonnie Stabile
Keyword(s):  
Stem Cell ◽  
Stem Cell Research ◽  
Policy Process ◽  
Contextual Factors ◽  
State Level ◽  
The State ◽  
Therapeutic Cloning ◽  
Policy Entrepreneurs ◽  
The Future ◽  
Restrictive Legislation

This paper examines the contextual factors shaping legislative debates affecting stem cell research in two states, Kansas and Massachusetts, which both permit therapeutic cloning for stem cell research but markedly vary in their legislative approach to the issue. In Kansas, restrictive legislation was proposed but effectively blocked by research proponents, while in Massachusetts permissive legislation was successfully implemented under the auspices of an act to promote stem cell research. The importance of university and industry involvement is highlighted in each case, as are the roles of enterprising and persistent policy entrepreneurs. Providing a close examination of the policy process attending the cloning debate in these states is intended to contribute to an enhanced understanding of the cloning-policy process as it has played out at the state level, with an eye toward informing legislative debates over related biotechnical advances in the future.

Advanced technology and its impact on the clinical laboratory.

1987 ◽  
Vol 33 (3) ◽  
pp. 352-357 ◽  
Author(s):  
C A Burtis
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Clinical Laboratory ◽  
Wide Spectrum ◽  
Advanced Technology ◽  
New Developments ◽  
Technical Developments ◽  
The Future ◽  
Made In ◽  
Care System

Abstract The analytical capabilities of the clinical laboratory have continued to expand and improve as a result of technical developments and advancements made in a wide spectrum of allied disciplines. As a consequence, the clinical laboratory has evolved from the small, manual operations of yesterday to the large, central organizations of today. Technology continues to have an impact on the laboratory, especially with the advent of the fully automated analytical systems that are having such a profound effect on how the laboratory is staffed, equipped, organized, and operated. With the accelerating rate at which new developments are occurring, it is safe to assume that dramatic changes will continue to occur in this area. Consequently, it will become increasingly important for clinical laboratorians to be aware of these new developments, to understand them, and to anticipate how they will be assimilated and integrated into the overall health care system. To quote from a recent Bell Atlantic advertisement, "The genius of the future lies not in technology alone, but in the ability to manage it."

Changing health care delivery system and certification at the state level

1972 ◽  
Author(s):  
Nathaniel Wagner ◽  
Cecil P. Peck ◽  
Bernard Borislow ◽  
Henry D. Remple ◽  
Allen V. Williams
Keyword(s):  
Health Care ◽  
Delivery System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
State Level ◽  
Health Care Delivery System ◽  
The State

Introduction

Mapping Power ◽  
2018 ◽  
pp. 1-27
Author(s):  
Sunila S. Kale ◽  
Navroz K. Dubash ◽  
Ranjit Bharvirkar
Keyword(s):  
Political Economy ◽  
State Level ◽  
The State ◽  
The Political ◽  
Analytic Framework ◽  
The Past ◽  
The Future ◽  
Political Economy Analysis ◽  
Economy Analysis

The introductory chapter lays out the rationale for the volume and provides a framework for analysing the political economy of Indian electricity. We first present a historically-rooted political economy analysis to understand the past and identify reforms for the future of electricity in India. We next outline an analytic framework to guide the empirical chapters of the book, which locates electricity outcomes in the larger political economy of electricity, the field of politics that are specific to each state, and each state’s broader political economy. The chapter ends by providing concise synopses of the state-level narratives of electricity in the fifteen states included in the volume.

scholarly journals Immigration of physicians to Slovakia – case study

2019 ◽  
Vol 17 (4) ◽  
pp. 262-273 ◽  
Author(s):  
Magdaléna Tupá ◽  
Karol Krajčo
Keyword(s):  
Health Care ◽  
Slovak Republic ◽  
State Level ◽  
The State ◽  
Avoidable Mortality ◽  
Negative Results ◽  
Lack Of Physicians ◽  
Market Situation ◽  
Foreign Doctors

The lack of physicians is a serious problem in the Slovak Republic (SR More than 5,000 physicians will be missing in the health care system in the next two years. From the report on health care status in Slovakia, according to OECD (2017), the state of health care in the country achieves very negative results in the indicators related to the human and financial resources of the monitored sector (mortality of newborns, preventable and avoidable mortality, urgent traffic, and others). The study was based on the analysis of the labor market situation in the health care sector for the profession of physician in the SR to identify the state and future need of physicians working in Slovakia, find possible solutions to the identified situation and determine which pull and push factors are the most important. The contribution of the study will be based on the analysis to suggest the ways to facilitate the employment of foreign doctors in Slovakia. The problem of the lack of specialists was considered in two directions of solving it on account of the flow of specialists from other countries: stimulation in order for the foreign medical students to stay in the country after their studies; engagement of foreign qualified doctors. Real situation with doctor stuffing in the Slovak Republic was evaluated, the forecasts until 2022 were made, the proposals on improving the management in solving this problem at the state level were made.

scholarly journals CORRUPTION IN MEDICAL SPHERE OF UKRAINE: CURRENT SITUATION AND WAYS OF PREVENTION

2019 ◽  
Vol 72 (9) ◽  
pp. 1814-1821
Author(s):  
Vladislava S. Batyrgareieva ◽  
Andriy M. Babenko ◽  
Sandra Kaija
Keyword(s):  
Health Care ◽  
Medical Practice ◽  
Health Care Professionals ◽  
Social Life ◽  
Military Service ◽  
State Level ◽  
Hospital Staff ◽  
The State ◽  
Positive Tendency

Introduction: All social life spheres in Ukraine are influenced by corruption. Ukrainian citizens were inquired in order to determine corruption rate in various social spheres. It was conditioned by reforming criminal justice and administrative management, which is directed, particularly, for liquidation of corruption in the state. Special emphasize is stressed on corruption rate in the medical sphere. The aim of the article is to determine: 1) population’s attitude towards to corruption, in particular, in the medical sphere; 2) the most corruptive social spheres; 3) efficiency of anti-corruption measures; 4) readiness of population to participate into struggle with corruption. Materials and methods: The study is grounded on dialectical, comparative, analytic, synthetic, sociological (special-purpose inquiry form, interview), statistic and comprehensive research methods. The study group consisted of 1 120 citizens and 513 medical and pharmaceutical professionals of Ukraine. Questions were related to: 1) citizens’ contact with corruption; 2) corruption expansion rate in state authorities, self-governing authorities, in various infrastructure spheres, particularly, in healthcare; 3) awareness about struggle with corruption in the state and in the region and determination of citizens’ readiness to cope with corruption. Results: Corruption contact level of citizens remains steadily high. Corruption in the medical sphere is the most widespread: during the previous year before the inquire 63% respondents were involved into corruptive schemes. Corruption in the medical sphere can be subdivided in the following levels: from patient to doctor; inside the hospital – from a healthcare institution employee to the executive hospital staff; on state level concerning state procurements of medications. A bribe to health care professionals was given for: receipt of a sick leave certificate and various references (for example, about unfitness for military service, fitness for driving a car or fulfillment of particular works); high-quality conduct of an operation, medical servicing rendering; writing out a “necessary” prescription; approval or hiding of any bodily injuries; falsification of a true cause of death. All health care professionals have come across different corruptive practices, among which the following payments are widespread: for employment in a hospital, license for private medical practice or establishment of private clinics, “avoidance” of checks of healthcare institutions’ activity. The largest bribes are given state officials for participation in tenders for medical drugs supply by pharmaceutical companies. All health care professionals have come across different corruptive practices, among which the following payments are widespread: for employment in a hospital, license for private medical practice or establishment of private clinics, “avoidance” of checks of healthcare institutions’ activity. Conclusion: Corruption on the sphere of medical practice is complex phenomenon. The conducted poll made it possible to structure the corruption problem, to see its various levels and levels. In respondents’ opinion, a scrupulous information campaign is a positive tendency: 45% consider this is a guarantee of anticorruption. Nevertheless, only 5% respondents assume personal notification of anticorruption bodies about receipt of a bribe by medical staff.

Enhancing the Participation of Indigenous Peoples at the Intergovernmental Level to Strengthen Self-Determination: Lessons from the Arctic

2018 ◽  
Vol 87 (1) ◽  
pp. 26-55
Author(s):  
Dorothée Cambou
Keyword(s):  
Decision Making ◽  
Indigenous Peoples ◽  
State Level ◽  
The State ◽  
Regional Level ◽  
Self Determination ◽  
The Arctic ◽  
Policy Goal ◽  
The Future ◽  
The Right

With a focus on the right of indigenous peoples to self-determination, and an eye on Arctic practices, this article analyses the right of indigenous peoples to self-determination and its exercise at the intergovernmental level. While the exercise of self-determination necessarily implies the right of indigenous peoples to autonomy in their internal and local matters and their involvement in decision-making at the state level, this article argues that self-determination additionally includes the right of indigenous peoples to be represented and to participate in the international arena: the intergovernmental aspect of self-determination. Although this analysis determines that it is yet too early to indicate the existence of a fully-fledged right, this article also evidences that there is a new policy goal at the un level, accompanied by practices at the arctic regional level, which could support the emergence of such a right in the future.

The Royal Barrows at Jelling Excavations made in 1941, 1942 and 1947, and finds and findings resulting therefrom

Antiquity ◽  
1948 ◽  
Vol 22 (88) ◽  
pp. 190-197
Author(s):  
Ejnar Dyggve
Keyword(s):  
World War Ii ◽  
The State ◽  
National Museum ◽  
World War ◽  
The Future ◽  
State Employment ◽  
Solid Foundation ◽  
The Subject ◽  
Bear Witness ◽  
Made In

In line with other endeavours expressive of the spirit of self-assertion aroused in the Danish people at the occupation of Denmark by foreign troops during World War II, the Danish National Museum, subsidized by the State Employment Department and the Carlsberg Foundation, undertook a series of thorough and methodical excavations of the two famous Royal Barrows at Jelling in East Jutland (FIG. I), dating from the middle of the 10th century A.D.Earlier excavations here, in 1821 and 1861 (1), had been inconclusive. Ample room still remained for hypotheses and suggestions, and divergent views gradually produced quite a literature on the subject (2). Through the recent examination, the most extensive excavations of their kind in Scandinavia, of the southern barrow, the so-called King Gorm Mound, excavated in 1941, and the northern barrow, the so-called Queen Tyre Mound, in 1942 (3), it became possible to eliminate several doubtful points which had confronted people interested in history for more than a hundred years. At the same time, a solid foundation was laid for the future understanding of the Jelling monuments—the barrows and the runestones—the most significant in Danish history, because they bear witness to the kings who united the smaller Danish Kingdoms into one realm (4).

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