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NEJM Catalyst ◽  
2021 ◽  
Vol 2 (12) ◽  
Author(s):  
Jonathan Bees

Author(s):  
Pierre V. Dantas ◽  
Waldir Sabino S. Júnior ◽  
Celso B. Carvalho

The main purpose of disaggregation is to decompose a signal into a set of other signals that together constitute it. This approach could be applied to audio signals, health care, home automation, ubiquitous systems and energy systems. It may be unworkable to individually measure the energy consumption of loads in a system simultaneously and, through disaggregation, we can make an inference using a main meter. The main contribution of this work is to use PCA to extract representativeness of an energy consumption signal we want to disaggregate, identifying its most relevant characteristics. The field of study is relevant because it allows information to be obtained in a simpler and cheaper way about the individual consumption of loads that make up a system. This opens up perspectives for other approaches such as smart grids and IoT. We demonstrate that when compared to other techniques, the proposal produces more accurate disaggregation results.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S66-S66
Author(s):  
David I Auerbach ◽  
Carie Michael ◽  
Douglas Levy ◽  
Peter Maramaldi ◽  
Robert Dittus ◽  
...  

Abstract As the US population ages, primary care is expected to be the health care “home” for older adults, and several initiatives are aimed at helping to transform primary care practice to care for this population. Wide variation in staffing has been observed. Meyers et al proposed ideal models of primary care staffing for a general population and for a frail elderly population (2018). We developed the 2018 Survey of Primary Care and Geriatric Clinicians to measure optimal team configuration in clinical practices caring for older adults. A majority employed NPs, MDs and PAs, with [r = -.53] between % of clinician labor of NPs and physicians). High-NP practices are more likely located in states with full scope of practice, perform well for frail elders and are less expensive. Meyers' models, with fewer physicians, more SW and CHWs, more RNs, perform better for frail elders, and are less expensive.


2019 ◽  
Vol 19 (3) ◽  
Author(s):  
Kabir Dasgupta ◽  
Gail Pacheco

Abstract Our analysis presents a case study on the impacts of Health Care Home (HCH) – a large-scale technology-based healthcare innovation in New Zealand’s primary healthcare system. For our analysis, we link the registered population of health practices within the Wellington region to administrative hospital admission data for quarterly periods between 2014 and 2017. By employing variation in the timing of HCH implementation across practices (selected via propensity score matching), we estimate differences-in-differences models to investigate the effects of the intervention on multiple patient outcomes. Additionally, we incorporate a number of empirical specifications to test the robustness of estimates. HCH results in a statistically significant reduction in the likelihood of emergency department (ED) presentations by 6–8 %, with no significant impacts on other health outcomes. The impact on ED presentations aligns with the expectation that the HCH intervention would produce downstream effects of a reduced economic burden on public hospital services.


2018 ◽  
Vol 26 (3) ◽  
pp. 242-252
Author(s):  
Jacqueline Cumming ◽  
Phoebe Dunn ◽  
Lesley Middleton ◽  
Claire O’Loughlin

Purpose The purpose of this paper is to report on the origins, development and early impacts of a Health Care Home (HCH) model of care being rolled out around New Zealand (NZ). Design/methodology/approach This paper draws on a literature review on HCHs and related developments in primary health care, background discussions with key players, and a review of significant HCH implementation documents. Findings The HCH model of care is emerging from the sector itself and is being tailored to local needs and to meet the needs of local practices. A key focus in NZ seems to be on business efficiency and ensuring sustainability of general practice – with the assumption that freeing up general practitioner time for complex patients will mean better care for those populations. HCH models of care differ around the world and NZ needs its own evidence to show the model’s effectiveness in achieving its goals. Research limitations/implications It is still early days for the HCH model of care in NZ and the findings in this paper are based on limited evidence. Further evidence is needed to identify the model’s full impact over the next few years. Originality/value This paper is one of the first to explore the HCH model of care in NZ.


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