Efficiency changes in orthopaedic trauma surgery and implications for resource allocation

Background/Aims The trauma and orthopaedic surgery department needed to modify practices as a result of the COVID-19 pandemic. This study quantitatively assessed the effects of changes in resource allocation on the efficiency of trauma, specifically the number of operations performed per defined trauma session. Methods Trauma lists were reviewed pre-COVID, at the peak and at the tail of the first wave of COVID-19 infections at a hospital in the UK. Efficiency was calculated before and after the reallocation of resources and this was defined as the number of cases per trauma session as well as turnaround times for each part of the surgical patient journey. Results The mean trauma list efficiency was 1.73 cases per session in February 2020 compared to 1.89 in February 2019. It reduced to 1.21 during the COVID peak in April 2020 compared to 1.90 in April 2019 and improved to 1.48 per session in June 2020 vs 1.82 in June 2019. Conclusions Measures introduced at the start of the pandemic are likely to continue for the foreseeable future. Increased allocation of resources would be needed to allow urgent trauma surgery to provide a timely and efficient service.

Either manufacturing sector rely on capital markets on the basis of financial resources An empirical study of industries in Pakistan

The present study employed the financial resources of the manufacturing sector in Pakistan was to discover compare the performance of the manufacturing sector in Pakistan. Pakistan manufacturing sector find out effect on the performance of financial resources. Capital market firms, public financing, reallocation of internal resources, commercial financing and venture capital use various sources of finance, funds Market bonds and shares. According to (Dai, Jo, & Kassicieh, 2013; Gallagher, 2012) Relied on the release of Commercial financing, funding for these mostly companies rely on financial institutions. Few companies also use their own funds in the absence of public finances as well as companies also funding and venture capital reallocation of resources to their own use. This funding cost, magnitude of the risk associated with these resources due to their cost has a direct effect on the performance of firms that is clear. The present study used financial resources are manufacturing firms and their effect on the performance of this funding has been conducted to explore.

Spatial Inequity in Access to Intensive Care Unit Beds at Regional Level in Italy

The high demand of hospitalization in the intensive care units (ICUs) during the first wave of the COVID-19 outbreak brought out the critical issues of the limited capacity of the regional systems to deal with high patient inflows in a short period of time. In this view, a rapid and efficient reallocation of resources is one of the main challenges to be addressed by regional systems to prevent overload and saturation. Aim of this study is to assess the spatial accessibility of ICU beds in the 20 Italian regions to capture the equity distribution of critical care services across the country. This analysis may contribute to gain a deeper understanding of the allocation of health resources. It can provide input for policy makers in view of a possible reorganization of the national system in terms of both its preparedness for emergency period and routine capability.

Enabling design characteristics and budget usefulness

Purpose This study aims to investigate the influence of budgeting design characteristics on perceived budgeting usefulness, based on the enabling-coercive framework. Design/methodology/approach This paper develops a survey in one large publicly-listed Brazilian company that operates in the electric utility industry. The sample comprises 75 middle managers from different areas of this organization. This study uses structural equation modeling as the data analysis method. Findings The results indicate that internal and global transparencies determine middle managers’ perceptions of budgeting usefulness, while no relationship was found for repair capacity and flexibility characteristics. This paper shows that managers, when provided with global and internal transparencies and independently of their level discretion regarding target revisions or the reallocation of resources, perceive budgeting systems as being useful for decision-facilitating and decision-influencing roles. Practical implications The findings might be relevant for budgeting professionals to review or design the budgeting system in terms of dribbling potential flaws and increasing its use in the organization. Originality/value The study explores the multidimensionality of the enabling-coercive budgeting design construct. This study provides a theoretical contribution to the literature by showing that budget alignment, integration, learning and information sharing are relevant such that an organization could improve the assertiveness using budgeting systems. Besides, this paper provides an opposing view about the supposed relation between flexible budgeting design and budgeting usefulness. Frequently, some management directions are offered by the literature and no guarantee is provided in terms of the connection between the adoption and the usefulness of those mechanisms. Therefore, the findings shed more light on the practical developments in budgeting.

Trade policy options for export diversification: The case of Mali, Chad, Niger, and Guinea

The landlocked and fragile countries’ ability to create a sustainable path to economic growth and poverty reduction is inextricably linked to their export diversification potential, itself related to their connectivity within themselves, in the region, and other external markets. Mali, Chad, and Niger are first challenged by their geography—their landlocked nature with their vast and thinly populated space serves to isolate the most vulnerable communities from external and internal markets. Adding to these geographic disadvantages non-landlocked is incentive environment—defined by high and variable customs common external tariff regimes resulting from multiple overlapping regional trade arrangements—places a wedge between domestic and international prices, provides a disincentive to exports in favor of non-tradable and domestic-oriented sectors. By bringing greater coherence and convergence between the many common external tariff regimes in operation and the rationalization of their structures, and improving connectivity within and between markets, Mali, Chad, Niger, and Guinea can better promote the reallocation of resources toward tradable goods and services, putting the countries on a path toward greater economic inclusion and sustainable growth.

How can we decide a fair allocation of healthcare resources during a pandemic?

Whenever the government makes medical resource allocation choices, there will be opportunity costs associated with those choices: some patients will have treatment and live longer, while a different group of patients will die prematurely. Because of this, we have to make sure that the benefits we get from investing in treatment A are large enough to justify the benefits forgone from not investing in the next best alternative, treatment B. There has been an increase in spending and reallocation of resources during the COVID-19 pandemic that may have been warranted given the urgency of the situation. However, these actions do not bypass the opportunity cost principle although they can appear to in the short term, since spending increases cannot continue indefinitely and there are patient groups who lose out when resources are redirected to pandemic services. Therefore, policy-makers must consider who bears the cost of the displaced healthcare resources. Failure to do so runs a risk of reducing overall population health while disproportionally worsening health in socially disadvantaged groups. We give the example of ethnic minorities in England who already had the worst health and, due to structural injustices, were hardest hit by the pandemic and may stand to lose the most when services are reallocated to meet the resource demands of the crisis. How can we prevent this form of health inequity? Our proposal is forward-looking: we suggest that the government should invest our resources wisely while taking issues of equity into account–that is, introduce cost–equity analysis.

Decentralization of power: challenges for newly elected local governments

The article is devoted to topical issues of power decentralization and the development of local government. The aim of the research is to identify challenges for local governments in the implementation of the decentralization reform and to develop proposals for the spatial development of territorial communities. The problems of functioning and development of united territorial communities have been identified. These problems are differentiation of powers between levels of government; reallocation of resources; discrepancy between delegated powers and financial support of communities; low level of training for the implementation of the powers of local authorities. The directions for overcoming the challenges are suggested. These directions are legislative support for the reform of the decentralization of power; ensuring the financial viability of communities; reallocation of resources; development of mechanisms, criteria for the spatial development of territorial communities; development of programs for the development of personnel of local authorities and newly created communities capable of ensuring the development of territories.

Modeling Trade Tensions

In this paper, we investigate the mechanisms through which import tariffs impact the macroeconomy in two large scale workhorse models used for quantitative policy analysis: a computational general equilibrium (CGE) model (Purdue University GTAP model) and a multi-country dynamic stochastic general equilibrium (DSGE) model (IMF GIMF model). The quantitative effects of an increase in tariffs reflect different mechanisms at work. Like other models in the trade literature, in GTAP higher tariffs generate a loss in terms of output arising from an inefficient reallocation of resources between sectors. In GIMF instead, as in other DSGE models, tariffs act as a disincentive to factor utilization. We show that the two models/channels can be broadly interpreted as capturing the impact of tariffs on different components of a country’s aggregate production function: aggregate productivity (GTAP) and factor supply/utilization (GIMF). We discuss ways to combine the estimates from these two models to provide a more complete assessment of the macro effects of tariffs.

COVID-19 and Acute Cardiovascular Diseases in Bangladesh- A Time Tested Medical Emergency to deal with

Covid-19 pandemic has affected millions of patients, killed more than half a million, and poses major health threat globally. There is high demand for clinical resources and bed space for COVID- 19 patients. Admission of patient of any cardiac emergency in a common block of hospital, country like Bangladesh, may exposes the risk of infection among non-COVID patient. Patient with COVID- 19 and pre-existing cardiovascular diseases (CVD) have increased risk of further aggravation and death. COVID-19 infection is usually associated with multiple direct and indirect cardiovascular complications, such as acute myocardial injury, myocarditis, arrhythmias, heart failure and venous thromboembolism. Health care worker may pose themselves in vulnerability as they become host or vectors of virus transmission. Defeating COVID-19 and managing acute cardiovascular emergencies in COVID-19 era exposes non-COVID-19 patient, may need dramatic reshaping of care delivery, novel approaches to patient’s management and large-scale reallocation of resources. Cardiovasc. j. 2020; 13(1): 75-80