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Resource allocation

Caroline Charette, Krista L Best, Emma M Smith, William C Miller, François Routhier
Background: Mobility limitations represent the third most prevalent cause of disability, affecting more than 1.9 million community-dwelling Canadians. Walking aids are often prescribed to reduce the impacts of mobility impairments. There are limited data on walking aids since 2004. Objective: The objective of this study was to investigate the prevalence of walking aid use in Canada and to explore demographic characteristics among users of walking aids. Design: The design used was a secondary analysis of a cross-sectional national survey...
March 14, 2018: Physical Therapy
Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Cliff C Kerr, Salvador Dura-Bernal, Tomasz G Smolinski, George L Chadderdon, David P Wilson
When standard optimization methods fail to find a satisfactory solution for a parameter fitting problem, a tempting recourse is to adjust parameters manually. While tedious, this approach can be surprisingly powerful in terms of achieving optimal or near-optimal solutions. This paper outlines an optimization algorithm, Adaptive Stochastic Descent (ASD), that has been designed to replicate the essential aspects of manual parameter fitting in an automated way. Specifically, ASD uses simple principles to form probabilistic assumptions about (a) which parameters have the greatest effect on the objective function, and (b) optimal step sizes for each parameter...
2018: PloS One
Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Samuel Johnson, Sharmala Thuraisingam, John Furler, Jo-Anne Manski Nankervis
Insulin initiation is often delayed in primary care partly because of clinician concerns about the additional clinical work. This study describes health services usage (HSU) pre- and post-insulin initiation in people with type 2 diabetes and out-of-target glycaemic levels. Secondary analysis of participant data from the Stepping Up randomised controlled trial of a model of care for insulin initiation in general practice was undertaken. For 142 people who commenced insulin, HSU in the 6 months prior was compared to that in the 12 months following insulin initiation...
March 16, 2018: Australian Journal of Primary Health
Markus Basan
Elucidating strategies of resource allocation and metabolism is crucial for a better understanding of microbial phenotypes. In particular, uncovering the governing principles underlying these processes would be a crucial step for achieving a central aim of systems microbiology, which is to quantitatively predict phenotypes of microbial cells or entire populations in diverse conditions. Here, some of the key concepts for understanding cellular resource allocation and metabolism that have been suggested over the past years are reviewed...
March 12, 2018: Current Opinion in Microbiology
Sophia Y Wang, Mariam S Hamid, David C Musch, Maria A Woodward
Importance: Nearly 2 million patients visit emergency departments (EDs) because of eye concerns annually in the United States. How hospitals currently assign these patients to treatment is important for designing systems that equitably allocate resources for eye care in urgent settings. Objective: To investigate factors associated with ophthalmology consultation for eye-related adult ED encounters to assess possible disparities by sex, race/ethnicity, language preference, or residential distance from the medical center...
March 15, 2018: JAMA Ophthalmology
Maria L Alva
This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions...
March 15, 2018: International Journal of Environmental Research and Public Health
Ramadhani Kigume, Stephen Maluka, Peter Kamuzora
While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space...
March 15, 2018: International Journal of Health Planning and Management
Martin Dlouhý
The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available...
2018: Frontiers in Public Health
Román Rodríguez-Aguilar, José Antonio Marmolejo-Saucedo, Sonia Tavera-Martínez
Background: The objective of this work is to estimate the financial impact of increasing the monitoring period for breast cancer, which is financed by the Sistema de Protección Social en Salud (SPSS-Social Protection System in Health). Methods: A micro-simulation model was developed to monitor a cohort of patients with breast cancer, and also an estimation was made on the probability of surviving the monitoring period financed by the SPSS. Using the Monte Carlo simulation, the maximum expected cost was estimated to broaden such monitoring...
2018: Cost Effectiveness and Resource Allocation: C/E
Sherrie L Kelly, Rowan Martin-Hughes, Robyn M Stuart, Xiao F Yap, David J Kedziora, Kelsey L Grantham, S Azfar Hussain, Iyanoosh Reporter, Andrew J Shattock, Laura Grobicki, Hassan Haghparast-Bidgoli, Jolene Skordis-Worrall, Zofia Baranczuk, Olivia Keiser, Janne Estill, Janka Petravic, Richard T Gray, Clemens J Benedikt, Nicole Fraser, Marelize Gorgens, David Wilson, Cliff C Kerr, David P Wilson
BACKGROUND: To move towards ending AIDS by 2030, HIV resources should be allocated cost-effectively. We used the Optima HIV model to estimate how global HIV resources could be retargeted for greatest epidemiological effect and how many additional new infections could be averted by 2030. METHODS: We collated standard data used in country modelling exercises (including demographic, epidemiological, behavioural, programmatic, and expenditure data) from Jan 1, 2000, to Dec 31, 2015 for 44 countries, capturing 80% of people living with HIV worldwide...
March 9, 2018: Lancet HIV
Geórgia Alcântara Alencar Melo, Andrea Bezerra Rodrigues, Mariana Alves Firmeza, Alex Sandro de Moura Grangeiro, Patrícia Peres de Oliveira, Joselany Áfio Caetano
OBJECTIVE: to evaluate the therapeutic effect of music on anxiety and vital parameters in patients with chronic kidney disease when compared to patients receiving conventional care in hemodialysis clinics. METHOD: randomized clinical trial conducted in three renal replacement therapy clinics. Sixty people with chronic kidney disease undergoing hemodialysis were randomly allocated to an experimental group and a control group, 30 persons per group). State anxiety was evaluated in both groups by the State-Trait Anxiety Inventory...
March 8, 2018: Revista Latino-americana de Enfermagem
X A Liu, Y Peng, J J Li, P H Peng
Resource amendments commonly promote plant invasions, raising concerns over the potential consequences of nitrogen (N) deposition; however, it is unclear whether invaders will benefit from N deposition more than natives. Growth is among the most fundamental inherent traits of plants and thus good invaders may have superior growth advantages in response to resource amendments. We compared the growth and allocation between invasive and native plants in different N regimes including controls (ambient N concentrations)...
March 12, 2018: Brazilian Journal of Biology, Revista Brasleira de Biologia
Sarah L Bornbusch, Jonathan S Lefcheck, J Emmett Duffy
Eusociality, one of the most complex forms of social organization, is thought to have evolved in several animal clades in response to competition for resources and reproductive opportunities. Several species of snapping shrimp in the genus Synalpheus, the only marine organisms known to exhibit eusociality, form colonies characterized by high reproductive skew, and aggressive territoriality coupled with cooperative defense. In eusocial Synalpheus colonies, individual reproduction is limited to female 'queens', whose fecundity dictates colony growth...
2018: PloS One
I Pulido, I Gomes, J Rodrigues, T Guerreiro, C Nunes
INTRODUCTION: Multiple sclerosis (MS) is a demyelinating and autoimmune disease with variable progression and high risk of hospital admission. In some studies these hospitalizations may be used as surrogate markers of disease progression, however in Portugal, due to organizational asymmetries and clinical safety choices this relationship is not linear. The admission patterns for this pathology can provide relevant data to the design of disease's management strategies and resource allocation...
March 16, 2018: Revista de Neurologia
Amirhossein Meisami, Jivan Deglise-Hawkinson, Mark E Cowen, Mark P Van Oyen
The decision of whether to admit a patient to a critical care unit is a crucial operational problem that has significant influence on both hospital performance and patient outcomes. Hospitals currently lack a methodology to selectively admit patients to these units in a way that patient health risk metrics can be incorporated while considering the congestion that will occur. The hospital is modeled as a complex loss queueing network with a stochastic model of how long risk-stratified patients spend time in particular units and how they transition between units...
March 13, 2018: Health Care Management Science
Tamara Tompsett, Kate Masters, Parastou Donyai
Background: A number of naturalistic studies have investigated paliperidone palmitate (PP) using proxy measures of effectiveness. An unexplored option is to examine the utility of the mental health clustering tool (MHCT), which is used in UK clinical practice to measure patient well-being and is linked to allocation of resources. This study evaluated the effectiveness of PP using the MHCT, the Health of the Nation Outcome Scales (HoNOS), and, for comparison, more conventional outcome measures...
2018: Neuropsychiatric Disease and Treatment
Kai Gao, Tiexia Zhu, Lin Wang, Yang Gao
The production of tuberous roots is usually reduced by vigorous vegetative growth because of the competition for resource between the vegetative parts and reproductive organs. In this study, we conducted root pruning to examine the vigorous vegetative growth by regulating root growth, subsequently limiting vegetative growth and improving tuber yield. Compared with the control, stem, tuber, and root biomasses were all improved, whereas both flower and leaf biomasses were increased. Tuber biomass was improved by 23...
March 13, 2018: Scientific Reports
Richard Njouom, Isabelle Siffert, Gaëtan Texier, Guillaume Lachenal, Mathurin Cyrille Tejiokem, Jacques Pépin, Arnaud Fontanet
Cameroon is thought to have one of the highest prevalences of Hepatitis C virus (HCV) infection in the world (4·9% among adults). A marked cohort effect exists in several communities where ≈50% of the elderly are infected. Better assessment of HCV distribution is needed for planning treatment programs. We tested for HCV antibodies 14150 capillary blood samples collected during the 2011 Demographic and Health Survey, whose participants were representative of the Cameroonian population aged 15-49 (both genders) and 50-59 years (men only)...
March 13, 2018: Journal of Viral Hepatitis
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