scholarly journals Effect of Regional Cooperation on Efficiency of Medical Care Delivery in secondary Medical Areas of Japan

2021 ◽  
Vol 13 (10) ◽  
pp. 1
Author(s):  
Hajime Hajime Watanabe ◽  
Asuka Suzuki ◽  
Yoshinori Nakata
Keyword(s):  
Regression Analysis ◽  
Medical Care ◽  
Regional Cooperation ◽  
Care Delivery ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Efficiency Score ◽  
Tobit Regression ◽  
Medical Area ◽  
The Impact

The Japanese population is aging and requires regional health facilities to cooperate to use medical resources efficiently. This study evaluated the impact of regional cooperation on the efficiency of medical care delivery in secondary medical areas. The discharge adjustment implementation rate of each secondary medical area was used as a proxy for regional cooperation. The study data were obtained from publicly available sources. The efficiency scores of secondary medical areas were calculated using the input-oriented Banker–Charnes–Cooper model for Data Envelopment Analysis. The inputs used were the number of general beds and the average length of hospital stay for each secondary medical area. The outputs used were the number of discharged patients and inpatient medical expenses per person. In addition, the relationship between discharge adjustment implementation rates and efficiency scores were assessed using tobit multiple regression analysis. The models were adjusted for the 7 variables. Ten secondary medical areas had an efficiency score of 1.00 (i.e., highest efficiency). Tobit regression analysis was performed on the 340 secondary medical areas for which efficiency scores were obtained. The discharge adjustment implementation rates and efficiency scores were significantly positively correlated (p = 0.032). While studies that quantitatively evaluate regional cooperation and efficiency are limited, these findings suggest that implementing regional cooperation may improve the efficiency of medical care delivery in secondary medical areas.

Labour-use Efficiency of Assam Gramin Vikash Bank: Branch- and District-level Analysis

2021 ◽  
pp. 232102222110243
Author(s):  
Mohuya Deb Purkayastha ◽  
Joyeeta Deb ◽  
Ram Pratap Sinha
Keyword(s):  
Efficiency Score ◽  
Significant Variable ◽  
Data Envelopment ◽  
Tobit Regression ◽  
Second Stage ◽  
Time Period ◽  
Use Efficiency ◽  
The Mean ◽  
The Impact ◽  
Observation Period

The present study estimated labour-use efficiency of 48 branches of Assam Gramin Vikash Bank at its branch level, covering three districts of Barak Valley, which falls under Silchar region of the bank for the time period from 2010–2011 to 2017–2018. The study applied data envelopment analysis for estimating labour-use efficiency. In the second stage, the study applied censored Tobit regression for determining the impact of several contextual variables on efficiency. The study reveals that the mean labour-use efficiency score of the selected branches is 76% when averaged for the in-sample branches over the observation period. Results of the Tobit regression identified cluster 2 and total business of the branches as the significant factors for determining efficiency and the number of employees as a significant variable influencing inefficiency. JEL Classifications: G2, G20, G21, J3

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

scholarly journals Involuntary out-patient commitment: 2-year follow-up

2013 ◽  
Vol 37 (2) ◽  
pp. 60-64 ◽  
Author(s):  
Laura Castells-Aulet ◽  
Miguel Hernández-Viadel ◽  
Pedro Asensio-Pascual ◽  
Carlos Cañete-Nicolás ◽  
Carmen Bellido-Rodríguez ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Emergency Room ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Delusional Disorder ◽  
Emergency Room Visits ◽  
Court Order ◽  
Severe Mental Disorder ◽  
The Impact

Aims and methodTo evaluate the impact of involuntary out-patient commitment (OPC) in patients with severe mental disorder who use hospital services. This is a retrospective–observational study in a population of 91 patients under OPC. The psychiatric diagnosis, sociodemographic variables, who requested the court order and for what motive were studied. The study also looked at the use of the available health services (emergency room visits, admissions, average length of hospital stay) for the period beginning 2 years before and ending 2 years after the initiation of the OPC.ResultsThe number of emergency room visits, admissions and the length of hospitalisation diminished in the 2 years following the initiation of the OPC. In terms of diagnosis, the OPC has the most impact on individuals with schizophrenia and delusional disorder.Clinical implicationsThe OPC can be useful for certain patients with severe mental disorder, particularly individuals with schizophrenia and delusional disorder.

Predicting the impact of new health technologies on average length of stay: Development of a prediction framework

2005 ◽  
Vol 21 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Sue Simpson ◽  
Claire Packer ◽  
Andrew Stevens ◽  
James Raftery
Keyword(s):  
Length Of Stay ◽  
Health Management ◽  
Average Length ◽  
New Technology ◽  
Length Of Hospital Stay ◽  
Health Technologies ◽  
Average Length Of Stay ◽  
Admission Policies ◽  
Mechanism Of Impact ◽  
The Impact

Objectives: The aim of this study was to develop a framework to predict the impact of new health technologies on average length of hospital stay.Methods: A literature search of EMBASE, MEDLINE, Web of Science, and the Health Management Information Consortium databases was conducted to identify papers that discuss the impact of new technology on length of stay or report the impact with a proposed mechanism of impact of specific technologies on length of stay. The mechanisms of impact were categorized into those relating to patients, the technology, or the organization of health care and clinical practice.Results: New health technologies have a variable impact on length of stay. Technologies that lead to an increase in the proportion of sicker patients or increase the average age of patients remaining in the hospital lead to an increase in individual and average length of stay. Technologies that do not affect or improve the inpatient case mix, or reduce adverse effects and complications, or speed up the diagnostic or treatment process should lead to a reduction in individual length of stay and, if applied to all patients with the condition, will reduce average length of stay.Conclusions: The prediction framework we have developed will ensure that the characteristics of a new technology that may influence length of stay can be consistently taken into consideration by assessment agencies. It is recognized that the influence of technology on length of stay will change as a technology diffuses and that length of stay is highly sensitive to changes in admission policies and organization of care.

The Impact of Additive Manufacturing for Medical Care Delivery in Space: A Systematic Review

2021 ◽  
pp. 2001002
Author(s):  
Sergio M. Navarro ◽  
Hashim Shaikh ◽  
Nory Klop‐Packel ◽  
Hetvi Jethwani ◽  
Jimmy Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Additive Manufacturing ◽  
Medical Care ◽  
Care Delivery ◽  
The Impact

MINI-SUMMARIES FROM THE U.K. HTA PROGRAMME

2001 ◽  
Vol 17 (2) ◽  
pp. 261-266
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Average Length ◽  
Clinical Pathways ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
The United States ◽  
Local Conditions ◽  
Orthopedic Rehabilitation ◽  
The Impact

SUMMARY POINTS[bull ] Geriatric service interventions after hip fracture are complex and strongly influenced by local conditions. The effectiveness of rehabilitation programs is uncertain, and comparative studies comparing different treatments and strategies are of poor to moderate quality.[bull ] Based on the available evidence, geriatric hip fracture and early supported discharge programs are probably cost-effective since they appear to shorten the average length of hospital stay and are associated with significantly increased rates of return to previous residential status. Clinical pathways also appear to reduce total length of stay in hospital.[bull ] Geriatric orthopedic rehabilitation units are unlikely to be cost-effective, but some frailer patients may benefit in respect of reduced readmission rates and need for nursing home placement.[bull ] Length of stay may be reduced by the introduction of prospective payment systems, but these have led to increased use of nursing homes in the United States.[bull ] There is no evidence that any of the programs evaluated are associated with changes in mortality. However, there are insufficient data to assess the impact of any program on level of function, morbidity, quality of life, or impact on carers.

scholarly journals The Impact of COVID-19 pandemic Lockdown on the utilization of acute surgical care, retrospective, multicenter analysis

2020 ◽  
Author(s):  
Jaroslav Presl ◽  
Martin Varga ◽  
Christof Mittermaier ◽  
Stefan Mitterwallner ◽  
Michael Weitzendorfer ◽  
...  
Keyword(s):  
General Surgery ◽  
Average Length ◽  
Surgical Care ◽  
Length Of Hospital Stay ◽  
Abdominal Wall Hernia ◽  
Colon Surgery ◽  
Emergency General Surgery ◽  
Multicenter Analysis ◽  
Medical Disciplines ◽  
The Impact

Abstract Background: The emergency general surgery encompasses the care of critically ill patients, with a potentially high mortality if delayed. As some medical disciplines have reported a strong decrease of emergencies during the COVID-19 pandemic, remains the effect of the Lockdown on the general surgery emergencies unclear. Methods:This study is a retrospective, multicentre analysis of the general surgery emergency operations performed during the 2020 Lockdown and in the same period of 2019 in three centers covering the surgical care of the area Salzburg-North, Austria. Results: In total 165 emergency surgeries were performed in the study period of 2020 compared to 287 in Year 2019. This is a significant decrease of 122 (42.5%) emergency surgeries during the COVID-19 Lockdown (p=0.005). The average length of hospital stay in the 2019 was in median 4 days and was reduced to 3 days during the Lockdown. Appendectomy remained the most performed emergency surgery for the both periods but the operations count reduced to less than a half with 72 cases in 2019 and 33 cases in 2020 (p=0.118). Considering the ration of appendectomy vs all emergency surgeries, it represented 25 % in 2019 and 20% in 2020. The emergency colon surgery observed the strongest decrease of 75% from 17 cases in 2019 to 4 in 2020. In addition, the emergency abdominal wall hernia, cholecystectomies for acute cholecystitis, small surgeries and proctological emergencies recorded drops of 70%, 39%, 33% and 47% respectively. A strongest reduction in frequency of 6 of 13 main categories of emergency surgeries was reported from Center 1, which was the only COVID designed Center (“Hot” hospital) in the examined region.Conclusions:The emergency general surgery is an essential service that continues to run under any circumstances. Our data showed that the COVID-19 related restriction and the fear of being infected with COVID-19 in the hospital result in a significant decrease of the utilization of acute surgical care. Policies and modern alternatives are needed to ensure continued access to specialized services to prevent patients from harm.

scholarly journals The Impact of International Trade on Central Bank Efficiency: An Application of DEA and Tobit Regression Analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 223-240
Author(s):  
Qaiser Farooq Dar ◽  
Young-Hyo Ahn ◽  
Gulbadin Farooq Dar
Keyword(s):  
Regression Analysis ◽  
International Trade ◽  
Central Bank ◽  
Malmquist Productivity Index ◽  
Productivity Index ◽  
Productivity Change ◽  
Tobit Regression ◽  
Bank Efficiency ◽  
Tobit Regression Analysis ◽  
The Impact

The purpose of this study is to introduce a novel methodology to measure the central bank efficiency. The data envelopment analysis (DEA) applies in the combination of three input and two output variables characterizing the economic balance in international trade.  Super-efficiency DEA model is applied for ranking & comparing the efficiency of different central banks. In contrast, the Malmquist productivity index (MPI) is used to measure the productivity change over the period of time. Further, the study is extended to quantify the impact of international trade dimension on the efficiency of the central bank by using Tobit regression analysis. Finally, based on our data analysis, we reported that the efficiency changes over the period of time and the total productivity changes significantly due to the technology shift as compared to efficiency change. Additionally, it is also observed that the central bank efficiency is impacted dramatically by the export level of the country as compared to import level, average exchange rate and GDP. It implies that the export level of the country significantly influences the performances of the central bank.

Mass-gathering Medicine: Risks and Patient Presentations at a 2-Day Electronic Dance Music Event

2015 ◽  
Vol 30 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Adam Lund ◽  
Sheila A. Turris
Keyword(s):  
Health Care ◽  
Average Length ◽  
Host Community ◽  
Public Health Care ◽  
Mass Gathering ◽  
Dance Music ◽  
Electronic Dance Music ◽  
Medical Area ◽  
Mass Gathering Medicine ◽  
The Impact

AbstractIntroductionMusic festivals, including electronic dance music events (EDMEs), increasingly are common in Canada and internationally. Part of a US $4.5 billion industry annually, the target audience is youth and young adults aged 15-25 years. Little is known about the impact of these events on local emergency departments (EDs).MethodsDrawing on prospective data over a 2-day EDME, the authors of this study employed mixed methods to describe the case mix and prospectively compared patient presentation rate (PPR) and ambulance transfer rate (ATR) between a first aid (FA) only and a higher level of care (HLC) model.ResultsThere were 20,301 ticketed attendees. Seventy patient encounters were recorded over two days. The average age was 19.1 years. Roughly 69% were female (n=48/70). Forty-six percent of those seen in the main medical area were under the age of 19 years (n=32/70). The average length of stay in the main medical area was 70.8 minutes. The overall PPR was 4.09 per 1,000 attendees. The ATR with FA only would have been 1.98; ATR with HLC model was 0.52. The presence of an on-site HLC team had a significant positive effect on avoiding ambulance transfers.DiscussionTwenty-nine ambulance transfers and ED visits were avoided by the presence of an on-site HLC medical team. Reduction of impact to the public health care system was substantial.ConclusionsElectronic dance music events have predictable risks and patient presentations, and appropriate on-site health care resources may reduce significantly the impact on the prehospital and emergency health resources in the host community.LundA, TurrisSA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event. Prehosp Disaster Med. 2015;30(3):18

Policy Options and the Impact of National Health Insurance Revisited

1977 ◽  
Vol 7 (3) ◽  
pp. 503-509 ◽  
Author(s):  
Joseph P. Newhouse ◽  
Charles E. Phelps ◽  
William B. Schwartz
Keyword(s):  
Medical Care ◽  
Delivery System ◽  
Gross National Product ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Hospital Utilization ◽  
Insurance Program ◽  
Short Run ◽  
Basic Concepts ◽  
The Impact

In his discussion, Jonas demonstrates a misunderstanding of the basic concepts of our paper. We nowhere implied that if medical care is free to the user, the health care delivery system would be “wrecked”; rather, we said that ambulatory utilization would, in the short run, be rationed on a basis other than price, whereas hospital utilization would be relatively little affected by a new insurance program. Over a period of time, the delivery system (if free to respond) would adjust to the increased demands, with an eventual level of expenditure on medical care of some 11 percent of gross national product (if technology does not change). Evidence from Canada is consistent with our analysis.

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