scholarly journals Disparities in emergency department access, resource allocation, and outcomes between migrants and the local population

2021 ◽  
Vol 151 (43-44) ◽  
Keyword(s):  
Emergency Department ◽  
Resource Allocation ◽  
Local Population ◽  
Access Resource

scholarly journals An Efficient Radio Access Resource Management Scheme Based on Priority Strategy in Dense mmWave Cellular Networks

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Jinsong Gui ◽  
Jianglin Liu
Keyword(s):  
Resource Allocation ◽  
Energy Efficiency ◽  
Resource Management ◽  
Cellular Networks ◽  
Resource Allocation Algorithm ◽  
Allocation Algorithm ◽  
Network Expansion ◽  
Radio Access ◽  
Directional Transmission ◽  
Access Resource

In millimeter wave (mmWave) communication systems, beamforming-enabled directional transmission and network densification are usually used to overcome severe signal path loss problem and improve signal coverage quality. The combination of directional transmission and network densification poses a challenge to radio access resource management. The existing work presented an effective solution for dense mmWave wireless local area networks (WLANs). However, this scheme cannot adapt to network expansion when it is applied directly to dense mmWave cellular networks. In addition, there is still room for improvement in terms of energy efficiency and throughput. Therefore, we firstly propose an efficient hierarchical beamforming training (BFT) mechanism to establish directional links, which allows all the small cell base stations (SBSs) to participate in the merging of training frames to adapt to network expansion. Then, we design a BFT information-aided radio access resource allocation algorithm to improve the downlink energy efficiency of the entire mmWave cellular network by reasonably selecting beam directions and optimizing transmission powers and beam widths. Simulation results show that the proposed hierarchical BFT mechanism has the smaller overhead of BFT than the existing BFT mechanism, and the proposed BFT information-aided radio access resource allocation algorithm outperforms the existing corresponding algorithm in terms of average energy efficiency and throughput per link.

To disinvest or invest? The role of programme budgeting and marginal analysis (PBMA) for economic evaluation and prioritization between public health interventions

2019 ◽  
pp. 312-340
Author(s):  
Joanna M. Charles ◽  
Rhiannon T. Edwards
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Local Population ◽  
Health Improvement ◽  
Evidence Based ◽  
Marginal Analysis ◽  
The Impact ◽  
Allocation Decisions

This chapter describes the application of programme budgeting and marginal analysis (PBMA) as an evidence-based framework to make resource allocation decisions such as whether to invest or disinvest in certain services, products, or interventions. This evidence-based eight-step decision-making process can help decision-makers to maximize the impact of healthcare resources on the health needs of a local population. Programme budgeting is an appraisal of past resource allocation in specified programmes or services with a view to tracking future resource allocation in those same programmes or services. Marginal analysis is the appraisal of the added benefits and added costs of a proposed investment or the lost benefits and lower costs of a proposed disinvestment. This chapter pays particular attention to the use of the PBMA framework to appraise a national health improvement budget as a case study to illustrate the methods practical application in public health.

scholarly journals Development and implementation of health technology assessment in Argentina: Two steps forward and one step back

2009 ◽  
Vol 25 (S1) ◽  
pp. 260-269 ◽  
Author(s):  
Adolfo Rubinstein ◽  
Andrés Pichon-Riviere ◽  
Federico Augustovski
Keyword(s):  
Resource Allocation ◽  
Health Policy ◽  
Social Security ◽  
Healthcare System ◽  
Latin American ◽  
Local Population ◽  
Developed Countries ◽  
Health Technologies ◽  
Allocation Process ◽  
Formal Tool

Objectives: The objectives of this study are to review the financing and organization of the Argentine healthcare system, the licensing and drug price setting mechanisms, the benefit packages and coverage policies of pharmaceuticals and other medical technologies, as well as the development of HTA in Argentina, and the role of the Institute of Clinical Effectiveness and Health Policy (IECS) as an HTA agency. Finally, the perspectives and future of HTA as a tool to make resource-allocation decisions and priority setting in Argentina is discussed.Methods: The study is a discussion/review based largely on the experiences of the authors, but supported by available literature.Results: Argentina is an upper-middle income country with major healthcare problems related to both equity and efficiency. Its healthcare system consists of a multitier system divided in three large sectors: public, social security, and private, where the federal Ministry of Health has a rather limited role in national health policy stewardship. Many of Argentina's shortcomings are due in part to its pluralistic and fragmented healthcare system. In the past decade, Argentina, like many other Latin American countries, has undergone a profound reform of its healthcare system. Whereas some of the objectives of the reforms were specific to each country, a common issue among all of them was to establish a mechanism that ensured a more efficient allocation of scarce resources, and guaranteed a wider provision of healthcare services on the basis of the local population needs and equity. Although some signals from the national government and congress show that there are plans to formally incorporate HTA to inform reimbursement policies, these signals are still very weak. Paradoxically, even though Argentina was the first country in the region to require formal health economic evidence for the adoption of technologies into the mandatory benefit package of the social security, this “fourth hurdle” is no longer required. Nevertheless, there is an increasing interest and demand for a more explicit and transparent resource-allocation process that include HTA as a formal tool to inform decision making, in most of Argentine healthcare stakeholders.Conclusions: In conclusion, what is needed in Argentina is a clear political will to push forward for a national agency of HTA that, similar to other developed countries, advance the regulation on the adoption of new health technologies to improve not only technical or allocative efficiency, but also health equity. Until this milestone is accomplished, the HTA production and use to inform healthcare coverage policies will continue to mirror the current fragmented healthcare system.

scholarly journals The importance of quantitative trait differentiation in restoration: landscape heterogeneity and functional traits inform seed transfer guidelines

AoB Plants ◽  
2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Zebadiah G Yoko ◽  
Kate L Volk ◽  
Ned A Dochtermann ◽  
Jill A Hamilton
Keyword(s):  
Resource Allocation ◽  
Morphological Traits ◽  
Quantitative Traits ◽  
Scale Effects ◽  
Local Population ◽  
Genetic Differences ◽  
Regional Differentiation ◽  
Seed Transfer ◽  
Population Scale ◽  
Seed Transfer Guidelines

Abstract For widely distributed species, understanding the scale over which genetic variation correlates to landscape structure and composition is critical. Particularly within the context of restoration, the evolution of genetic differences may impact success if seeds are maladapted to the restoration environment. In this study, we used Geum triflorum to quantify the scale over which genetic differences for quantitative traits important to adaptation have evolved, comparing the proportion of variance attributed to broad regional- and local population-level effects. Geum triflorum is a widely distributed species spanning a range of environments, including alvar and prairie habitats, which have extreme regional differences in soil-moisture availability. Alvar habitats are regions of thin soil over limestone that experience substantial seasonal variation in water availability, from flooding to desiccation annually. This contrasts with prairie habitats, whose deeper soils mitigate irregular flood–desiccation cycles. Using a common garden experiment, we evaluated 15 traits broadly grouped into three trait classes: resource allocation, stomatal characteristics, and leaf morphological traits for individuals sourced from prairie and alvar environments. We quantified the proportion of trait variance explained by regional- and population-scale effects and compared the proportion of regional- and population-trait variances explained across trait classes. Significant regional differentiation was observed for the majority of quantitative traits; however, population-scale effects were equal or greater than regional effects, suggesting that important genetic differences may have evolved across the finer population scale. Stomatal and resource allocation trait classes exhibited substantial regional differentiation relative to morphological traits, which may indicate increased strength of selection for stomatal and resource allocation traits relative to morphological traits. These patterns point towards the value in considering the scale over which genetic differences may have evolved for widely distributed species and identify different functional trait classes that may be valuable in establishing seed transfer guidelines.

Multiple Access Resource Allocation

2017 ◽  
pp. 127-148
Author(s):  
Linling Kuang ◽  
Chunxiao Jiang ◽  
Yi Qian ◽  
Jianhua Lu
Keyword(s):  
Resource Allocation ◽  
Multiple Access ◽  
Access Resource

scholarly journals Local trends in emergency department attendances by older patients in an ageing national population

2009 ◽  
Vol 33 (1) ◽  
pp. 117 ◽  
Author(s):  
Kevin Chu ◽  
Anthony Brown ◽  
William Lukin
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Local Population ◽  
Nursing Home Residents ◽  
Aged Care ◽  
Annual Growth Rate ◽  
Patient Demographics ◽  
Care Services ◽  
Discharge Status ◽  
Set Up

Nursing-led aged care services were set up at our Emergency Department (ED) in 2004?05 to assist in the appropriate discharge of older patients. This study examined local trends in ED attendances by older patients. A retrospective study was conducted at an inner-city adult ED in a region with a 2.2% annual growth rate. Patient demographics, Australasian Triage Scale (ATS) category and admission/discharge status were collected from January 2002 to December 2006. Total ED attendances increased 7.7% from 66 687 in 2002 to 71 801 in 2006. Older patients? attendances, however, decreased 3.1% from 12 356 to 11 971. This decrease in ED attendances by older patients was unexpected. This may represent local population trends and/or be related to ED services designed to manage older patients and nursing home residents in the community. The planning of health services for older people therefore needs to take into consideration the influences on local trends in changing population demographics.

scholarly journals Physical Trauma among Refugees: Comparison between Refugees and Local Population Who Were Admitted to Emergency Department—Experience of a State Hospital in Syrian Border District

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Yigit Duzkoylu ◽  
Salim Ilksen Basceken ◽  
Emrullah Cem Kesilmez
Keyword(s):  
Emergency Department ◽  
Local Population ◽  
Emergency Admission ◽  
High Ratio ◽  
Retrospective Evaluation ◽  
Access To Health Services ◽  
Physical Trauma ◽  
Access To Health ◽  
Local Residents ◽  
Mechanism Of Trauma

Background. Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. Aims. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Methods. Retrospective evaluation of results and comparison with the results of local population. Results. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Conclusion. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.

scholarly journals Factors and outcomes associated with paediatric emergency department arrival patterns through the day

2018 ◽  
Vol 24 (5) ◽  
pp. 323-329
Author(s):  
Hathami Almubarak ◽  
Garth Meckler ◽  
Quynh Doan
Keyword(s):  
Emergency Department ◽  
Resource Allocation ◽  
Cross Sectional Study ◽  
Time Of Day ◽  
Minor Trauma ◽  
Patient Acuity ◽  
Cross Sectional ◽  
Utilization Patterns ◽  
Multivariable Regression ◽  
Ed Visits

Abstract Introduction Steadily increasing emergency department (ED) utilization has prompted efforts to increase resource allocation to meet demand. Little is known about the distribution and characteristics of patient arrivals by time of day. This study describes the variability and patterns of ED resource utilization related to patient, acuity, clinical, and disposition characteristics over a 24-hour period. Methods Retrospective cross-sectional study of all visits to a tertiary children’s hospital over a 1-year period. We use descriptive statistics to present ED visit details stratified by shift of arrival, and multivariable regression to explore the association between shift of presentation and hospital admission at index and 7-day return ED visits. Results Of 46,942 visits during the study period, 12% arrived overnight, 42% during the day, and 45% during the evening with variability in pattern of shift arrival by day of week. Overnight arrivals had a higher acuity (Canadian Triage and Acuity Scale [CTAS]) and different presenting complaints (more viral infection, less minor trauma) than day and evening arrivals, but similar ED length of stay. Shift of arrival was not associated with admission to hospital, but age, gender, socioeconomic status (SES), and day of week were. Discussion ED utilization patterns vary by shift of arrival. Though overnight arrivals represent a smaller proportion of total daily arrivals, their acuity is higher, and the spectrum of disease differs from day or evening arrivals. Conclusions Understanding variations and patterns of ED utilization by shift of arrival and day of week may be helpful in tailoring resource allocation to more accurately and specifically meet demands.

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