Does adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? A single-centre retrospective study

ObjectivesTo measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation.DesignRetrospective observational single-centre study, based on electronic medical and administrative records.SettingIntensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome.ParticipantsRecords of 3063 consecutive mechanically ventilated patients admitted to the ICU between 2012 and 2017 were extracted, of whom 583 were eligible adults for further analysis. Patients’ weaning protocols were evaluated for daily adherence to quality standards until ICU discharge. Patients with <65% compliance were assigned to the low adherence group (LAG), patients with ≥65% to the high adherence group (HAG).Primary and secondary outcome measuresEconomic healthcare costs, clinical outcomes and patients’ characteristics.ResultsThe LAG consisted of 378 patients with a median negative economic results of −€3969, HAG of 205 (−€1030), respectively (p<0.001). Median duration of ventilation was 476 (248; 769) hours in the LAG and 389 (247; 608) hours in the HAG (p<0.001). Length of stay (LOS) in the LAG on ICU was 21 (12; 35) days and 16 (11; 25) days in the HAG (p<0.001). LOS in the hospital was 36 (22; 61) days in the LAG, and within the HAG, respectively, 26 (18; 48) days (p=0.001).ConclusionsHigh adherence to this single QI is associated with better clinical outcome and improved economic returns. Therefore, the results support the adherence to QI. However, the examined QI does not influence economic outcome as the decisive factor.

Alternative Non-Economic Measures of CDFI Lending Impact: An Exploratory Analysis

CDFI impacts are overwhelmingly viewed through an economic lens. Little consideration is given to other types of metrics. Yet we believe a positive economic impact is a necessary but not sufficient condition to being an effective development institution. We assess the relationship between a CDFI's lending activities and aggregate social capital levels. Social capital – the entrepreneurial networks which occur when small businesses flourish – are a key non-economic outcome of CDIF financing and technical assistance interventions.

Framework to structure the Brazilian electricity futures market

Purpose This study aims to formulate a mechanism design in the derivatives market, summarizing a framework to set up the Brazilian electricity futures market. Design/methodology/approach This exploratory study formulates a mechanism design in the derivatives market, summarizing a framework to set up the Brazilian electricity futures market. Findings The results show a positive economic outcome for the creation of the Brazilian futures electricity market. Originality/value The main feature in this work is to summarize a framework to set up the Brazilian electricity futures market applying mechanism design, applicable in other countries. The features of the mechanism are the space of expected results (Z), the strategies to survey the environmental space (θ) and the mechanism design – messages space (M).

The Destiny of a “Baby” Industry: Turkish Animation

The word “destiny” is rooted in the word “destination”, the place where someone is going. In order to draw a map for our journey we have to know where we are standing and we have to have a groundwork. Animation in Turkey dates back to the first animation experimentations of Turkish cartoonists and the first public screening of Disney’s “The Skeleton Dance” in 1932. The pioneering animations are either unfinished, lost or obscure. Just like the doomed faith of the first -unfinished- animated feature film project “Once Upon a Time” that has been carried out for almost 9 years or the questionable and -sued- authenticity of the first highly popular domestic cartoon character on Turkish TV, animation in Turkey have so many low points. Nevertheless there is a growing number of domestic feature films with record breaking number of audiences. Animation education is only 30 years old with little number of departments devoted to it, -yet- the numbers are growing. “Design Centers” are established by the encouragement of Turkish Ministry of Industry and Technology to support animation studios, professional associations are forming, intellectual property rights are the talk of the day, the academy and industry interaction is getting stronger, little festivals flourish... These are indeed turning points for the -baby- animation industry in Turkey. We need to study this map in order to get to our destination: a mature industry with established work ethics, high artistic standards and rich economic outcome and make a good destiny out of it.