scholarly journals Value Based Healthcare. A Strategy for the Cost and Clinically Effective Healthcare System Operation

2020 ◽  
Vol 2/2020 (88) ◽  
pp. 11-28
Author(s):  
Ewelina Nojszewska ◽  
◽  
Michał Kobyliński ◽  
Keyword(s):  
Performance Indicators ◽  
Design Methodology ◽  
Systems Design ◽  
Clinical Effectiveness ◽  
A Value ◽  
European Healthcare ◽  
The Cost ◽  
Improve Cost ◽  
Macroeconomic Environment ◽  
Lengthy Process

Purpose: The submitted article focuses on how to solve the problems faced by the European healthcare systems. Design/Methodology: The article consists of two sections. The first one is theoretical and presents interdisciplinary achievements of researchers. The second section includes examples of solutions applied in Sweden, Germany and Great Britain. In the theoretical part, books and articles on the methodology of VBHC creation were reviewed. The empirical part is based on reports on the introduction of VBHC. Findings: The desire to improve cost and clinical effectiveness indicates the need for a value-based healthcare (VBHC). Thus, the concept of VBHC should contribute, according to experts, economists as well as finance and management specialists, to the economic efficiency and clinical effectiveness. Research limitations/implications: Unfortunately, this is a lengthy process to be preceded by many activities. Healthcare registers and databases belong to the most important ones. Thanks to them, it is possible to create the key performance indicators (KPI) allowing for a rational health policy. Original value: To the achievements contained in the publications, the submitted article adds the need to take into account appropriately selected KPIs analyzing the macroeconomic environment for the functioning of hospitals.

scholarly journals Disaster Preparedness Technician = Striking Cost Savings

2019 ◽  
Vol 34 (s1) ◽  
pp. s122-s123
Author(s):  
Jasmine Dexter ◽  
Melanie Morrow ◽  
Kelly Fogarty ◽  
Abigail Trewin
Keyword(s):  
Performance Indicators ◽  
Disaster Preparedness ◽  
Cost Savings ◽  
Field Hospital ◽  
Expiry Date ◽  
Stock Control ◽  
Pharmacy Technician ◽  
A Value ◽  
Time Period ◽  
The Cost

Introduction:The workplace holds a rapidly deployable, self-sufficient field hospital including a medicine cache valued at $80,000. The cache is rotated through the affiliated hospital pharmacy when they have less than 12 months to their expiry. Rotations are done regularly due to the short expiry dates of stock coming from suppliers. A senior pharmacy technician is employed two days per week at a cost of $13,024.80 per annum to manage this cache.Aim:To demonstrate the associated cost savings of employing a pharmacy technician to manage a medication cache.Methods:Every month, the technician extracts items with less than a year expiry from the stock control system and compares these dates with that of the stock held in the pharmacy. All items with a better expiry date are rotated as long as there is sufficient turnover to ensure use before its expiry. Automatic recording occurs of items rotated, items discarded, and their costs are used as key performance indicators (KPI).Results:Over a 12 month period, $52,803 worth of stock was rotated. On average, 48 lines and 7,619 individual items were rotated monthly with a value of $4,061.83 (range $0-$8,820 per month). During this period, there were 2 months where no rotations occurred due to staff changeover and annual leave. 10 lines of medicines at a value of $4,041 were discarded over this time period. The two main reasons for discarding were that the medicine was not a pharmacy item or was not used in a large enough quantity to allow rotation.Discussion:The equivalent of four times the technician’s wage was saved over 12 months. This illustrates striking cost savings gained by efficient, timely rotations and the cost benefits of employing a technician.

REKAYASA NILAI HARGA PEMBUATAN TERHADAP EFEKTIFITAS PENGGUNAAN BAHAN PADA PEMBANGUNAN PERUMAHAN TIRTO PENATARAN ASRI TIPE 70/135 KECAMATAN NGLEGOK KABUPATEN BLITAR

2017 ◽  
Vol 7 (1) ◽  
pp. 43-52
Author(s):  
Mochamad Tamim Ma’ruf
Keyword(s):  
Engineering Application ◽  
Cost Savings ◽  
Comparison Method ◽  
Value Engineering ◽  
Design Work ◽  
Housing Projects ◽  
Initial Design ◽  
A Value ◽  
The Cost ◽  
Design Proposal

One-solving methods and techniques necessary to avoid inefficiencies and not economic costs as well as reduce the cost of housing construction is the method of Value Engineering. Value engineering is a method and cost control techniques to analyze a function to its value at the lowest cost alternative (most economical) without reducing the quality desired.At the writing of this study used a comparison method by comparing the initial design to the design proposal of the author. In the housing projects Upgrading Tirto Penataran Asri type 70, the application of Value Engineering conducted on the job a couple walls and roofs pair by replacing some work items with a more economical alternative but does not change the original function and high aesthetic level and still qualify safe. For that performed the step of determining a work item, the alternative stage, the analysis stage, and the stage of recommendations to get a Value Engineering application and cost savings against the wall a couple of work items and partner roof.The proposed design as compared to the initial design. Work items discussed was the work of a couple wall having analyzed obtained savings of Rp. 2,747,643.56 and the work of the roof pair obtained savings of Rp. 2,363,446.80. Thus the total overall savings gained is Rp 5,111,090.36 or savings of 0048%.

scholarly journals Legal Complexities of Animal Welfare in Australia: Do On-Animal Sensors Offer a Future Option?

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 91
Author(s):  
Jaime Manning ◽  
Deborah Power ◽  
Amy Cosby
Keyword(s):  
Animal Welfare ◽  
Data Transmission ◽  
Continuous Measurement ◽  
Mental Wellbeing ◽  
Value Proposition ◽  
Data Governance ◽  
Behavioural State ◽  
A Value ◽  
Welfare Measures ◽  
The Cost

The five freedoms and, more recently, the five domains of animal welfare provide internationally recognised frameworks to evaluate animal welfare practices which recognise both the physical and mental wellbeing needs of animals, providing a balanced view of their ability to cope in their environment. Whilst there are many techniques to measure animal welfare, the challenge lies with how best to align these with future changes in definitions and expectations, advances in science, legislative requirements, and technology improvements. Furthermore, enforcement of current animal welfare legislation in relation to livestock in Australia and the reliance on self-audits for accreditation schemes, challenges our ability to objectively measure animal welfare. On-animal sensors have enormous potential to address animal welfare concerns and assist with legislative compliance, through continuous measurement and monitoring of an animal’s behavioural state and location being reflective of their wellbeing. As reliable animal welfare measures evolve and the cost of on-animal sensors reduce, technology adoption will increase as the benefits across the supply chain are realised. Future adoption of on-animal sensors by producers will primarily depend on a value proposition for their business being clear; algorithm development to ensure measures are valid and reliable; increases in producer knowledge, willingness, and trust in data governance; and improvements in data transmission and connectivity.

Autopilot design for an aircraft by using Luenberger observer design

2018 ◽  
Vol 90 (5) ◽  
pp. 858-868 ◽  
Author(s):  
Muhammad Taimoor ◽  
Li Aijun ◽  
Rooh ul Amin ◽  
Hongshi Lu
Keyword(s):  
Design Methodology ◽  
Research Work ◽  
Linear Quadratic Regulator ◽  
Observer Design ◽  
Linear Quadratic ◽  
Content Type ◽  
Luenberger Observer ◽  
Level Flight ◽  
Aerial Vehicle ◽  
The Cost

Purpose The purpose of this paper is to design linear quadratic regulator (LQR) based Luenberger observer for the estimation of unknown states of aircraft. Design/methodology/approach In this paper, the LQR-based Luenberger observer is deliberated for autonomous level flight of unmanned aerial vehicle (UAV) which has been attained productively. Various modes like phugoid and roll modes are exploited for controlling the rates of UAV. The Luenberger observer is exploited for estimation of the mysterious states of the system. The rates of roll, yaw and pitch are used as an input to the observer, while the remaining states such as velocities and angles have been anticipated. The main advantage of using Luenberger observer was to reduce the cost of the system which has been achieved lucratively. The Luenberger observer proposes sturdiness at the rate of completion to conquest over the turmoil and insecurities to overcome the privileged recital. The FlightGear simulator is exploited for the endorsement of the recital of the Luenberger observer-based autopilot. The level flight has been subjugated lucratively and has been legitimated by exploiting the FlightGear simulator. The authenticated and the validated results are offered in this paper. Microsoft Visual Studio has been engaged as a medium between the MATLAB and FlightGear Simulator. Findings The suggested observer based on LQR ensures the lucrative approximation of the unknown states of the system as well as the successful level flight of the system. The Luenberger observer is used for approximation of states while LQR is used as controller. Originality/value In this research work, not only the estimation of unknown states of both longitudinal and lateral model is made but also the level flight is achieved by using those estimated states and the autopilot is validated by using the FlightGear, while in most of the research work only the estimation is made of only longitudinal or lateral model.

scholarly journals “There is no magic bullet.” Considerations for the adoption of molecular chlamydia and gonorrhoea point of care tests into routine care.

2020 ◽  
Author(s):  
Sebastian Fuller ◽  
Emma Harding-Esch
Keyword(s):  
Sexual Health ◽  
Point Of Care ◽  
Clinical Effectiveness ◽  
Routine Care ◽  
Good Evidence ◽  
Magic Bullet ◽  
Value Proposition ◽  
Healthcare Settings ◽  
A Value ◽  
Point Of Care Tests

IntroductionSexually Transmitted Infections (STIs), including Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), continue to be a global health problem, with the majority of the disease burden in Low and Middle Income Countries. This could in part be addressed through increased access to rapid point-of-care-tests (POCTs) for infection detection and appropriate clinical management. Guidelines and criteria for the development of STI POCTs have been established, and several POCTs for CT and NG have been brought to market. Yet even those diagnostics with good evidence of clinical effectiveness often fail to be implemented and adopted into routine care. Here we review the current literature for test development and implementation alongside studies of how the Cepheid CT/NG GeneXpert POCT has been utilised in different healthcare settings, to develop a value proposition for CT/NG POCT adoption.MethodsWe review whether the Cepheid CT/NG GeneXpert fulfil the (RE)ASSURED and Target Product Profile (TPP) criteria, and present published literature reporting on the test’s implementation, to demonstrate its range of values in different settings and to a variety of stakeholders. This information is then applied to the value proposition for laboratory medicine, to form the basis of a value proposition for a CT/NG POCT. ResultsThe Cepheid CT/NG GeneXpert did not fulfil all (RE)ASSURED or TPP criteria, however, studies of test implementation showed multiple stakeholder values for the use of the test across various healthcare settings and geographic locations. The majority of values identified were setting specific. Sexual health services and outreach services had the least overlap in values, whereas General Practice and other non-sexual health specialist services served as a “bridge” between the two.ConclusionWe recommend that those wishing to improve CT/NG diagnosis be supported to identify the values most relevant to their settings and context, and prioritise implementation of those tests most closely aligned with those values.

scholarly journals Pembrolizumab for Microsatellite Instability-High or Mismatch Repair Deficient Small Bowel Adenocarcinoma or Appendiceal Adenocarcinoma

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Keeley Farrell ◽  
Jennifer Horton
Keyword(s):  
Small Bowel ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Progression Free Survival ◽  
Clinical Effectiveness ◽  
Complete Response ◽  
Small Bowel Adenocarcinoma ◽  
Appendiceal Adenocarcinoma ◽  
The Cost ◽  
Evidence Based Guidelines

Some adult patients with microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) small bowel adenocarcinoma might benefit from pembrolizumab in controlling the disease (i.e., some patients achieved a partial or complete response after treatment). These findings are based on 2 single-arm studies (i.e., no comparator) with fewer than 20 patients in each study, which limits the certainty of the findings. The longer-term benefit of pembrolizumab is unclear, as some outcomes (e.g., progression-free survival, overall survival) were not reached at the time of data analysis. The safety of pembrolizumab in patients with MSI-H/dMMR small bowel adenocarcinoma is unknown (no evidence was found for this population). No evidence was identified regarding the clinical effectiveness of pembrolizumab monotherapy for patients with MSI-H/dMMR appendiceal adenocarcinoma. No evidence was identified regarding the cost-effectiveness of pembrolizumab monotherapy for patients with MSI-H/dMMR small bowel adenocarcinoma or appendiceal adenocarcinoma. No evidence-based guidelines were identified regarding pembrolizumab monotherapy for patients with MSI-H/dMMR appendiceal adenocarcinoma. One guideline was identified that recommends pembrolizumab as an option for initial or subsequent therapy in patients with advanced or metastatic MSI-H/dMMR small bowel adenocarcinoma.

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