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Results for “Resource Allocation”

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At least 415 records · Page 23Linked to original sources
PubMed1990

Principles of cost-effective resource allocation in health care organizations.

Cost-effectiveness analysis (CEA) is a method of economic evaluation that can be used to assess the efficiency with which health care technologies use limited resources to produce health outputs. However, inconsistencies in the way that such ratios are constructed often lead to misleading conclusions when CEAs are compared. Some of these inconsistencies, such as failure to discount or to calculate incremental ratios correctly, reflect analytical errors that, if corrected, would resolve the inconsistencies. Others reflect fundamental differences in the viewpoint of the analysis. The perspectives of different decision-making entities can properly lead to different items in the numerator and denominator of the cost-effectiveness (C/E) ratio. Producers and consumers of CEA need to be more conscious of the perspectives of analysis, so that C/E comparisons from a given perspective are based upon a common understanding of the elements that are properly included.

Cost-Benefit Analysis↗
PubMed1987

Patient classification and resource allocation in Veterans Administration nursing homes.

Patient classification for Veterans Administration and non-Veterans Administration long-term care patients is discussed. Results are reported from 290 patients in two VA nursing homes by using both resource utilization groups and an independently generated classification system. Patient classes were generated by using the Automatic Interaction Detection Program, which was the methodology used to create the diagnosis related groups. The use of diagnoses in long-term care patient classification is also reviewed. The effect of disaggregated nursing times by type of provider and by type of nursing activity on patient classes is examined.

Activities of Daily Living↗
PubMed1987

Effects of a poverty-clients' agenda on resource allocations by community decision makers.

A coalition of human service agencies in one city used the Concerns Report Method of Basic Needs and Vital Services to obtain information on the concerns of their poverty clients. Results were disseminated to local decision makers of the United Way agency, city commission, and county commission during their annual budget deliberations. Two standard accounting methods were used to compare budget allocations to agencies serving low-income people before and after dissemination of the Concerns Report, to other items in the three budgets, and to allocations to similar agencies in a second city. Allocations to agencies serving those most in need in the experimental community grew 17% faster than the total budget, increased 3.96% in share of total budget, and gained 22% over other allocations following dissemination of the Concerns Report.

Community Health Services↗
PubMed1994

Prompt fixation of isolated femur fractures in a rural trauma center: a study examining the timing of fixation and resource allocation.

Early fixation is defined by most authors as fracture fixation within 24 hours of admission. This definition of early is arbitrary and may not be achievable in a rural environment where interhospital transfer is often required and operating room resources are constrained. A review of isolated femur fractures was performed to determine if prompt fixation (24-72 hours, Early) was more effective than late fixation (> 72 hours, Late) and similar to immediate fixation (< 24 hours, Immediate) with regard to complications, mortality, and resource utilization. Between October 1, 1987 and December 31, 1990, 67 patients were admitted and stratified into one of the three groups based on the timing of fixation. The number of emergency operations was significantly greater in the Immediate group and the surgery took significantly longer to perform than in either the Early or Late groups (p < 0.004; ANOVA). There were significantly fewer pulmonary and infectious complications in the Immediate and Early groups compared with the Late group (p < 0.05, chi 2). Fixation of isolated femur fractures after 24 hours but before 72 hours had morbidity similar to fixation within the first 24 hours, but utilized operating room resources more efficiently.

Adult↗
PubMedDate not supplied

[Strategy and resources allocation in biomedical investigation].

At the end of the present century a significant coincidence underpins the growing interest for the social legitimation of the public health systems by means of a scientific knowledge base as well as an unprecedented transformation of some research organizative features--multidisciplinarity, resource concentration and common utilisation of the support infrastructures--the paradigms and the technological domain related to genomics and molecular engineering. Under such circumstances there has been a renewed interest about strategic thinking from the perspective of biomedical science and technology. The central question addressed by this report aims to review some issues related with the economic analysis of biomedical research as a collectively provided public good and to discuss the impact of the new economics of information on creating research strategies.

Financing, Government↗
PubMed1979

Transportation or CT scanners: a theory and method of health resources allocation.

Cost containment and access to appropriate care are the two most frequently discussed issues in contemporary health policy. Conceiving of the health services available in specific regions as "packages" of diverse items, the authors of this article consider the economic trade-offs among the various resources needed for appropriate care. In the discussion that follows, we examine the trade-offs between two divergent offering of the health care system: high technology medicine and support services. Specifically, we examine several strategies designed to achieve an optimal mix of investments in CT scanners and transportation resources in the South Chicago region. Using linear programming as a method for examining these options, the authors found that 1) the proper location of CT scanners is as important for cost containment as optimal number, and 2) excess capacity in the utilization of a single resource--CT scanners--need not imply inefficiency in the overall delivery of the service. These findings help demonstrate the importance of viewing health care as a package of interrelated services, both for achieving cost containment and for providing access to appropriate care.

Catchment Area, Health↗
PubMed1980

Metabolic resource allocation vs. mating attractiveness: Adaptive pressures on the "alba" polymorphism of Colias butterflies.

The sex-limited "alba" genetic polymorphism in wing color of Colias butterflies has been studied with respect to potential selective pressures on this locus. Alba female pupae, carrying at least one dominant A allele, redirect resources, used by aa pupae for pigmentation, to other metabolic ends. Associated with this reallocation, alba, A-, female adults eclose earlier, retain more larva-derived resources in their fat bodies for somatic maintenance and for reproduction, and, in some conditions, mature their eggs faster than do aa females. Alba females are also less attractive to males than are aa females and mate less frequently. Evolutionary implications of these results are discussed.

Journal Article↗
PubMedDate not supplied

Service learning. Resource allocation.

Service learning has the potential to increase student learning, assist communities, and provide faculty members with one focus area that brings teaching, service, scholarship, and practice together As nursing programs revise curricula to include community based service learning opportunities, the impact of these projects on material and human resources must be assessed. Planning can increase the probability of adequate resources, faculty productivity, and student learning. When planning service learning activities, addressing the following questions will assist in evaluating projects: Is there a the match between academic mission and community needs? What commitment will be made to the community? Will the project promote faculty productivity? Will it offer students superior learning opportunities? What resources will the project require?

Clinical Competence↗
PubMed1998

Public hospital resource allocations in El Salvador: accounting for the case mix of patients.

National hospitals in developing countries command a disproportionate share of medical care budgets, justified on the grounds that they have a more difficult patient case mix and higher occupancy rates than decentralized district hospitals or clinics. This paper empirically tests the hypothesis by developing direct measures of the severity of patient illness, hospital case-mix and a resource intensity index for each of El Salvador's public hospitals. Based on an analysis of inpatient care staffing requirements, national hospitals are found to receive funding far in excess of what case-mix and case-load considerations would warrant. The findings suggest that significant system-wide efficiency gains can be realized by allocating hospital budgets on the bases of performance-related criteria which incorporate the case-mix approach developed here.

Bed Occupancy↗
PubMed2003

Resource allocation in offspring provisioning: an evaluation of the conditions favoring the evolution of matrotrophy.

We used analytic and simulation models to determine the ecological conditions favoring evolution of a matrotrophic fish from a lecithotrophic ancestor given a complex set of trade-offs. Matrotrophy is the nourishment of viviparous embryos by resources provided between fertilization and parturition, while lecithotrophy describes embryo nourishment provided before fertilization. In fishes and reptiles, embryo nourishment encompasses a continuum from solely lecithotrophic to primarily matrotrophic. Matrotrophy has evolved independently from lecithotrophic ancestors many times in many groups. We assumed matrotrophy increased the number of offspring a viviparous female could gestate and evaluated conditions of food availability favoring lecithotrophy or matrotrophy. The matrotrophic strategy was superior when food resources exceeded demand during gestation but at a risk of overproduction and reproductive failure if food intake was limited. Matrotrophic females were leaner during gestation than lecithotrophic females, yielding shorter life spans. Our models suggest that matrotrophic embryo nourishment evolved in environments with high food availability, consistently exceeding energy requirements for maintaining relatively large broods. Embryo abortion with some resorption of invested energy is a necessary preadaptation to the evolution of matrotrophy. Future work should explore trade-offs of age-specific mortality and reproductive output for females maintaining different levels of fat storage during gestation.

Animals↗
PubMed1996

Health status index models for use in resource allocation decisions. A critical review in the light of observed preferences for social choice.

In the last two decades a number of health status index models have been developed for assessing the value of health outcomes in terms of quality-adjusted life years. The models can be tested by comparing their implications with direct observations of how societies think resources should be distributed across patient groups. This paper reviews empirical evidence of this kind from various countries and summarizes the evidence in three rules of thumb for selecting values for health states. Nine different models are judged relative to these rules of thumb. Eight of the models underestimate the strength of social preferences for treating the severely ill before the less severely ill. The ninth has a strong bias against states associated with emotional distress. As a consequence, none of the models can be seen as sufficient stand-alone instruments for valuing health outcomes. Instead, the models may be seen as complementary and adjustable parts of a tool kit that should also include the rules of thumb suggested in this paper.

Bias↗
PubMed1985

Identifying costs of medical care. An essential step in allocating resources.

Financial constraints are imposing an urgent requirement on American medicine to control the increasing costs of medical care. Valid data on "true" costs are required to make optimum trade-offs between quality-availability and cost of medical services; unfortunately, these data are generally lacking. Standard accounting procedures provide information on expenditures for items such as utilities, pharmaceuticals, and payroll; however, these procedures cannot identify personnel costs related to a specific medical service. The Laboratory Workload Recording Method developed by the College of American Pathologists offers a proved method for calculating personnel costs in performing each type of procedure in the clinical laboratory as well as projected costs of alternative management actions. Similar principles could be applied in other areas of health care.

Canada↗
PubMed1990

Loaves & fishes by the sea. One answer to resource allocation.

How can community units ensure that services are provided on the basis of need rather than history? This article describes the efforts being made in Portsmouth and South East Hampshire (one of the country's largest health authorities) to meet this fundamental challenge. The approach taken is to match information on workloads, health care needs and neighbourhoods to facilitate effective resource management.

Catchment Area, Health↗