SEARCH · Search PubMed

Results for “Resource Allocation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources

PubMed1997

The critique of DALYs: a counter-reply.

The DALY Review Group of the WHO Advisory Committee on Health Research (ACHR) believes that, unless they are constructed purely as an intellectual exercise, indicators should have a function--ultimately to guide decision-making about resource allocation. Disability-adjusted life years (DALYs) obscure too much and in its present stage of development the DALY approach does not solve the problem of prioritization and of resource allocation and may yet turn out to have been a side-track.

Persons with Disabilities↗

PubMed2004

Algorithmic mechanism design for load balancing in distributed systems.

Computational grids are promising next-generation computing platforms for large-scale problems in science and engineering. Grids are large-scale computing systems composed of geographically distributed resources (computers, storage etc.) owned by self interested agents or organizations. These agents may manipulate the resource allocation algorithm in their own benefit, and their selfish behavior may lead to severe performance degradation and poor efficiency. In this paper, we investigate the problem of designing protocols for resource allocation involving selfish agents. Solving this kind of problems is the object of mechanism design theory. Using this theory, we design a truthful mechanism for solving the static load balancing problem in heterogeneous distributed systems. We prove that using the optimal allocation algorithm the output function admits a truthful payment scheme satisfying voluntary participation. We derive a protocol that implements our mechanism and present experiments to show its effectiveness.

Journal Article↗

PubMed2001

Allocating fertility services by medical need.

Infertility services often receive little or no public funding because they are perceived not to meet a medical need. This article argues that it is plausible to think of fertility treatment as a medical need. Medical needs deserve serious consideration in resource allocation. Such needs arise when there is a disruption of normal species function (disease), which results in a limitation of fair equality of opportunity. Fair equality of opportunity is important because it is required for a person's ability to live a good life. Infertility can result in a medical need because it can be a disruption of normal species function and can result in diminished opportunity, which it is highly relevant to the conception of a good life of many people. Infertility services deserve serious consideration in resource allocation.

Female↗

PubMed1987

A grant rationing model for a health care system.

Most public health programs are created through a political process and the health administrator's resource allocation decision is influenced not only by the relative performance of the subunits but also by political considerations. This paper presents a goal programming model for rationing available grants to competing health care subunits on the basis of performance subject to resource and political constraints. Performance is defined in terms of output adjusted for non-compliance on the identified quality of care and administrative efficiency criteria. The quality and efficiency criteria are those specified by the Federal agency as amended by local funding authorities and subunit administrators through a Delphi process. The model has the advantage of flexibility and can be easily adapted to suit prevailing financial and political conditions. In particular, it can be used as a viable analytical tool in health care and other public service agencies where political considerations are important in resource allocation decisions.

Community Health Centers↗

PubMed2001

The pattern of ambulance arrivals in the emergency department of an acute care hospital in Singapore.

OBJECTIVES: (1) To determine the pattern of ambulance arrivals in the emergency department (ED) and (2) to review resource allocation based on these data. METHODS: All (13 697) ambulance arrivals in 1996 to the ED of Tan Tock Seng Hospital were studied and where relevant compared with the walk in and total arrivals of the same year. The following data were obtained from computer records: (a) patients' demographic data; (b) number of ambulance arrivals by hour; (c) the classification of the ambulance arrivals by emergency or non-emergency, trauma or non-trauma; (d) cause of injury for trauma cases; (e) discharge status. RESULTS: The ambulance arrivals in 1996 constituted 12.4% of the patient load for this department. There was no difference in modes of patient arrival to the ED by sex and ethnic group. However, there was significant evidence to show that more patients age > 60 came by ambulance than those age < 12 (p << 0.01). Some 98.5% of the ambulance arrivals were emergencies; 40.7% of the ambulance arrivals were attributable to trauma versus 27.3% of the walk in arrivals. The majority of the trauma cases brought in by ambulance were because of road traffic accidents (15.3%) or home accidents (7.4%). The peak in ambulance arrivals was between 2100-2300 hours compared with 1000-1200 for the walk in arrivals. More than half of the ambulance arrivals were admitted. CONCLUSION: In planning resource allocation and in the development of contingency plans, the resource use of ambulance patients and the pattern of their arrivals should be taken into account.

Adolescent↗

PubMed1999

[Efficacy indicators for the allocation of health resources].

This review proposes an analytical method for the development of efficacy indicators, that will allow the integration of diverse technical criteria in the allocation of health resources. Indicators of epidemiological, clinical, organizational and economic efficiency were the four levels of conceptual approach integrated in the analytical framework. The different elements of each level are interrelated to compose an analytical perspective that can be used to guide the mechanisms of resource allocation based on technical criteria. This perspective allows the development of new relevant public health instruments, specially designed for the allocation of resources.

Health Care Rationing↗

PubMed1997

Auditing outcomes from a medicine for the elderly service.

Measurement of outcome and quality of health care is currently a subject of great interest, as clinicians aim to improve the service they provide to patients, and purchasers try to allocate resources wisely. Measurement of outcome and quality of health care is currently a subject of great interest, as clinicians aim to improve the service they provide to patients and purchasers try to allocate resources wisely. Details of outcomes from a Medicine for the Elderly service are presented and their relevance discussed.

Activities of Daily Living↗

PubMed2005

The plant's capacity in regulating resource demand.

Regulation of resource allocation in plants is the key to integrate understanding of metabolism and resource flux across the whole plant. The challenge is to understand trade-offs as plants balance allocation between different and conflicting demands, e.g., for staying competitive with neighbours and ensuring defence against parasites. Related hypothesis evaluation can, however, produce equivocal results. Overcoming deficits in understanding underlying mechanisms is achieved through integrated experimentation and modelling the various spatio-temporal scaling levels, from genetic control and cell metabolism towards resource flux at the stand level. An integrated, interdisciplinary research concept on herbaceous and woody plants and its outcome to date are used, while drawing attention to currently available knowledge. This assessment is based on resource allocation as driven through plant-pathogen and plant-mycorrhizosphere interaction, as well as competition with neighbouring plants in stands, conceiving such biotic interactions as a "unity" in the control of allocation. Biotic interaction may diminish or foster effects of abiotic stress on allocation, as changes in allocation do not necessarily result from metabolic re-adjustment but may obey allometric rules during ontogeny. Focus is required on host-pathogen interaction under variable resource supply and disturbance, including effects of competition and mycorrhization. Cost/benefit relationships in balancing resource investments versus gains turned out to be fundamental in quantifying competitiveness when related to the space, which is subject to competitive resource exploitation. A space-related view of defence as a form of prevention of decline in competitiveness may promote conversion of resource turnover across the different kinds of biotic interaction, given their capacity in jointly controlling whole plant resource allocation.

Energy Metabolism↗

PubMed1991

QALYs and the equity-efficiency trade-off.

As the volume of research on quality-adjusted life years (QALYs) has increased, concern has begun to be expressed about the equity aspects of resource allocation decisions based on the results of this research. This paper suggests that a common theme running through the criticisms of the QALY approach is a concern about inequality. It also suggests that the method for incorporating distributional concerns which is currently being pursued by advocates of the QALY approach will only ever capture concerns other than a concern about inequality. The paper suggests a method for incorporating both sets of concerns into resource allocation decisions.

Cost-Benefit Analysis↗

PubMed1984

Budgeting in health care systems.

During the last decade there has been a recognition that all health care systems, public and private, are characterised by perverse incentives (especially moral hazard and third party pays) which generate inefficiency in the use of scarce economic resources. Inefficiency is unethical: doctors who use resources inefficiently deprive potential patients of care from which they could benefit. To eradicate unethical and inefficient practices two economic rules have to be followed: (i) no service should be provided if its total costs exceed its total benefits; (ii) if total benefits exceed total costs, the level of provision should be at that level at which the additional input cost (marginal cost) is equal to the additional benefits (marginal benefit). This efficiency test can be applied to health care systems, their component parts and the individuals (especially doctors) who control resource allocation within them. Unfortunately, all health care systems neither generate this relevant decision making data nor are they flexible enough to use it to affect health care decisions. There are two basic varieties of budgeting system: resource based and production targeted. The former generates obsession with cash limits and too little regard of the benefits, particularly at the margins, of alternative patterns of resource allocation. The latter generates undue attention to the production of processes of care and scant regard for costs, especially at the margins. Consequently, one set of budget rules may lead to cost containment regardless of benefits and the other set of budget rules may lead to output maximization regardless of costs. To close this circle of inefficiency it is necessary to evolve market-like structures. To do this a system of client group (defined broadly across all existing activities public and private) budgets is advocated with an identification of the budget holder who has the capacity to shift resources and seek out cost effective policies. Negotiated output targets with defined budgets and incentives for decision makers to economise in their use of resources are being incorporated into experiments in the health care systems of Western Europe and the United States. Undue optimism about the success of these experiments must be avoided because these problems have existed in the West and in the Soviet bloc for decades and efficient solutions are noticeable by their absence.

Budgets↗

PubMed2003

The economic impact of HIV/AIDS on the education sector in Zambia.

OBJECTIVES: To estimate and project the economic impact of HIV/AIDS on the supply of education in Zambia. DESIGN: An analysis of the financial implications of HIV/AIDS for the Ministry of Education (MoE) and donors funding education in Zambia. METHODS: A mathematical model was used to project the number of primary school teachers and their HIV status under current plans for teacher training and recruitment. Cost data were compiled from the MoE, the Teacher Education Department, teacher training colleges and the donor consortium BESSIP (Basic Education Sub-Sector Investment Programme). Multivariate sensitivity analyses were performed. RESULTS: The impact of HIV/AIDS on the supply of primary education imply costs to the MoE and BESSIP estimated at US$1.3-3.1 million in 1999, and projected at $10.6-41.3 million over the period 1999-2010. These costs include salaries paid to teachers absent as a result of HIV-associated illness (71%), additional training of teachers to cope with AIDS-related attrition (22%) and funeral costs contractually met by the MoE (7%). They do not include the additional costs of an active care and prevention response by the MoE, or the burden of ensuring enrolment of AIDS orphans. The annual cost of HIV/AIDS is a relatively small fraction of the overall MoE budget (2.5% in 1999) but has substantial implications for resource allocation to some functions. Expenditure on teacher training will need to increase by 26% if Education for All targets are to be met in the face of AIDS. CONCLUSIONS: HIV/AIDS has significant implications for resource allocation in the education sector in Zambia.

Absenteeism↗

PubMed1994

Do poverty programs alleviate poverty? The case of the Mexican National Solidarity Program.

In recent years, compensatory poverty programs have been adopted in several countries in response to the social and political effects of structural adjustment programs implemented by most Latin American and African countries. The authors analyze the Mexican National Solidarity Program "Pronasol," often cited as an exemplary social compensation program, by inquiring into its impact on poverty. The authors first investigate the relationship between structural adjustment and the process of impoverishment, in order to establish the dynamics and magnitude of poverty in Mexico. They find that the structural adjustment program has considerably increased poverty, mainly through a sustained wage decrease and job losses. The authors next discuss whether Pronasol complies with the requisites of a program that warrants a social minimum for the poor, and whether the resource allocation complies with objective criteria of the sociogeographic distribution of poverty. The data suggest that Pronasol cannot be considered to guarantee a social minimum for the poor, given the magnitude of poverty, the scarce resources allocated, the orientation of the subprograms, and the regional distribution of funds. Nor does it qualify as a social compensation program of any importance. Finally, an alternative interpretation of Pronasol is offered in the field of legitimation and political control.

Employment↗

PubMed2005

Neural approximation of open-loop feedback rate control in satellite networks.

A resource allocation problem for a satellite network is considered, where variations of fading conditions are added to those of traffic load. Since the capacity of the system is finite and divided in finite discrete portions, the resource allocation problem reveals to be a discrete stochastic programming one, which is typically NP-Hard. In practice, a good approximation of the optimal solution could be obtained through the adoption of a closed-form expression of the performance measure in steady-state conditions. Once we have summarized the drawbacks of such optimization strategy, we address two novel optimization approaches. The first one derives from Gokbayrak and Cassandras and is based on the minimization over the discrete constraint set using an estimate of the gradient, obtained through a "relaxed continuous extension" of the performance measure. The computation of the gradient estimation is based on infinitesimal perturbation analysis (IPA). Neither closed forms of the performance measures, nor additional feedbacks concerning the state of the system and very mild assumptions about the stochastic environment are requested. The second one is the main contribution of the present work, and is based on an open-loop feedback control (OLFC) strategy, aimed at providing optimal reallocation strategies as functions of the state of the network. The optimization approach leads us to a functional optimization problem, and we investigate the adoption of a neural network-based technique, in order to approximate its solution. As is shown in the simulation results, we obtain near-optimal reallocation strategies with a small real time computational effort and avoid the suboptimal transient periods introduced by the IPA gradient descent algorithm.

Algorithms↗

PubMed1994

Pharmaceutical services and inpatient drug costs in bone marrow transplantation.

A survey of U.S. bone marrow transplantation (BMT) programs was conducted to determine the role of pharmaceutical services in those programs and the pharmacy department resources allocated to support them. Surveys were sent to 92 U.S. BMT programs to solicit the following information: characteristics of the institution and the BMT program, extent of pharmacist involvement in the BMT program, and pharmacy resource allocation to the program. Fifty-five responses were received (60% response rate). BMT pharmacists were employed by 53 of these institutions (a total of 66 pharmacists). BMT pharmacists at 49 of the 53 institutions (92%) received their salary from the department of pharmacy. Common BMT pharmacist responsibilities included managing adverse effects (100% of respondents), adjusting medication doses (96%), providing drug information (94%), participating in BMT team rounds (87%), maintaining medication profiles (85%), and developing medication protocols (81%). Inpatient BMT-related drug costs (reported by 37 respondents) averaged 12% of the pharmacy's annual inpatient drug budget. One or more pharmacists were members of the BMT team at 46 of 53 institutions. BMT-related drug costs accounted for 12% of the total inpatient drug budget at the 37 institutions reporting cost data.

Bone Marrow Transplantation↗

PubMed1993

Guidelines for the adoption of new technologies: a prescription for uncontrolled growth in expenditures and how to avoid the problem.

The guidelines proposed by Laupacis and associates do not stem from economic theory and are a prescription for uncontrolled growth in health care expenditure. In particular, cost-effectiveness ratios provide information relevant to allocation decisions only in very special circumstances that do not usually apply in practice. When two interventions are compared a positive cost-effectiveness ratio (the common case) can tell us, at best, what additional costs will be incurred to generate the additional outcomes. From an economic perspective the information required to determine the attractiveness of a new technology is different: the source of the additional resource requirements must be identified and the opportunity cost of their redeployment estimated. Because the cost-effectiveness ratio (cost/-QALY) is sensitive to the method chosen to calculate QALYs, guidelines that do not specify (or justify) the appropriate method for calculating outcomes are unlikely to produce comparable results (or common yardsticks). In a health care system such as Canada's in which there is always pressure to introduce more effective technology, even if it is more costly, there is a risk of using such noncomparable data to justify adoption of particular technologies. The method of technology evaluation proposed by us is consistent with the stated goal of maximizing the community's health-related well-being for a given level of resources allocated to health care and ensures that new technologies are adopted only if this adoption represents an improvement in resource allocation.

Canada↗

PubMed2002

Effect of geographic migration on SMI prevalence estimates.

The prevalence of serious mental illness (SMI) varies by the socioeconomic characteristics of communities. This variation is presumed to be due to the differential incidence of disorders caused by adverse social factors (social causation) and differential geographic migration (social selection and drift). The objective of this study was to measure the geographic migration patterns of adults treated for SMI. A sample of 11,725 adults with three or more psychiatric hospital admissions between July 1978 and November 1992 was drawn from inpatient records. At least one third migrated to different counties between first and last admission. Migration rates were higher for Whites than for African Americans and higher for unmarried than for married patients. There were no significant differences in migration rates by gender or mental disorder. Patient migration did not parallel shifts in the general population. Patient migration was generally toward medium-size, low-income urban counties with relatively declining general populations, and movement was away from both the most rural and the largest urban counties. Public needs assessments and resource allocation policies may understate the need in communities with net SMI out-migration and overstate endemic need where there is net in-migration. In the long term, these same policies may induce migration through resource allocation decisions.

Adolescent↗

PubMed1999

Metabolic engineering from a cybernetic perspective. 2. Qualitative investigation of nodal architechtures and their response to genetic perturbation

A cybernetic representation of the branch point development of Stephanopoulos and Vallino is formulated. The model systems are employed to translate the qualitative properties of the nodal control architectures characterized by Stephanopoulos and Vallino into a mathematical context. It is shown that a cybernetic model in which the objective is the independent maximization of the levels of branch point products is consistent with the characterization of a flexible node. In contrast, the rigid control architecture is shown to be equivalent to the maximization of the mathematical product of the branch point products. It has been demonstrated subsequently that cybernetic metabolic network models are capable of predicting the system response to enzymatic amplification. However, given the complicated nature of the subsequent models, a clear illustration of the basic mechanism by which such predictions are manifested is not forthwith. Thus, a second objective of the present work is the examination of the response of the flexible and rigid control architectures to genetic perturbation, specifically enzymatic overexpression, with the expressed aim of elucidating the mechanism by which a cybernetic model predicts metabolic network responsiveness. It is shown that the ramifications of genetic perturbation are transmitted through the cybernetic representation of a metabolic network via the resource allocation structure which acts as the conduit by which regulatory signals are transmitted to seemingly unconnected portions of the network. It is postulated that enzymatic overexpression under an artificial promoter represents, from the perspective of the microorganism, an uncontrollable resource drain that forces the metabolic network control architecture to reevaluate the standing resource allocation policy as implemented via the cybernetic control variables. In biological terms, the reevaluation of allocation policy implies a shift in the level and activity of network enzymes yielding, in some cases, qualitatively different network function. It is our position that, conceptually, this is equivalent to the conventional wisdom that genetic manipulation of a metabolic network is the impetus for shifts in the network functionality, i.e., enzyme levels as well as activity. Thus, this development provides a necessary intellectual precursor for the formulation and analysis of the model systems that follow.

Journal Article↗

PubMedDate not supplied

[Neuropsychologic function of the depressive patient. A lexical decision investigation in major depression].

According to the Resource Allocation Model, it is logical to think that emotional mood states modulate the allocation of capacity, most cognitive tasks require some allocation of capacity, and in many instances there is a positive correlation between effort and memory. In cognitive science, the experimental paradigm of lexical decision task is used to investigate visual words recognition and lexical access. According to the Resource Allocation Model, we postulated that depressed patients take more time to recognize items from an affective loaded list. In order to compare their behavior in lexical decision task in this study, depressed patients and healthy controls were studied. We hoped to find an interaction between the mood state of subjects and the categories (affective or neutral) of words. This kind of interaction is expected to figure among the cognitive markers of depression. Two groups of right-handed adults served as subjects in our experiment. The subjects were living in the north west region of Quebec. The first group consisted of 11 depressed patients (mean age: 40.2; SD: 6.8). All of them met the DSM III criteria for major depressive disorder and the RDC. Patients were rated using the 24-item Hamilton Depression Rating Scale (HDRS). All depressed patients were without medications. The control group was composed with 24 subjects (mean age: 32.7; SD: 7.9). We built a depressive word-list (Mood-list) and a neutral word-list (Neutral-list) and used a computer for the lexical-decision task. We noted a significant interaction [F(1.33) = 10,035, p < 0.001] between the subjects group (depression vs control) and the words category (Moodlist vs Neutral-list).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗