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Results for “resource allocation”

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At least 163 records · Page 9Linked to original sources
PubMed1999

Factors other than environmental issues influence resource allocation decisions of school foodservice directors.

OBJECTIVE: To identify resource allocation decisions and policies and procedures used by school foodservice directors that were based on the concepts of pollution prevention, product stewardship, and sustainable development. DESIGN: A questionnaire about operational characteristics (including equipment and production systems, menu selection and service style) and environmental issues was mailed to school foodservice directors. SUBJECTS/SETTING: Subjects were school foodservice directors in major cities who were members of the American School Food Service Association. Of the 389 questionnaires mailed, 168 (45.5%) were returned and used for data analysis. STATISTICAL ANALYSIS PERFORMED: Descriptive statistics, analysis of variance, and correlation were used to analyze data. RESULTS: Cost factors were rated more important (P < or = .05) than environmental factors when operational decisions were made. Labor was ranked as the most important future issue by 45.0% of respondents, but it was not the most important factor when current operational decisions were made. Less than 20.0% of the respondents indicated that their districts had specific water (3.3%), energy (14.2%), or solid waste management policies (16.0%). However, 62.6% of respondents stated that their district had a recycling program. APPLICATIONS/CONCLUSIONS: With the exception of recycling programs, school foodservice departments have not adopted a framework of pollution prevention, product stewardship, and sustainable development practices. Recycling and energy conservation programs and use of locally grown food products would minimize the environmental impact of school foodservice operations while reducing operational costs.

Conservation of Natural Resources↗
PubMed1993

Rurality and resource allocation in the UK.

Unlike many other countries, the health and health care of rural populations are not often seen as specific concerns by the United Kingdom's health service. This paper considers the present ways in which resource allocation within the National Health Service takes account of rural areas and highlights a number of inconsistencies. It goes on to discuss ways in which rurality could influence future resource allocation formulas, and identifies priorities for future research.

Data Collection↗
PubMed1995

Values, participatory democracy, and healthcare resource allocation: an application to a campus community.

As healthcare reform is debated, it is important that decision makers consider the values of all citizens, that is, what people find desirable or useful about healthcare services. Several states have used town meetings in an effort to determine their citizens' views on the values in the realm of healthcare. In this article, the authors describe a process in which individuals actively participate in an open discussion about issues surrounding allocation of healthcare resources in a university setting. Three different groups from the university community participated in separate, structured meetings to discuss their values concerning the allocation of scarce healthcare resources. Such meetings give participants opportunities to learn about their values and those of other persons in the community.

Democracy↗
PubMed1997

Resource allocation in neonatal and medical ICUs. Epidemiology and rationing at the extremes of life.

This study compared resource allocation to patients who eventually die in neonatal ICUs (NICUs) and adult medical ICUs (MICUs). It was performed via retrospective, chart review study at ICUs at the University of Chicago-an inner city, tertiary care, academic medical center. All patients were admitted to the neonatal, general medical, or coronary ICU during 1 calendar yr. Overall mortality in the NICU (66/827; 7.9%) was significantly lower than in the adult ICUs (219/1320; 16.5%) (p < 0.001). However, mortality for the smallest newborns (< 751 g; 51% mortality) was higher than for the oldest adults (> 54 yr; 30% mortality) (p = 0.05). Fifty-six percent (37/66) of all neonates who died in the NICU did so within the first 48 hr of life. In contrast, nearly two-thirds (134/219) of adult ICU deaths occurred after 48 hours in the ICU (p < 0.02). The percentage of ICU bed-days devoted to nonsurviving adults (28.8%) was significantly larger than the percentage of NICU bed-days devoted to nonsurviving babies (7.8%). Even among babies at greatest risk to die (birth weight < 751 g), the percentage of NICU bed-days allocated to nonsurviving infants was less than 20%. In contrast, for the oldest ICU patients (> 84 yr) this value exceeded 50%, for ICU patients > 84 yr old who required mechanical ventilation, the percentage of ICU bed-days allocated to nonsurvivors approached 90%. Care for the elderly in MICUs involves a far greater proportional expenditure of money toward those who will not survive than does care for newborns in NICUs. To the extent that allocation decisions are driven by concerns about distributive justice and the efficient use of scarce resources, it would be more justifiable to ration intensive care for the very old than the very young.

Adult↗
PubMed1992

Resource allocation problems and health services for the elderly.

The provision of appropriate health support services for the elderly has increased in importance because of the trend towards aging populations in Europe and other developed regions. Health service resource allocation models and their roles in health service systems, which are also changing to reflect changing needs for the elderly, are discussed in this article. Different types of economic and health care delivery systems are examined, particularly those leading towards decentralization, consumer participation and "deinstitutionalization". A promising resource allocation approach--the "balance-of-care" approach--is described in some detail. This and other potential approaches make it possible to identify areas which hold promise for crossnational research.

Aged↗
PubMed1999

Resource allocation in integrated delivery systems and healthcare networks: a proposed framework to guide ethical thinking.

Drawing on a management perspective and the literature, this article suggests an ethical framework to be used at the meso or community level of resource allocation in a Canadian setting. The suggested framework enlarges on the program-level framework developed by Meslin et al primarily by building in stakeholder inclusiveness and public accountability, both of which are essential to resource allocation at the population-based level.

Canada↗
PubMed1998

Caries preventive services for children and adolescents in Denmark, Iceland, Norway and Sweden: strategies and resource allocation.

According to the dental acts of Denmark, Iceland, Norway and Sweden, emphasis is placed on preventive dental care. The purpose of this study was to describe and compare two aspects of the caries preventive services: the strategies and the resource allocation for preventive dental care of children and adolescents in Denmark, Iceland, Norway and Sweden. Questionnaires were sent to samples of dentists and other dental personnel who provided preventive care to children during 1995 and 1996. Comparisons between the countries showed significant differences in recall routines and in implementation of risk-based and population-based preventive strategies. Multivariate analyses showed that the time used for preventive care varied by country and was not associated with the DMFT of the children. More time was allocated for prevention when more operating dental auxiliaries were available at the clinic, when the recall interval was shorter, when the time used for routine examination was longer and when the clinician was an auxiliary rather than a dentist. In conclusion, resource allocation and strategies used for prevention were not consistent between the countries.

Adolescent↗
PubMed1995

"Socialized medicine," resource allocation and two-tiered health care--the Danish experience.

This paper describes the present resource allocation problems in the Danish tax-based public health care system and presents an analysis of the two policy options put forward as a solution to these problems: (1) explicit rationing of services, and (2) the introduction of two-tiered health care. It is argued that a two-tiered system with a private second tier is unlikely to be acceptable and viable in Denmark, whereas an introduction of a second tier within the public system may be more acceptable. It is further argued that present implicit rationing methods may be unethical and ought to be replaced by explicit rationing.

Delivery of Health Care↗
PubMedDate not supplied

Severity of illness and resource allocation in DNR patients in ICU.

This study examined the differences in severity of illness and resource allocation between patients with do-not-resuscitate (DNR) orders and non-DNR patients in intensive care units. Severely ill intensive care patients with DNR orders continued receiving aggressive medical care following cardiac or respiratory arrest. The continued use of advanced therapies for DNR patients raises important questions about the use of costly intensive care resources.

Adult↗
PubMed1997

Is it cost effective to introduce screening programmes for colorectal cancer? Illustrating the principles of optimal resource allocation.

This paper seeks to shed light on the relative cost effectiveness of colorectal cancer by comparing the cost effectiveness of this programme with the economics of another screening programme which is widely implemented: cervical cancer screening. The paper illustrates the principles of optimal resource allocation, and discusses the limitations and strengths of the analysis presented. The paper concludes that colorectal cancer is a cost effective option relative to cervical cancer screening when health is seen as the only outcome of the screening programmes. However, further insight into consumer preferences and inclusion of intangible costs and benefits is necessary in order to guarantee optimal resource allocation.

Adult↗
PubMed1998

Sailing without radar: an excursion in resource allocation.

This paper deals with the knowledge base employed in resource allocation. It deliberately distinguishes between 'thick-textured' and 'thin-textured' knowledge. A thick-textured view of change in the health sector accounts for the history, civic goods and variety of human needs and passions which rationalist economics defines out as a thin-textured matter of individual choices in a free market. The narrative material begins with a discussion of health service policy-making in South Australia and elsewhere in the 1980s and 1990s, then proceeds to a discussion of priority-setting literature, which we regard as thin-textured. We offer two accounts of approaches to setting priorities in health care which we think have overcome some of the deficiencies of the thin-textured approach.

Community Participation↗
PubMed1996

Data and information requirements for the Department of Veterans Affairs resource allocation systems.

The department of Veterans Affairs (VA) uses a global budgeting process to allocate congressionally appropriated resources to provide medical care to veterans. The Department of Veterans Affairs has developed this process to accommodate the effects of changes in pure inflation, workload, and cost per unit of work in forecasting operating dollars required for facility global budgets. In 1990, VA began shifting to a new method of allocating its global budget called Resource Planning and Management (RPM), based on a capitated system. Facilities receive resources according to their unit costs and the number and type of patients they are expected to serve. A key characteristic of any global budgeting information system is flexibility. The VA information system accesses the portion of each patients's care that is provided at every facility and aggregates this information across all facilities to create a single prorated patient record; the system reconstructs prior years of data into the new patient-centered format to forecast workload. No other health care system in the United States pays for and directly provides such a diverse set of services for such a large population as does VA. Nevertheless, many of the problems VA faces are similar to those of other providers and insurers.

Budgets↗
PubMed2006

Law, patient's rights and NHS resource allocation: is Eurostar the answer?

Historically attempts to use the courts as a means of challenging decisions to refuse NHS resources have met with little success. However two recent developments, that of the Human Rights Act 1998 and the development of European Union law through the application of Article 49 of the EC Treaty have provided the prospect for a challenge to this position. This article examines the impact of a recent case that of Watts v Bedford PCT in which a woman sought to by-pass NHS waiting lists by seeking treatment in France and then claimed reimbursement of the cost of the operation and the possible impact of this case in the context of patients's rights and resource allocation.

European Union↗
PubMed2006

Do tiny males grow up? Sperm competition and optimal resource allocation schedule of dwarf males of barnacles.

Barnacles, marine crustaceans, have three sexual patterns: simultaneous hermaphroditism, dioecy and androdioecy. In dioecy and androdioecy, large individuals (females and hermaphrodites, respectively) are attached by dwarf males. Depending on species, some dwarf males grow up, others do not in their life time. To investigate which environmental conditions affect growth patterns of dwarf males of barnacles, we investigate the evolutionarily stable life history strategy of dwarf males using Pontryagin's maximum principle. Sperm competition among dwarf males and that among dwarf males and large hermaphrodites is taken into account. Dwarf males grow up in food-rich environments, while they do not grow at all in food-poor environments. ESS of the resource allocation schedule between reproduction and growth follows an "intermediate growth strategy" (simultaneous growth and reproduction) for dioecious species, in which sperm competition is not severe. On the other hand, it approaches "bang-bang control" (switching from allocating all resources toward growth then to reproduction), as sperm competition against surrounding large hermaphrodites becomes severe in androdioecious species.

Animals↗
PubMed2005

Age and season impact resource allocation to eggs and nesting behavior in the painted turtle.

Theory predicts that in long-lived organisms females should invest less energy in reproduction and more in growth and self-maintenance early in life, with this balance shifting as females age and the relative value of each reproductive event increases. We investigated this potential trade-off by characterizing within-population variation in resource allocation to eggs by female painted turtles (Chrysemys picta) and relating this variation to their nesting ecology and life history. We examined lipid and protein allocation to yolks, accounting for both relative female age and seasonal effects (first vs. second clutches within a female). Older females appear to increase their investment in reproduction by producing larger eggs, but these eggs are not disproportionately more lipid or protein rich than the smaller eggs from younger females. Within the nesting season, first clutches have more lipid and protein than second clutches. We also found that younger females nest closer to the water than older females. Our results indicate that trade-offs involving resource allocation and nesting behavior do occur both seasonally and with age, suggesting ontogenetic variation in life-history strategies in this long-lived organism.

Age Factors↗
PubMed2006

Resource allocation to brain research in Europe (RABRE).

This article is a markedly condensed summary of a longer report [Resource allocation to brain research in Europe (RABRE), part 2] that is simultaneously published on line: (i) as supplementary material linked to this European Journal of Neuroscience article (http://www.blackwell-synergy.com/loi/ejn) and (ii) on the website of the European Brain Council (http://www.europeanbraincouncil.org/publications). We have recently shown that brain diseases account for 35% of the overall disease burden and cost European society almost euro 400 billion per year (a billion is understood to mean one thousand million throughout this report). The aim of the present study was to estimate funding for brain research in Europe and the cost-benefit of further investments in this area of research. The assessment of funding included public sources (governmental agencies plus charities) and industry funding. The assessment of publicly financed research support for brain research was based on a comprehensive survey, and industry investment in brain research was assessed based on published data on pharmaceutical development. The total funding of brain research in Europe was estimated at euro 4.1 billion in 2005, of which public grants amounted to < euro 900 million. Thus, industry funding accounted for 79%. Although cancer only incurred 50% of the cost of brain diseases in 2005, public grants for cancer research were almost twice as high as the public financial support of brain research. US-based funding of brain research was almost four times higher than European funding. We assessed the cost-benefit of further investment in brain research using different methods. They all showed that increased investment in brain research is likely to be highly cost-effective. We conclude that European spending on brain research, particularly public spending, is low compared to other fields of research and to the US, and that increased investment in brain research seems warranted.

Animals↗
PubMed1998

The ethics of resource allocation: the views of general practitioners in Lincolnshire, U.K.

Concerns about the intrusion of economic and financial considerations into patient management have increased in the United Kingdom, largely as a result of the passage of the 1990 National Health Services Act. Based on an agenda set by the British Medical Association, a questionnaire was designed to reveal general practitioners' attitudes to potential ethical problems posed by rationing and resource allocation. The questionnaire was issued to each of the 105 practices in Lincolnshire and 70 replies were returned for analysis. The survey revealed that, in certain areas, there existed a wide divergence of opinion amongst physicians. Examples included the extent to which the government was to be held responsible for full health care funding, the legitimacy or otherwise of general practice budgets and the extent to which service provision should be dependent on upon personal remuneration. On the other hand, relatively high degrees of consensus appeared to exist with respect to issues such as rationing by deterrence and service dilution. Additional, qualitative, evidence suggests that practitioners perceive themselves to be under increasing pressure from patient demand and that morale in the profession is falling. The results of the present study appear consistent with those obtained in other countries. In view of recent policy initiatives with respect to public sector health care, it is likely that the debate over the ethical dimensions of resource allocation in the U.K. will become more vigorous.

Attitude of Health Personnel↗
PubMed2004

A resource allocation model describing consequences of artificial selection under metabolic stress.

Long-term selection on production results in increased environmental sensitivity. This often is expressed through decreased fertility and increased health problems. The phenomenon has been described in all common farm animal species. One theory is that potential resource intake is insufficient to express production potential. Additional resources are drawn away from fitness-related traits, such as fertility and health, to further increase observed production. In addition, resources for maintaining fitness depend on the demands by the environment. In a harsh environment, more resources are required for fitness-related traits than in an optimal environment. Literature results show that selection in an optimal environment will increase sensitivity to less optimal environments. The objectives of this paper were to increase understanding of the underlying mechanism behind the development of environmental sensitivity and to gain insight into correlated response(s) when selection is on observed production. A resource allocation model was defined where observed production depended on production potential, resource intake potential, and the allocation of resources to production or fitness, including maintenance, health, and reproduction. Penalties for reproductive performance and probability of survival were included when the proportion of resources assigned to fitness dropped below a certain, environment-related, threshold. Mass selection was practiced on observed production during 40 generations using stochastic simulation. Depending on the heritabilities of the underlying components and on the environment, selection on observed production resulted in a decrease in reproductive rate and in the development of environmental sensitivity when resource intake becomes limiting. Correlations of observed production with underlying components changed across generations, following a nonlinear pattern. The proposed model is simple, but increases the understanding of underlying mechanisms and consequences of selection for production when resources are limiting.

Animal Husbandry↗