Employment-based health benefits and public-sector coverage: opportunity for leadership.

PubMed

Darling, Helen

2006-01-01

In this commentary, Helen Darling, speaking from the large-employer perspective, responds to James Robinson's paper on the mature health insurance industry, which faces declining opportunities with employer-based health benefits and growing but less appealing public-sector opportunities for management and other services. The similar needs of public and private employers and payers provide an opportunity for leadership, accelerating innovation and using value-added services to improve safety, quality, and efficiency of health care for all.

"Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory.

PubMed

Preker, A S; Harding, A; Travis, P

2000-01-01

A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced.

"Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory.

PubMed Central

Preker, A. S.; Harding, A.; Travis, P.

2000-01-01

A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced. PMID:10916915

Firm efficiency and returns-to-scale in the honey bee pollination services industry

USDA-ARS?s Scientific Manuscript database

Honeybees are well-known for producing honey, but they also provide critical ecosystem services through pollination (Goulson, 2003; Potts et al., 2010; Ványi et al., 2012). This pollination service is vital to the production of many cash crops, on which the U.S. agricultural sector depends (Aizen an...

Scaling up the energy service company business: market status and company feedback in the Russian Federation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roshchanka, Volha; Evans, Meredydd

Many energy efficiency professionals have proposed using Energy Performance Contracts (EPCs) as a mechanism to improve public sector energy efficiency in countries with restrictive government budgets. However, in practice, most middle-income countries have used this mechanism only in a limited way. Russia offers an interesting case study because of its huge energy savings opportunities, increasing energy prices, robust political backing for public sector energy efficiency, and evolving legislation that supports EPCs. In 2009, the Russian Federation launched a program to reduce the energy intensity of the country’s large public sector, which accounts for 9 percent of Russia’s total energy consumption.more » To achieve energy efficiency goals, Russia experimented with its public procurement rules, adjusting them to encourage EPCs. We conducted structured interviews with Energy Service Companies (ESCOs) in Russia and supplemented them with online research. Our review shows that, to date, nearly 50 ESCOs signed about 150 contracts in public facilities. Most ESCO contracts in Russia are for 5 years, and they generally are small (under $100,000). ESCOs in Russia face a challenging environment, which leads to smaller projects. ESCOs also are concerned about costly and risky tender procedures, uncertainty regarding repayment from public facilities, the inability to expand projects, and financing. We discuss these challenges and propose potential solutions at policy and company levels. The ESCOs feedback regarding Russia’s experimental model can inform the country’s program for public sector energy efficiency and offer lessons for other countries attempting to develop the EPC mechanism.« less

Modeling Financial Innovation and Economic Growth: Why the Financial Sector Matters to the Real Economy

ERIC Educational Resources Information Center

Chou, Yuan K.

2007-01-01

The author devises a simple way of incorporating the financial sector into a growth model that is pedagogically useful. Financial innovation raises the efficiency of financial intermediation by increasing the variety of financial products and services, resulting in improved matching of the needs of individual savers with those of firms raising…

Managing risk selection incentives in health sector reforms.

PubMed

Puig-Junoy, J

1999-01-01

The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Langner, Rois; Hendron, Bob; Pless, Shanti

Small buildings have been left behind in the energy efficiency marketplace because financial and technical resources have flowed to larger commercial buildings. DOE's Building Technologies Office works with the commercial building industry to accelerate the uptake of energy efficiency technologies and techniques in existing and new commercial buildings (DOE 2013). BTO recognizes the SBSP sector'spotential for significant energy savings and the need for investments in resources that are tailored to this sector's unique needs. The industry research and recommendations described in this report identify potential approaches and strategic priorities that BTO could explore over the next 3-5 years that willmore » support the implementation of high-potential energy efficiency opportunities for thisimportant sector. DOE is uniquely positioned to provide national leadership, objective information, and innovative tools, technologies, and services to support cost-effective energy savings in the fragmented and complex SBSP sector. Properly deployed, the DOE effort could enhance and complement current energy efficiency approaches. Small portfolios are loosely and qualitatively defined asportfolios of buildings that include only a small number of small buildings. This distinction is important because the report targets portfolio owners and managers who generally do not have staff and other resources to track energy use and pursue energy efficiency solutions.« less

The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries.

PubMed Central

Palmer, N.

2000-01-01

Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919

Exploring the influence of context and policy on health district productivity in Cambodia.

PubMed

Ensor, Tim; So, Sovannarith; Witter, Sophie

2016-01-01

Cambodia has been reconstructing its economy and health sector since the end of conflict in the 1990s. There have been gains in life expectancy and increased health expenditure, but Cambodia still lags behind neighbours One factor which may contribute is the efficiency of public health services. This article aims to understand variations in efficiency and the extent to which changes in efficiency are associated with key health policies that have been introduced to strengthen access to health services over the past decade. The analysis makes use of data envelopment analysis (DEA) to measure relative efficiency and changes in productivity and regression analysis to assess the association with the implementation of health policies. Data on 28 operational districts were obtained for 2008-11, focussing on the five provinces selected to represent a range of conditions in Cambodia. DEA was used to calculate efficiency scores assuming constant and variable returns to scale and Malmquist indices to measure productivity changes over time. This analysis was combined with qualitative findings from 17 key informant interviews and 19 in-depth interviews with managers and staff in the same provinces. The DEA results suggest great variation in the efficiency scores and trends of scores of public health services in the five provinces. Starting points were significantly different, but three of the five provinces have improved efficiency considerably over the period. Higher efficiency is associated with more densely populated areas. Areas with health equity funds in Special Operating Agency (SOA) and non-SOA areas are associated with higher efficiency. The same effect is not found in areas only operating voucher schemes. We find that the efficiency score increased by 0.12 the year any of the policies was introduced. This is the first study published on health district productivity in Cambodia. It is one of the few studies in the region to consider the impact of health policy changes on health sector efficiency. The results suggest that the recent health financing reforms have been effective, singly and in combination. This analysis could be extended nationwide and used for targeting of new initiatives. The finding of an association between recent policy interventions and improved productivity of public health services is relevant for other countries planning similar health sector reforms.

Privatization of municipal waste management services in Virginia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arner, R.

As the cost of waste management has increased dramatically in recent years, public works and environmental services officials in Virginia responsible for waste management are exploring how various delivery systems can enhance the efficiency and effectiveness of these services. Shifting some service delivery from the public to the private sector, or vice versa, are approaches that may have the potential to improve efficiency. However, each jurisdiction's waste management requirements differ, and there is no cookie-cutter approach. The following discusses various privatization/publicization opportunities and under what conditions these strategies may be developed to the benefit of localities.

Technology Transfer: Use of Federally Funded Research and Development

DTIC Science & Technology

2007-03-19

private sector ; the government’s requirements for products and processes to operate effectively and efficiently; and the demand for increased goods and services at the state and local level. Congress has established a system to facilitate the transfer of technology to the private sector and to state and local governments. Despite this, use of federal R&D results has remained restrained, although there has been a significant increase in private sector interest and activities over the past several years. Critics argue that

Land use efficiency: anticipating future demand for land-sector greenhouse gas emissions abatement and managing trade-offs with agriculture, water, and biodiversity.

PubMed

Bryan, Brett A; Crossman, Neville D; Nolan, Martin; Li, Jing; Navarro, Javier; Connor, Jeffery D

2015-11-01

Competition for land is increasing, and policy needs to ensure the efficient supply of multiple ecosystem services from land systems. We modelled the spatially explicit potential future supply of ecosystem services in Australia's intensive agricultural land in response to carbon markets under four global outlooks from 2013 to 2050. We assessed the productive efficiency of greenhouse gas emissions abatement, agricultural production, water resources, and biodiversity services and compared these to production possibility frontiers (PPFs). While interacting commodity markets and carbon markets produced efficient outcomes for agricultural production and emissions abatement, more efficient outcomes were possible for water resources and biodiversity services due to weak price signals. However, when only two objectives were considered as per typical efficiency assessments, efficiency improvements involved significant unintended trade-offs for the other objectives and incurred substantial opportunity costs. Considering multiple objectives simultaneously enabled the identification of land use arrangements that were efficient over multiple ecosystem services. Efficient land use arrangements could be selected that meet society's preferences for ecosystem service provision from land by adjusting the metric used to combine multiple services. To effectively manage competition for land via land use efficiency, market incentives are needed that effectively price multiple ecosystem services. © 2015 John Wiley & Sons Ltd.

Renewing Occupational Cultures--Bridging Boundaries in Learning Spaces

ERIC Educational Resources Information Center

Kalliola, Satu; Nakari, Risto

2007-01-01

Professional bureaucracies of the Finnish municipal services are challenged by many modernization pressures manifested currently in the form of New Public Management. Along with efficiency demands the new emphasis is on the provision of client-oriented services by the means of multi-professional teamwork crossing the traditional sector boundaries.…

Efficiency losses in the pollination services market: A data envelopment analysis

USDA-ARS?s Scientific Manuscript database

Honeybees, mainly known for producing honey, also provide critical ecosystems services (Goulson, 2003; Potts et al., 2010). Their pollination is vital to the production of numerous cash crops that the U.S.’s agricultural sector depends on, particularly almonds (Aizen and Harder 2009, Bond et al. 201...

Higher Education and the Market

ERIC Educational Resources Information Center

Hill, Catharine

2015-01-01

Neoclassical economists make the case for profit seeking firms in the private sector because they supply goods and services efficiently, meeting consumer demand at the least possible price and the highest quality. The government also supplies some goods and services directly, and also has made provisions for non-profit firms to do so, recognizing…

The politics of public sector change.

PubMed

Harvey, Peter

2003-05-01

As the changes underpinning the Coordinated Care Trials in South Australia have become more apparent, similarities have emerged between the rationalisation of public schooling in the mid 1980s and the transformation of public health in the 1990s. This article aims to discuss the evolution of health services in South Australia and help us answer the question of how best to manage our public and private health infrastructure in a changing economic and social context. Both strategies in education and health share common elements of cost cutting, attempts at improving efficiencies, a flirting with the private sector and the attendant risk of reduced quality of services to the public. This situation in both sectors is indicative of a shift in public policy and a growth in the belief that private management of public sector infrastructure can help resolve the funding crises around our education and health systems.

Trade in health services.

PubMed Central

Chanda, Rupa

2002-01-01

In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

Health sector reform in Brazil: a case study of inequity.

PubMed

Almeida, C; Travassos, C; Porto, S; Labra, M E

2000-01-01

Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.

[Diagnostics and Eradication Therapy for MRSA Carriers in the Outpatient Sector: an Analysis of the Reimbursement Situation in the Light of Current Reimbursement Changes].

PubMed

Schwendler, M; Hübner, C S; Fleßa, S

2017-10-01

Infection with methicillin-resistant Staphylococcus aureus (MRSA) occurs in both the inpatient and outpatient sector. The reimbursement for diagnostic services and eradication therapy in the outpatient sector was regulated for the first time on 01.04.2012 and after a 2-year test period, has been adopted into the standard range of care services. The aim of this retrospective study was to give an overview of the current situation in services and reimbursement in Germany and describe MRSA patients and their treatment in the outpatient sector. Secondary data, namely reimbursement data of the National Association of Statutory Health Insurance Physicians (KBV) und the Physicians' Association (KV) Mecklenburg-West Pomerania for the period 01/04/2012-31/03/2014 were analyzed. Results show that on the federal level, MRSA services amounting to € 3,235,870.18 have been reimbursed and that diagnostic costs exceed treatment costs. In Germany, 5,627 doctors invoiced services related to MRSA; 51,56% of these were general practitioners and 21,25% specialists in internal medicine working in general practice. In the KV Mecklenburg-Western Pomerania, patients were elderly (average age 69,13), cost for services were on average 27,76 €, and 76,85% of the patients were treated within one quarter. On the whole, there were regional differences in the identification and eradication of MRSA in the outpatient setting. In order to provide an extended base for a more efficient resource allocation in the health care sector, in addition to analysis of MRSA eradication from the medical point of view, attention needs to be paid to patient flow between the out- and inpatient sectors, as well as economic aspects. © Georg Thieme Verlag KG Stuttgart · New York.

Cost accounting methodologies in price setting of acute inpatient services in Hungary.

PubMed

Gaal, Peter; Stefka, Nóra; Nagy, Júlia

2006-08-01

On the basis of documentary analysis and interviews with decision makers, this paper discusses the cost accounting methodologies used for price setting of inpatient services in the Hungarian health care system focusing on sector of acute inpatient care, which is financed through the Hungarian adaptation of Diagnosis Related Groups since 1993. Hungary has a quite sophisticated DRG system, which had a deep impact on the efficiency of the acute inpatient care sector. Nevertheless, the system requires continuous maintenance, where the cooperation of hospitals, as well as the minimisation of political influence are critical success factors.

Performance Contracting and Energy Efficiency in the State Government Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bharvirkar, Ranjit; Goldman, Charles; Gilligan, Donald

There is growing interest in energy efficiency (EE) among state policymakers as a result of increasing environmental concerns, rising electricity and natural gas prices, and lean economic times that motivate states to look more aggressively for cost-saving opportunities in public sector buildings. One logical place for state policymakers to demonstrate their commitment to energy efficiency is to 'lead by example' by developing and implementing strategies to reduce the energy consumption of state government facilities through investments in energy efficient technologies. Traditionally, energy efficiency improvements at state government facilities are viewed as a subset in the general category of building maintenancemore » and construction. These projects are typically funded through direct appropriations. However, energy efficiency projects are often delayed or reduced in scope whereby not all cost-effective measures are implemented because many states have tight capital budgets. Energy Savings Performance Contracting (ESPC) offers a potentially useful strategy for state program and facility managers to proactively finance and develop energy efficiency projects. In an ESPC project, Energy Service Companies (ESCOs) typically guarantee that the energy and cost savings produced by the project will equal or exceed all costs associated with implementing the project over the term of the contract. ESCOs typically provide turnkey design, installation, and maintenance services and also help arrange project financing. Between 1990 and 2006, U.S. ESCOs reported market activity of {approx}$28 Billion, with about {approx}75-80% of that activity concentrated in the institutional markets (K-12 schools, colleges/universities, state/local/federal government and hospitals). In this study, we review the magnitude of energy efficiency investment in state facilities and identify 'best practices' while employing performance contracting in the state government sector. The state government market is defined to include state offices, state universities, correctional facilities, and other state facilities. This study is part of a series of reports prepared by Lawrence Berkeley National Laboratory (LBNL) and the National Association of Energy Services Companies (NAESCO) on the ESCO market and industry trends. The scope of previous reports was much broader: Goldman et al. (2002) analyzed ESCO project costs and savings in public and private sector facilities, Hopper et al. (2005) focused on ESCO project activity in all public and institutional sectors, while Hopper et al (2007) provided aggregate results of a comprehensive survey of ESCOs on current industry activity and future prospects. We decided to focus the current study on ESCO and energy efficiency activity and potential market barriers in the state government market because previous studies suggested that this institutional sector has significant remaining energy efficiency opportunities. Moreover, ESCO activity in the state government market has lagged behind other institutional markets (e.g., K-12 schools, local governments, and the federal market). Our primary objectives were as follows: (1) Assess existing state agency energy information and data sources that could be utilized to develop performance metrics to assess progress among ESPC programs in states; (2) Conduct a comparative review of the performance of selected state ESPC programs in reducing energy usage and costs in state government buildings; and (3) Delineate the extent to which state government sector facilities are implementing energy efficiency projects apart from ESPC programs using other strategies (e.g. utility ratepayer-funded energy efficiency programs, loan funds).« less

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed Central

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-01-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance. PMID:17143460

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-11-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance.

[Central purchasing bodies and spending review in health sector].

PubMed

Spampinato, Luigi

2017-01-01

The aim of this paper is to analyze the new model of centralization of purchases in Italy after the approval of the 2016 Stability Law, with particular reference to the health sector. In fact, the spending review process in Italy in the health sector has had a strong evolution with the 2016 Stability Law, which has introduced the obligation for the institutions of the National Health Service to obtain supplies, exclusively, from aggregators subjects, for certain product categories of the health sector. The legislature, over the years, was mainly characterized by measures to reduce the spending limits for purchases of goods and services or by resetting the fees, including the provision of an obligation for the renegotiation of health goods and services contracts, in order to ensure the effective implementation of the expenditure rationalization by aggregation of goods and services. From 2016, the legislature has provided an innovative model of centralization of purchases based on a new network governance model on several levels, national and regional, which should ensure an efficiency of procurement processes. The proper functioning of the governance model adopted can be an important driver of economic policy in order to understand that it is important not only to spend less, but to spend better. This can be realized in the public administration with a strong innovation process in this administration and also with a strong investment in skills, in order to ensure the same service quality throughout the national territory to the health sector.

The role of private non-profit healthcare organizations in NHS systems: Implications for the Portuguese hospital devolution program.

PubMed

Almeida, Álvaro S

2017-06-01

The national health services (NHS) of England, Portugal, Finland and other single-payer universalist systems financed by general taxation, are based on the theoretical principle of an integrated public sector payer-provider. However, in practice one can find different forms of participation of non-public healthcare providers in those NHS, including private for profit providers, but also third sector non-profit organizations (NPO). This paper reviews the role of non-public non-profit healthcare organizations in NHS systems. By crossing a literature review on privatization of national health services with a literature review on the comparative performance of non-profit and for-profit healthcare organizations, this paper assesses the impact of contracting private non-profit healthcare organizations on the efficiency, quality and responsiveness of services, in public universal health care systems. The results of the review were then compared to the existing evidence on the Portuguese hospital devolution to NPO program. The evidence in this paper suggests that NHS health system reforms that transfer some public-sector hospitals to NPO should deliver improvements to the health system with minimal downside risks. The very limited existing evidence on the Portuguese hospital devolution program suggests it improved efficiency and access, without sacrificing quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Efficiency dilution: long-term exergy conversion trends in Japan.

PubMed

Williams, Eric; Warr, Benjamin; Ayres, Robert U

2008-07-01

This analysis characterizes century-scale trends in exergy efficiency in Japan. Exergy efficiency captures the degree to which energy inputs (such as coal) are converted into useful work (such as electricity or power to move a vehicle). This approach enables the estimation of net efficiencies which aggregate different technologies. Sectors specifically analyzed are electricity generation, transport, steel production, and residential space heating. One result is that the aggregate exergy efficiency of the Japanese economy declined slightly over the last half of the 20th century, reaching a high of around 38% in the late 1970s and falling to around 33% by 1998. The explanation for this is that while individual technologies improved dramatically over the century, less exergy-efficient ones were progressively adopted, yielding a net stabilization or decline. In the electricity sector, for instance, adoption of hydropower was followed by fossil-fired plants and then by nuclear power, each technology being successively less efficient from an exergy perspective. The underlying dynamic of this trend is analogous to declining ore grades in the mining sector. Increasing demand for exergy services requires expended utilization of resources from which it is more difficult to extract utility (e.g., falling water versus coal). We term this phenomenon efficiency dilution.

Private sector joins family planning effort.

PubMed

1989-12-01

Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.

The challenges of good governance in the aquatic animal health sector.

PubMed

Kahn, S; Mylrea, G; Yaacov, K Bar

2012-08-01

Animal health is fundamental to efficient animal production and, therefore, to food security and human health. This holds true for both terrestrial and aquatic animals. Although partnership between producers and governmental services is vital for effective animal health programmes, many key activities are directly carried out by governmental services. Noting the need to improve the governance of such services in many developing countries, the World Organisation for Animal Health (OIE), using the OIE Tool for the Evaluation of Performance of Veterinary Services, conducts assessments of Veterinary Services and Aquatic Animal Health Services (AAHS) to help strengthen governance and support more effective delivery of animal health programmes. While good governance and the tools to improve governance in the aquatic animal sector are largely based on the same principles as those that apply in the terrestrial animal sector, there are some specific challenges in the aquatic sector that have a bearing on the governance of services in this area. For example, the aquaculture industry has experienced rapid growth and the use of novel species is increasing; there are important gaps in scientific knowledge on diseases of aquatic animals; there is a need for more information on sustainable production; the level of participation of the veterinary profession in aquatic animal health is low; and there is a lack of standardisation in the training of aquatic animal health professionals. Aquaculture development can be a means of alleviating poverty and hunger in developing countries. However, animal diseases, adverse environmental impacts and food safety risks threaten to limit this development. Strengthening AAHS governance and, in consequence, aquatic animal health programmes, is the best way to ensure a dynamic and sustainable aquaculture sector in future. This paper discusses the specific challenges to AAHS governance and some OIE initiatives to help Member Countries to address them.

Trends in Department of Defense hospital efficiency.

PubMed

Ozcan, Y A; Bannick, R R

1994-04-01

This study employs a simple cross sectional design using longitudinal data to explore the underlying factors associated with differences in hospital technical efficiency using data envelopment analysis (DEA) in the Department of Defense (DOD) sector across three service components, the Army, Air Force and Navy. The results suggest that the services do not differ significantly in hospital efficiency. Nor does hospital efficiency appear to differ over time. With respect to the efficient use of input resources, the services experienced a general decline in excessive usage of various inputs over the three years. Analysis of the returns to scale captures opportunities for planners of changing the relative mix of output to input slacks for increasing a hospital's efficiency. That is, policy makers would get more immediate "bang per buck" with emphasis on improving the efficiencies of hospitals with higher returns to scale than other hospitals. Findings also suggest a significant degree of comparability between the DEA measure and these measures often used to indicate efficiency.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fell, Harrison; Kaffine, Daniel; Steinberg, Daniel

We investigate the role of energy efficiency in rate-based emissions intensity standards, a particularly policy-relevant consideration given that the Environmental Protection Agency's Clean Power Plan allows crediting of electricity savings as a means of complying with state-specific emissions standards. We show that with perfectly inelastic energy services demand, crediting efficiency measures can recover the first-best allocation. However, when demand for energy services exhibits some elasticity, crediting energy efficiency can no longer recover first-best. While crediting removes the relative distortion between energy generation and energy efficiency, it distorts the absolute level of energy services. Building on these results, we derive themore » conditions determining the second-best intensity standard and crediting rule. Simulations calibrated to the electricity sector in Texas find that while some form of crediting is generally welfare-improving, the proposed one-for-one crediting of energy savings is unlikely to achieve efficient outcomes.« less

Lessons learned from health sector reform: a four-country comparison.

PubMed

Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md

Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability.

Financing health development projects: some macro-economic considerations.

PubMed

Sorkin, A L

1986-01-01

The paper briefly discusses the importance of macro-economic policy in health sector financing. The ways in which monetary and fiscal policy (macro-economic policy) affect interest rates, price levels and aggregate output are presented. The main portion of the paper considers a variety of methods for public financing of health and development projects. These approaches are analyzed in light of distributional and efficiency considerations. One way of increasing health sector resources is through reallocation from other sectors of the economy. The potential for redistribution from the defense to the health service industry is briefly considered.

Quality management standards for facility services in the Italian health care sector.

PubMed

Cesarotti, Vittorio; Di Silvio, Bruna

2006-01-01

Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

Airspace Complexity and its Application in Air Traffic Management

NASA Technical Reports Server (NTRS)

Sridhar, Banavar; Chatterji, Gano; Sheth, Kapil; Edwards, Thomas (Technical Monitor)

1998-01-01

The United States Air Traffic Management (ATM) system provides services to enable safe, orderly and efficient aircraft operations within the airspace over the continental United States and over large portions of the Pacific and Atlantic Oceans, and the Gulf of Mexico. It consists of two components, Air Traffic Control (ATC) and Traffic Flow Management (TFM). The ATC function ensures that the aircraft within the airspace are separated at all times while the TFM function organizes the aircraft into a flow pattern to ensure their safe and efficient movement. In order to accomplish the ATC and TFM functions, the airspace over United States is organized into 22 Air Route Traffic Control Centers (ARTCCs). The Center airspace is stratified into low-altitude, high-altitude and super-high altitude groups of Sectors. Each vertical layer is further partitioned into several horizontal Sectors. A typical ARTCC airspace is partitioned into 20 to 80 Sectors. These Sectors are the basic control units within the ATM system.

Non-Profit Education Providers vis-a-vis the Private Sector: Comparative Analysis of Non-Governmental Organizations and Traditional Voluntary Organizations in Pakistan

ERIC Educational Resources Information Center

Bano, Masooda

2008-01-01

Under the New Policy Agenda, international development institutions have promoted non-profit organizations (NPOs) in developing countries, on a dual logic: firstly, they deliver social services more efficiently than the state; secondly, they mitigate equity concerns around privatization of basic social services by reaching out to the poor. Based…

Performance of private sector health care: implications for universal health coverage.

PubMed

Morgan, Rosemary; Ensor, Tim; Waters, Hugh

2016-08-06

Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

Frito-Lay North America/NREL CRADA: Cooperative Research and Development Final Report, CRADA Number CRD-06-176

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walker, A.

2013-06-01

Frito Lay North America (FLNA) requires technical assistance for the evaluation and implementation of renewable energy and energy efficiency projects in production facilities and distribution centers across North America. Services provided by NREL do not compete with those available in the private sector, but rather provide FLNA with expertise to create opportunities for the private sector renewable/efficiency industries and to inform FLNA decision making regarding cost-effective projects. Services include: identifying the most cost-effective project locations based on renewable energy resource data, utility data, incentives and other parameters affecting projects; assistance with feasibility studies; procurement specifications; design reviews; and other servicesmore » to support FNLA in improving resource efficiency at facilities. This Cooperative Research and Development Agreement (CRADA) establishes the terms and conditions under which FLNA may access capabilities unique to the laboratory and required by FLNA. Each subsequent task issued under this umbrella agreement would include a scope-of-work, budget, schedule, and provisions for intellectual property specific to that task.« less

An impact assessment of sustainable technologies for the Chinese urban residential sector at provincial level

NASA Astrophysics Data System (ADS)

Xing, Rui; Hanaoka, Tatsuya; Kanamori, Yuko; Dai, Hancheng; Masui, Toshihiko

2015-06-01

Recently, energy use in the urban residential sector of China has drastically increased due to higher incomes and urbanization. The fossil fuels dominant energy supply has since worsened the air quality, especially in urban areas. In this study we estimate the future energy service demands in Chinese urban residential areas, and then use an AIM/Enduse model to evaluate the emission reduction potential of CO2, SO2, NOx and PM. Considering the climate diversity and its impact on household energy service demands, our analysis is down-scaled to the provincial-level. The results show that in most of the regions, penetration of efficient technologies will bring CO2 emission reductions of over 20% compared to the baseline by the year 2030. Deployment of energy efficient technologies also co-benefits GHG emission reduction. However, efficient technology selection appears to differ across provinces due to climatic variation and economic disparity. For instance, geothermal heating technology is effective for the cold Northern areas while biomass technology contributes to emission reduction the most in the warm Southern areas.

The Changing Political Undercurrents in Health Services Delivery in Sub-Saharan Africa.

PubMed

Ichoku, H E; Ifelunini, A I

2017-07-01

This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.

[Application of extended exergy method in driving mechanism and efficiency of regional eco-economy].

PubMed

Fan, Xin Gang; Mi, Wen Bao; Hou, Jing Wei

2017-01-01

To analyze social-economic causes of the regional ecological degradation, and avoid such problems as the complex circulation network and difficulty to identify laws caused by extended exergy analysis (EEA) previously applied at the national scale, this paper reduced spatial scale to the county scale and took Pengyang County in Ningxia as an example. Eco-economic system in Peng-yang County was divided into seven interrelated sectors. The exergy value of circulations in the eco-economic system including materials, labor and capital were calculated respectively to analyze the extended exergy characteristics of the driving sectors, factors and paths and evaluate their ecological efficiency. The results showed that agriculture and households were the main driving sectors of the eco-economic system in Pengyang County. The average exergy value of 31 flow paths among the sectors was 0.80 PJ. There were only 8 flow paths whose exergy values were higher than the average value. Eco-economic system in Pengyang County development was driven by two continuous flow paths, labor output of the households sector and demands of the households sector supported by other sectors. The mineral resources were massively exploited, and then directly exported to the outside, which could not promote the local development from the inside, but, on the contrary, increase the ecological environment pressure because of the over-exploitation. The eco-efficiency of Pengyang County in 2014 was 68.1%, almost equivalent to the by-level of the national scale at home and abroad ten years ago, mainly because of the lower eco-efficiencies of the service sector and households sector. EEA had the advantage of networking and structuring, could specify the sectors, factors and driven paths, and break through the bottleneck of driving mechanism research of the eco-economic system. EEA had certain adaptability to explore the operational principle and optimal pattern of the regional eco-economic system. Compared with the national scale, EEA at the regional scale could more easily identify the driving mechanism of eco-economic system, and could clearly guide the regional administrative department to reduce the ecological environment pressure.

Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

PubMed Central

Osei, Daniel; d'Almeida, Selassi; George, Melvill O; Kirigia, Joses M; Mensah, Ayayi Omar; Kainyu, Lenity H

2005-01-01

Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination) in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i) to estimate the relative technical efficiency (TE) and scale efficiency (SE) of a sample of public hospitals and health centres in Ghana; and (ii) to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA) approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47%) hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD) of 12%. Ten (59%) hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%). Out of the 17 health centres, 3 (18%) were technically inefficient, with a mean TE score of 49% (STD = 27%). Eight health centres (47%) were scale inefficient, with an average SE score of 84% (STD = 16%). Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres) in the course of the implementation of health sector reforms. PMID:16188021

The Process of Privatization of Health Care Provision in Poland.

PubMed

Kaczmarek, Krzysztof; Flynn, Hannah; Letka-Paralusz, Edyta; Krajewski-Siuda, Krzysztof; Gericke, Christian A

In January 1999, a new institutional structure for Poland's health care system was laid out, instigated by the dramatic change in both the political and economic system. Following the dissolution of state socialism, private financing of health care services was encouraged to fill an important role in meeting rising consumer demand and to encourage a more efficient use of resources through competition and private initiative. However, from the outset of the intended transformations, systemic limitations to the privatization process hindered progression, resulting in varying rates of privatization amongst the distinct health care sectors. The aim of this paper is to describe the privatization process and to analyze its pace and differences in strategic approach in all major health care sectors. Policy analysis of legislation, government directives, and published national and international scientific literature on Polish health reforms between 1999 and 2012 was conducted. The analysis demonstrates a clear disparity in privatization rates in different sectors. The pharmaceutical industry is fully privatized in 2012, and the ambulatory and dental sectors both systematically increased their private market shares to around 70% of all services provided. However, despite a steady increase in the number of private hospitals in Poland since 1999, their overall role in the health care system is comparatively limited. Unclear legal regulations have resulted in a gray area between public and private health care, where informal payments impede the intended function of the system. If left unchanged, official health care in Poland is likely to become an increasingly residual service for the worst-off population segments that are unable to afford the legal private sector or the informal payments which guarantee a higher quality service in the public sector. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

The nonprofit sector's $100 billion opportunity.

PubMed

Bradley, Bill; Jansen, Paul; Silverman, Les

2003-05-01

Imagine what an extra $100 billion a year could do for philanthropic and other nonprofit institutions. According to a new study, the nonprofit sector could free that amount--maybe even more--by making five changes in the way it operates. The study asked two central questions: Does the sector's money flow from its source to its ultimate use as efficiently and effectively as possible? If not, where are the big opportunities to increase social benefit? According to former senator Bill Bradley and McKinsey's Paul Jansen and Les Silverman, nonprofits could save roughly $25 billion a year by changing the way they raise funds. By distributing funds more quickly, they could put an extra $30 billion to work. Organizations could generate more than $60 billion a year by streamlining and restructuring the way in which they provide services and by reducing administrative costs. And they could free up even more money--an amount impossible to estimate--by better allocating funds among service providers. The authors admit that making those changes won't be easy. The nonprofit world, historically seen as a collection of locally focused charities, has become an enormous sector, but it lacks the managerial processes and incentives that help keep the for-profit world on track. And when the baby boomers start to retire in less than a decade, public budgets will be squeezed even more than they are today. If the nonprofit sector is to help the nation cope with the stresses ahead, it must become more efficient and challenge its traditional concepts of stewardship.

Household utilization and expenditure on private and public health services in Vietnam.

PubMed

Ha, Nguyen Thi Hong; Berman, Peter; Larsen, Ulla

2002-03-01

The private provision of health services in Vietnam was legalized in 1989 as one of the country's means to mobilize resources and improve efficiency in the health system. Ten years after its legalization, the private sector has widely expanded its activities and become an important provider of health services for the Vietnamese people. However, little is known about its contribution to the overall objectives of the health system in Vietnam. This paper assesses the role of the private health care provider by examining utilization patterns and financial burden for households of private, as compared with public, services. We found that the private sector provided 60% of all outpatient contacts in Vietnam. There was no difference by education, sex or place of residence in the use of private ambulatory health care. Although there was evidence suggesting that rich people use private care more than the poor, this finding was not consistent across all income groups. The private sector served young children in particular. Also, people in households with several sick members at the same time relied more on private than public care, while those with severe illnesses tended to use less private care than public. The financial burden for households from private health care services was roughly a half of that imposed by the public providers. Expenditure on drugs accounted for a substantial percentage of household expenditure in general and health care expenditure in particular. These findings call for a prompt recognition of the private sector as a key player in Vietnam's health system. Health system policies should mobilize positive private sector contributions to health system goals where possible and reduce the negative effects of private provision development.

Accounting Information Systems in Healthcare: A Review of the Literature.

PubMed

Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

2017-01-01

As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

UK Health and Social Care Case Studies: Iterative Technology Development.

PubMed

Blanchard, Adie; Gilbert, Laura; Dawson, Tom

2017-01-01

As a result of increasing demand in the face of reducing resources, technology has been implemented in many social and health care services to improve service efficiency. This paper outlines the experiences of deploying a 'Software as a Service' application in the UK social and health care sectors. The case studies demonstrate that every implementation is different, and unique to each organisation. Technology design and integration can be facilitated by ongoing engagement and collaboration with all stakeholders, flexible design, and attention to interoperability to suit services and their workflows.

Procurement of construction services: a case study on bidding competition in Singapore public sector contracts

NASA Astrophysics Data System (ADS)

Oo, B. L.; Yan, Y.

2018-04-01

There are many variables that public clients need to consider in their bidding procedure to enhance efficiency in their procurement for construction services. This paper focusses on the competitive bidding process for public sector procurement of construction services in Singapore. A distinctive feature of the Singapore government competitive bidding process is that full bidding feedback information is released to all competing bidders (and public). The specific objectives are: (i) to examine the degree of competition in the construction markets; and (ii) to examine the bidding performance of competing bidders. Based on a collection of bidding data for a 15-month period, the results show the market environment of the Singapore public sector construction contracting is highly competitive with long bidder lists. In selection of contractors, only 50% of the contracts were awarded to lowest bidders. The results also show that the competing contractors can be broadly classified into three groups based on their bidding performance in terms of number of bidding attempts, bidding success rate and bidding competitiveness. These results provide a useful insight into the bidding competition in the Singapore public sector construction contracting, especially to new market entrants and foreign contractors who want to bid for jobs in Singapore.

Basing care reforms on evidence: The Kenya health sector costing model

PubMed Central

2011-01-01

Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead, productivity will rise in particular in under-utilized private health care institutions. The results of this study also show that private-for-profit health care facilities are not only the luxurious providers catering exclusively for the rich but also play an important role in the service provision for the poorer population. The study findings also demonstrated a high degree of cost variability across private providers, suggesting differences in quality and efficiencies. PMID:21619567

Basing care reforms on evidence: the Kenya health sector costing model.

PubMed

Flessa, Steffen; Moeller, Michael; Ensor, Tim; Hornetz, Klaus

2011-05-27

The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead, productivity will rise in particular in under-utilized private health care institutions. The results of this study also show that private-for-profit health care facilities are not only the luxurious providers catering exclusively for the rich but also play an important role in the service provision for the poorer population. The study findings also demonstrated a high degree of cost variability across private providers, suggesting differences in quality and efficiencies.

A cost and performance comparison of Public Private Partnership and public hospitals in Spain.

PubMed

Caballer-Tarazona, Maria; Clemente-Collado, Antonio; Vivas-Consuelo, David

2016-12-01

Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to traditional public health systems, with the intention of making them more efficient.There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts with the private, up to the complete privatisation of the service. As such, we may say the involvement of the private sector embraces the development, financing and provision of public infrastructures and delivery services.In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other European and Latin American countries is evaluated for first time: the integrated healthcare delivery Alzira model.Through a comparison of public and PPP hospital performance, cost and quality indicators, the efficiency of the PPP experience in five hospitals is evaluated to identify the influence of private management in the results.Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good results, above the average, but not always better than those directly managed. It is necessary to conduct studies with a greater number of PPP hospitals to obtain conclusive results.

Ecosystem service tradeoff analysis reveals the value of marine spatial planning for multiple ocean uses

PubMed Central

White, Crow; Halpern, Benjamin S.; Kappel, Carrie V.

2012-01-01

Marine spatial planning (MSP) is an emerging responsibility of resource managers around the United States and elsewhere. A key proposed advantage of MSP is that it makes tradeoffs in resource use and sector (stakeholder group) values explicit, but doing so requires tools to assess tradeoffs. We extended tradeoff analyses from economics to simultaneously assess multiple ecosystem services and the values they provide to sectors using a robust, quantitative, and transparent framework. We used the framework to assess potential conflicts among offshore wind energy, commercial fishing, and whale-watching sectors in Massachusetts and identify and quantify the value from choosing optimal wind farm designs that minimize conflicts among these sectors. Most notably, we show that using MSP over conventional planning could prevent >$1 million dollars in losses to the incumbent fishery and whale-watching sectors and could generate >$10 billion in extra value to the energy sector. The value of MSP increased with the greater the number of sectors considered and the larger the area under management. Importantly, the framework can be applied even when sectors are not measured in dollars (e.g., conservation). Making tradeoffs explicit improves transparency in decision-making, helps avoid unnecessary conflicts attributable to perceived but weak tradeoffs, and focuses debate on finding the most efficient solutions to mitigate real tradeoffs and maximize sector values. Our analysis demonstrates the utility, feasibility, and value of MSP and provides timely support for the management transitions needed for society to address the challenges of an increasingly crowded ocean environment. PMID:22392996

Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada.

PubMed

Hanlon, Neil; Rosenberg, Mark; Clasby, Rachael

2007-07-01

Services offered by voluntary organisations are an integral but often overlooked component of health and social care. Of late, there has been a renewed interest in voluntary welfare provision as a viable alternative to state and market. Recent developments in welfare provision in Canada appear to have brought greater social care roles for the voluntary sector at the same time as new and arguably more restrictive funding and accountability mechanisms are being imposed by different arms of the state. To explore these issues more closely, the present paper examines the impressions and experiences of voluntary and formal sector providers of services for senior citizens and people with disabilities in a remote urban centre (population less than 100 000) in the interior of British Columbia, Canada. Two important operational pressures provide the context of the analysis: (1) reform of provincial government funding and regulation of voluntary services; and (2) the restructuring of welfare provision, especially in the areas of health care and social services. The authors found evidence of an escalating incursion of the state into local voluntary sector affairs that needs to be understood in the context of long-standing institutional links between government and 'professional' voluntary welfare provision in British Columbia. The results point to three important directions in contemporary local voluntary provision: (1) an emerging ethos of accountability, efficiency and competition in voluntary provision; (2) increasing pressure to centralise volunteer services; and consequently, (3) the potential erosion of flexibility and personalisation that are seen to characterise the voluntary sector.

Civil society, third sector, and healthcare: the case of social cooperatives in Italy.

PubMed

Borzaga, Carlo; Fazzi, Luca

2014-12-01

In many European countries, the third sector is considered an actor able to improve both the efficiency and the efficacy of public healthcare systems afflicted by the crisis of the welfare state. Attributed to third-sector organizations is the role of a hybrid actor tasked with the professional supply of services, not for profit but rather for mutualistic purposes, and to serve the public interest. However, empirical evidence on the capacity of the third sector to pursue objectives of social inclusion in a phase of withdrawal by the public sector is almost entirely lacking in the European countries. The article describes the results of research on the transformation of the Italian healthcare system and on the emergence of a new third sector in Italy. The results of the inquiry highlight the strategies, characteristics, and governance processes which enable third-sector organizations operating in the healthcare sector to pursue objectives of inclusion, and to serve the needs of disadvantaged groups by assuming the form of social enterprises. Copyright © 2014 Elsevier Ltd. All rights reserved.

The consequences of health service privatisation for equality and equity in health care in South Africa.

PubMed

Price, M

1988-01-01

The trend towards the privatisation of health services in South Africa reflects a growing use of private sources of finance and the growing proportion of privately owned fee-for-service providers and facilities. Fee-for-service methods of reimbursement aggravate the geographical maldistribution of personnel and facilities, and the competition for scarce personnel resources aggravates the difference in the quality of the public and private services. Thus the growth in demand for these types of providers may be expected to increase inequality of access in these two respects. The potential expansion of medical scheme coverage is shown to be limited to well under 50% of the population, leaving the majority of the population without access to private sector health care. Even for members of the medical schemes, benefits are linked to income, thus clashing with the principle of equal care for equal need. The public funds needed to overcome financial obstacles to access to private providers could be more efficiently deployed by financing publicly owned and controlled health services directly. Taxation also offers the most equitable method of financing health services. Finally, attention is drawn to the dilemma resulting from the strengthening of the private health sector; while in the short term this can offer better care to more people on a racially non-discriminatory basis, in the long term, health care for the population as a whole may become more unequal and for those dependent on the public sector it may even deteriorate.

Compliance Issues in Higher Education

ERIC Educational Resources Information Center

Benedek, Petra

2016-01-01

Efficiency in the 1980's, quality in the 1990's, compliance in the 2010's - private sector management techniques and mechanisms find their way to public services. This paper facilitates the understanding of how compliance management controls can improve operations and prevent or detect failure or wrong doing. The last few years' empirical research…

On to the Past: Wrong-Headed School Reform.

ERIC Educational Resources Information Center

Moffett, James

1994-01-01

Business should participate in school reform but has too narrow a perspective to guide it. Nationalizing education through comparative testing is a move to cut spending for social services, to increase accountability and efficiency without increasing financial responsibility or equity. Imposing private-sector rules on public education undermines…

Optimising value and quality in general practice within the primary health care sector through relationship marketing: a conceptual framework.

PubMed

Bansal, Manjit K

2004-01-01

Discusses the rationale of applying relationship marketing and service quality concepts within the primary health care sector. The use of relational strategies in general practice, by modelling the relationships between practitioners and patients from a marketing perspective, could potentially lead to sustained high quality service being provided, and to more efficient use of resources. This essentially conceptually focused paper addresses an area that has not yet been researched in detail, and furthers understanding of the relationships that facilitate exchange within general practice and service delivery in non-profit, resource-constrained conditions. Deeper understanding of the needs and expectations of patients and the way these can be delivered by general practice can only lead to improvements for all parties involved. The relationship marketing paradigm presents itself as a potentially exciting way of addressing issues associated with ensuring that the highest level of quality is delivered in this area of the UK National Health Service.

Bridging Climate Change Resilience and Mitigation in the Electricity Sector Through Renewable Energy and Energy Efficiency: Emerging Climate Change and Development Topics for Energy Sector Transformation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cox, Sarah L; Hotchkiss, Elizabeth L; Bilello, Daniel E

Reliable, safe, and secure electricity is essential for economic and social development and a necessary input for many sectors of the economy. However, electricity generation and associated processes make up a significant portion of global greenhouse gas (GHG) emissions contributing to climate change. Furthermore, electricity systems are vulnerable to climate change impacts - both short-term events and changes over the longer term. This vulnerability presents both near-term and chronic challenges in providing reliable, affordable, equitable, and sustainable energy services. Within this context, developing countries face a number of challenges in the energy sector, including the need to reliably meet growingmore » electricity demand, lessen dependence on imported fuels, expand energy access, and improve stressed infrastructure for fuel supply and electricity transmission. Energy efficiency (EE) and renewable energy (RE) technical solutions described in this paper can bridge action across climate change mitigation and resilience through reducing GHG emissions and supporting electric power sector adaptation to increasing climate risk. Integrated planning approaches, also highlighted in this paper, play an integral role in bringing together mitigation and resilience action under broader frameworks. Through supporting EE and RE deployment and integrated planning approaches, unique to specific national and local circumstances, countries can design and implement policies, strategies, and sectoral plans that unite development priorities, climate change mitigation, and resilience.« less

Evaluating the impact of contracting out basic health care services in the state of São Paulo, Brazil

PubMed Central

Greve, Jane; Schattan Ruas Pereira Coelho, Vera

2017-01-01

Abstract As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services. This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases. PMID:28419264

76 FR 6927 - Radio Experimentation and Market Trials Under Part 5 of the Commission's Rules and Streamlining...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...In this document, the Commission seeks to promote innovation and efficiency in spectrum use in the Experimental Radio Service (ERS). For many years, the ERS has provided fertile ground for testing innovative ideas that have led to new services and new devices for all sectors of the economy. The Commission proposes to leverage the power of experimental radio licensing to accelerate the rate at which these ideas transform from prototypes to consumer devices and services. Its goal is to inspire researchers to dream, discover and deliver the innovations that push the boundaries of the broadband ecosystem. The resulting advancements in devices and services available to the American public and greater spectrum efficiency over the long term will promote economic growth, global competitiveness, and a better way of life for all Americans.

Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali

PubMed Central

Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

2017-01-01

Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. Methods and Results: The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Conclusion: Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family planning services, even in settings with low contraceptive prevalence. PMID:28655803

Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali.

PubMed

Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

2017-06-27

Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family planning services, even in settings with low contraceptive prevalence. © Gold et al.

Application of GIS in exploring spatial dimensions of Efficiency in Competitiveness of Regions

NASA Astrophysics Data System (ADS)

Rahmat, Shahid; Sen, Joy

2017-04-01

Infrastructure is an important component in building competitiveness of a region. Present global scenario of economic slowdown that is led by slump in demand of goods and services and decreasing capacity of government institutions in investing public infrastructure. Strategy of augmenting competitiveness of a region can be built around improving efficient distribution of public infrastructure in the region. This efficiency in the distribution of infrastructure will reduce the burden of government institution and improve the relative output of the region in relative lesser investment. A rigorous literature study followed by an expert opinion survey (RIDIT scores) reveals that Railway, Road, ICTs and Electricity infrastructure is very crucial for better competitiveness of a region. Discussion with Experts in ICTs, Railways and Electricity sectors were conducted to find the issues, hurdles and possible solution for the development of these sectors. In an underdeveloped country like India, there is a large constrain of financial resources, for investment in infrastructure sector. Judicious planning for allocation of resources for infrastructure provisions becomes very important for efficient and sustainable development. Data Envelopment Analysis (DEA) is the mathematical programming optimization tool that measure technical efficiency of the multiple-input and/or multiple-output case by constructing a relative technical efficiency score. This paper tries to utilize DEA to identify the efficiency at which present level of selected components of Infrastructure (Railway, Road, ICTs and Electricity) is utilized in order to build competitiveness of the region. This paper tries to identify a spatial pattern of efficiency of Infrastructure with the help of spatial auto-correlation and Hot-spot analysis in Arc GIS. This analysis leads to policy implications for efficient allocation of financial resources for the provision of infrastructure in the region and building a prerequisite to boost an efficient Regional Competitiveness.

How much can we gain from improved efficiency? An examination of performance of national HIV/AIDS programs and its determinants in low- and middle-income countries

PubMed Central

2012-01-01

Background The economic downturn exacerbates the inadequacy of resources for combating the worldwide HIV/AIDS pandemic and amplifies the need to improve the efficiency of HIV/AIDS programs. Methods We used data envelopment analysis (DEA) to evaluate efficiency of national HIV/AIDS programs in transforming funding into services and implemented a Tobit model to identify determinants of the efficiency in 68 low- and middle-income countries. We considered the change from the lowest quartile to the average value of a variable a "notable" increase. Results Overall, the average efficiency in implementing HIV/AIDS programs was moderate (49.8%). Program efficiency varied enormously among countries with means by quartile of efficiency of 13.0%, 36.4%, 54.4% and 96.5%. A country's governance, financing mechanisms, and economic and demographic characteristics influence the program efficiency. For example, if countries achieved a notable increase in "voice and accountability" (e.g., greater participation of civil society in policy making), the efficiency of their HIV/AIDS programs would increase by 40.8%. For countries in the lowest quartile of per capita gross national income (GNI), a notable increase in per capita GNI would increase the efficiency of AIDS programs by 45.0%. Conclusions There may be substantial opportunity for improving the efficiency of AIDS services, by providing more services with existing resources. Actions beyond the health sector could be important factors affecting HIV/AIDS service delivery. PMID:22443135

Private Agricultural Extension System in Kenya: Practice and Policy Lessons

ERIC Educational Resources Information Center

Muyanga, Milu; Jayne, T. S.

2008-01-01

Private extension system has been at the centre of a debate triggered by inefficient public agricultural extension. The debate is anchored on the premise that the private sector is more efficient in extension service delivery. This study evaluates the private extension system in Kenya. It employs qualitative and quantitative methods. The results…

Denmark's Master of Public Governance Program: Assessment and Lessons Learned

ERIC Educational Resources Information Center

Greve, Carsten; Pedersen, Anne Reff

2017-01-01

This paper focuses on Denmark's Master of Public Governance and its assessments and lessons learned. Denmark is seen to have an efficient economy and public sector, a digitalized public service delivery system, and an advanced work-life balance. The Danish government invested substantial resources into developing a Master of Public Governance…

Parallel high-performance grid computing: capabilities and opportunities of a novel demanding service and business class allowing highest resource efficiency.

PubMed

Kepper, Nick; Ettig, Ramona; Dickmann, Frank; Stehr, Rene; Grosveld, Frank G; Wedemann, Gero; Knoch, Tobias A

2010-01-01

Especially in the life-science and the health-care sectors the huge IT requirements are imminent due to the large and complex systems to be analysed and simulated. Grid infrastructures play here a rapidly increasing role for research, diagnostics, and treatment, since they provide the necessary large-scale resources efficiently. Whereas grids were first used for huge number crunching of trivially parallelizable problems, increasingly parallel high-performance computing is required. Here, we show for the prime example of molecular dynamic simulations how the presence of large grid clusters including very fast network interconnects within grid infrastructures allows now parallel high-performance grid computing efficiently and thus combines the benefits of dedicated super-computing centres and grid infrastructures. The demands for this service class are the highest since the user group has very heterogeneous requirements: i) two to many thousands of CPUs, ii) different memory architectures, iii) huge storage capabilities, and iv) fast communication via network interconnects, are all needed in different combinations and must be considered in a highly dedicated manner to reach highest performance efficiency. Beyond, advanced and dedicated i) interaction with users, ii) the management of jobs, iii) accounting, and iv) billing, not only combines classic with parallel high-performance grid usage, but more importantly is also able to increase the efficiency of IT resource providers. Consequently, the mere "yes-we-can" becomes a huge opportunity like e.g. the life-science and health-care sectors as well as grid infrastructures by reaching higher level of resource efficiency.

Outsourcing in the Italian National Health Service: findings from a national survey.

PubMed

Macinati, Manuela S

2008-01-01

Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency. This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service. In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was around 42%. Results showed that outsourcing is a widespread phenomenon within health care, especially in the ancillary services area. Moreover, results showed many criticalities of the outsourcing practice in the Italian health-care sector. On the one hand, criticalities concerned the reasons for outsourcing, the characteristics of the outsourced services and the management of the relationship with the vendor. With reference to essential clinical service, outsourcing, as currently managed by health-care providers, may potentially weaken their ability to reach its own objectives. On the other hand, criticalities related to respondent-perceived benefits. Despite the overall positive outsourcing experience expressed in the survey, the results on perceived benefits showed that the effects of outsourcing did not always align to managers' expectations, especially in the cost containment and efficiency area.

Fund allocation within Australian dental care: an innovative approach to output based funding.

PubMed

Tennant, M; Carrello, C; Kruger, E

2005-12-01

Over the last 15 years in Australia the process of funding government health care has changed significantly. The development of dental funding models that transparently meet both the service delivery needs for data at the treatment level and policy makers' need for health condition data is critical to the continued integration of dentistry into the wider health system. This paper presents a model of fund allocation that provides a communication construct that addresses the needs of both policy makers and service providers. In this model, dental treatments (dental item numbers) have been grouped into eight broad dental health conditions. Within each dental health condition, a weighted average price is determined using the Department of Veterans Affairs' (DVA) fee schedule as the benchmark, adjusted for the mix of care. The model also adjusts for the efficiency differences between sectors providing government funded dental care. In summary, the price to be applied to a dental health condition category is determined by the weighted average DVA price adjusted by the sector efficiency. This model allows governments and dental service providers to develop funding agreements that both quantify and justify the treatment to be provided. Such a process facilitates the continued integration of dental care into the wider health system.

The long-run effects of economic, demographic, and political indices on actual and potential CO2 emissions.

PubMed

Adom, Philip Kofi; Kwakwa, Paul Adjei; Amankwaa, Afua

2018-07-15

This study examines the long-run drivers of potential and actual CO 2 emissions in Ghana, a sub-Saharan Africa country. The use of the former helps address the reverse causality problem and capture the true long-run effects. The Stock-Watson dynamic OLS is used with data from 1970 to 2014. The result shows that potential CO 2 emissions improve model efficiency. Income (except in "other sector") and financial development (except in manufacturing and construction sector) have compelling positive and negative effects on actual and potential CO 2 emissions, respectively. A higher price (oil and electricity) reduces actual and potential CO 2 emissions, but electricity price is more vital in residential, buildings and commercial and public services sector, while oil price is crucial in the transport sector. Democracy lowers actual and potential CO 2 emissions in the aggregate (insignificant) and transport sectors but raises it in the manufacturing and construction sector. The effect is, however, inconsistent for the remaining sectors. Urbanization raises aggregate actual and potential CO 2 emissions, but the effect is inconsistent for the transport sector. The findings have important implications for policy formulation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Assessing the relative efficiency of water companies in the English and Welsh water industry: a metafrontier approach.

PubMed

Molinos-Senante, María; Maziotis, Alexandros; Sala-Garrido, Ramon

2015-11-01

The assessment of relative efficiency of water companies is essential for managers and authorities. This is evident in the UK water sector where there are companies with different services such as water and sewerage companies (WaSCs) and water-only companies (WoCs). Therefore, it is a critical limitation to estimate a common production frontier for both types of companies, as it might lead to biased efficiency estimates. In this paper, a robust and reliable methodology, the metafrontier model, is applied to compare the efficiency of water companies providing different services. The results illustrate the superior performance of WaSCs compared to WoCs. It also confirms the presence of economies of scope in the UK water industry. The methodology and results of this study are of great interest for both regulators and water utility managers to make informed decisions.

Crisis as a serendipity for change in Cyprus' healthcare services.

PubMed

Petrou, Panagiotis

2015-01-01

As Cyprus signed a financial agreement with a team of international lenders, several reform measures were outlined as pre-requisites for disbursement of financial instalments. The health sector was massively reformed in order to enhance efficiency and reduce waste. The magnitude of reforms included introduction of guidelines and clinical algorithms, co-payments, and revision of criteria for public beneficiary status. In order to safeguard equity in access, solidarity in coverage and sustainability of its healthcare sector, reforms must continue unabated and, more importantly, the introduction of a universal health system should be the ultimate goal.

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; Hasanbeigi, Ali; Sathaye, Jayant

This report on the California Energy Balance version 2 (CALEB v2) database documents the latest update and improvements to CALEB version 1 (CALEB v1) and provides a complete picture of how energy is supplied and consumed in the State of California. The CALEB research team at Lawrence Berkeley National Laboratory (LBNL) performed the research and analysis described in this report. CALEB manages highly disaggregated data on energy supply, transformation, and end-use consumption for about 40 different energy commodities, from 1990 to 2008. This report describes in detail California's energy use from supply through end-use consumption as well as the datamore » sources used. The report also analyzes trends in energy demand for the "Manufacturing" and "Building" sectors. Decomposition analysis of energy consumption combined with measures of the activity driving that consumption quantifies the effects of factors that shape energy consumption trends. The study finds that a decrease in energy intensity has had a very significant impact on reducing energy demand over the past 20 years. The largest impact can be observed in the industry sector where energy demand would have had increased by 358 trillion British thermal units (TBtu) if subsectoral energy intensities had remained at 1997 levels. Instead, energy demand actually decreased by 70 TBtu. In the "Building" sector, combined results from the "Service" and "Residential" subsectors suggest that energy demand would have increased by 264 TBtu (121 TBtu in the "Services" sector and 143 TBtu in the "Residential" sector) during the same period, 1997 to 2008. However, energy demand increased at a lesser rate, by only 162 TBtu (92 TBtu in the "Services" sector and 70 TBtu in the "Residential" sector). These energy intensity reductions can be indicative of energyefficiency improvements during the past 10 years. The research presented in this report provides a basis for developing an energy-efficiency performance index to measure progress over time in the State of California.« less

How size matters: exploring the association between quality of mental health services and catchment area size.

PubMed

Ala-Nikkola, Taina; Sadeniemi, Minna; Kaila, Minna; Saarni, Samuli; Kontio, Raija; Pirkola, Sami; Joffe, Grigori; Oranta, Olli; Wahlbeck, Kristian

2016-08-12

The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size. To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system.

Water footprint characteristic of less developed water-rich regions: Case of Yunnan, China.

PubMed

Qian, Yiying; Dong, Huijuan; Geng, Yong; Zhong, Shaozhuo; Tian, Xu; Yu, Yanhong; Chen, Yihui; Moss, Dana Avery

2018-03-30

Rapid industrialization and urbanization pose pressure on water resources in China. Virtual water trade proves to be an increasingly useful tool in water stress alleviation for water-scarce regions, while bringing opportunities and challenges for less developed water-rich regions. In this study, Yunnan, a typical province in southwest China, was selected as the case study area to explore its potential in socio-economic development in the context of water sustainability. Both input-output analysis and structural decomposition analysis on Yunnan's water footprint for the period of 2002-2012 were performed at not only an aggregated level but also a sectoral level. Results show that although the virtual water content of all economic sectors decreased due to technological progress, Yunnan's total water footprint still increased as a result of economic scale expansion. From the sectoral perspective, sectors with large water footprints include construction sector, agriculture sector, food manufacturing & processing sector, and service sector, while metal products sector and food manufacturing & processing sector were the major virtual water exporters, and textile & clothing sector and construction sector were the major importers. Based on local conditions, policy suggestions were proposed, including economic structure and efficiency optimization, technology promotion and appropriate virtual water trade scheme. This study provides valuable insights for regions facing "resource curse" by exploring potential socio-economic progress while ensuring water security. Copyright © 2018 Elsevier Ltd. All rights reserved.

Calculation of Costs of Pregnancy- and Puerperium-related Care: Experience from a Hospital in a Low-income Country

PubMed Central

Medin, E.; Gazi, R.; Koehlmoos, T.P.; Rehnberg, C.; Saifi, R.; Bhuiya, A.; Khan, J.

2010-01-01

Calculation of costs of different medical and surgical services has numerous uses, which include monitoring the performance of service-delivery, setting the efficiency target, benchmarking of services across all sectors, considering investment decisions, commissioning to meet health needs, and negotiating revised levels of funding. The role of private-sector healthcare facilities has been increasing rapidly over the last decade. Despite the overall improvement in the public and private healthcare sectors in Bangladesh, lack of price benchmarking leads to patients facing unexplained price discrimination when receiving healthcare services. The aim of the study was to calculate the hospital-care cost of disease-specific cases, specifically pregnancy- and puerperium-related cases, and to indentify the practical challenges of conducting costing studies in the hospital setting in Bangladesh. A combination of micro-costing and step-down cost allocation was used for collecting information on the cost items and, ultimately, for calculating the unit cost for each diagnostic case. Data were collected from the hospital records of 162 patients having 11 different clinical diagnoses. Caesarean section due to maternal and foetal complications was the most expensive type of case whereas the length of stay due to complications was the major driver of cost. Some constraints in keeping hospital medical records and accounting practices were observed. Despite these constraints, the findings of the study indicate that it is feasible to carry out a large-scale study to further explore the costs of different hospital-care services. PMID:20635637

An approach for message exchange using archetypes.

PubMed

Moraes, João L C; Souza, Wanderley L; Cavalini, Luciana T; Pires, Luís F; Prado, Antonio F

2013-01-01

The application of ICT on the whole range of health sector activities, known as e-health, can simplify the access to health care services and will only be acceptable for realistic scenarios if it supports efficient information exchange amongst the caregivers and their patients. The aim of this paper is present an approach for message exchange to realistic scenarios.

Managerialist vis-à-vis Learning and Development Goals for EAL Teachers: A Case Study of an In-Service Professional Development Provider

ERIC Educational Resources Information Center

Gurney, Laura; Liyanage, Indika

2015-01-01

Under current Western neoliberal philosophy, promotion of efficiency and resolution of issues are typically expected to result from effective management. The education sector, too, has responded well to these expectations. Amongst such expectations, engagement in professional development activities (PDAs) by teachers of English as an additional…

National workshop on forest productivity & technology: cooperative research to support a sustainable & competitive future - progress and strategy

Treesearch

Eric D. Vance

2010-01-01

The Agenda 2020 Program is a partnership among government agencies, the forest products industry, and academia to develop technology capable of enhancing forest productivity, sustaining environmental values, increasing energy efficiency, and improving the economic competitiveness of the United States forest sector. In November 2006, the USDA Forest Service, in...

Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

PubMed

Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

2014-04-01

Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Facing the future: the effects of the impending financial drought on NHS finances and how UK radiology services can contribute to expected efficiency savings

PubMed Central

Grant, L; Appleby, J; Griffin, N; Adam, A; Gishen, P

2012-01-01

The recent turmoil within the banking sector has led to the development of the most significant recession since the “great depression” of the 1930s. Although the coalition government has promised to “guarantee that health spending increases in real terms in each year of Parliament”, this may still not be enough to meet future needs over the coming years due to increasing demand and cost pressures. The expected mismatch between actual National Health Service (NHS) funding post-2011 and that required to satisfy increasing demand has been estimated by the Department of Health to require efficiency savings representing up to one-fifth of the overall NHS budget. This paper explains the reasons behind the anticipated slowdown in the growth of real NHS funding, and how, as a discipline, radiology can increase the efficiency of the services it provides in anticipation of future financial austerity within the NHS. PMID:22167516

Evaluating the impact of contracting out basic health care services in the state of São Paulo, Brazil.

PubMed

Greve, Jane; Schattan Ruas Pereira Coelho, Vera

2017-09-01

As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

An Investigation into Customer Service Policies and Practices within the Scottish College Library Sector: A Comparison between the Customer Service Exemplars from the Retail Sector with Current Scottish College Library Practice

ERIC Educational Resources Information Center

Paterson, Neil

2011-01-01

The aim of this research project was to investigate the customer care methods within the Scottish college library sector. The researcher sought to compare examples of the customer care and service policies and practices from the sector with exemplars of good customer service from the retail sector. A qualitative, grounded theory approach was…

Going private: clinicians' experience of working in UK independent sector treatment centres.

PubMed

Waring, Justin; Bishop, Simon

2012-02-01

With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors. Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services. Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience'. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experience, but there were concerns about management priorities and the reconfiguration of work. Clinicians' experience of moving between sectors reveals mixed experiences. Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Leveraging the private health sector to enhance HIV service delivery in lower-income countries.

PubMed

Rao, Pamela; Gabre-Kidan, Tesfai; Mubangizi, Deus Bazira; Sulzbach, Sara

2011-08-01

Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.

Public Sector Reform and Governance for Adaptation: Implications of New Public Management for Adaptive Capacity in Mexico and Norway

NASA Astrophysics Data System (ADS)

Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie

2011-03-01

Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation—namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability—have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform.

Public sector reform and governance for adaptation: implications of new public management for adaptive capacity in Mexico and Norway.

PubMed

Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie

2011-03-01

Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation--namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability--have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform.

Is bigger better? An empirical analysis of waste management in New South Wales

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carvalho, Pedro, E-mail: pedrotcc@gmail.com; CESUR – Center for Urban and Regional Systems, Instituto Superior Técnico, University of Lisboa, Av. Rovisco Pais, 1049-001 Lisbon; Marques, Rui Cunha, E-mail: rui.marques@tecnico.ulisboa.pt

Highlights: • We search for the most efficient cost structure for NSW household waste services. • We found that larger services are no longer efficient. • We found an optimal size for the range 12,000–20,000 inhabitants. • We found significant economies of output density for household waste collection. • We found economies of scope in joint provision of unsorted and recycling services. - Abstract: Across the world, rising demand for municipal solid waste services has seen an ongoing increase in the costs of providing these services. Moreover, municipal waste services have typically been provided through natural or legal monopolies, wheremore » few incentives exist to reduce costs. It is thus vital to examine empirically the cost structure of these services in order to develop effective public policies which can make these services more cost efficient. Accordingly, this paper considers economies of size and economies of output density in the municipal waste collection sector in the New South Wales (NSW) local government system in an effort to identify the optimal size of utilities from the perspective of cost efficiency. Our results show that – as presently constituted – NSW municipal waste services are not efficient in terms of costs, thereby demonstrating that ‘bigger is not better.’ The optimal size of waste utilities is estimated to fall in the range 12,000–20,000 inhabitants. However, significant economies of output density for unsorted (residual) municipal waste collection and recycling waste collection were found, which means it is advantageous to increase the amount of waste collected, but maintaining constant the number of customers and the intervention area.« less

Cross-sector Service Provision in Health and Social Care: An Umbrella Review.

PubMed

Winters, Shannon; Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

2016-04-08

Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out-comes related to cross-sector service provision are still needed before any claims about effectiveness can be made.

Cross-sector Service Provision in Health and Social Care: An Umbrella Review

PubMed Central

Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

2016-01-01

Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out-comes related to cross-sector service provision are still needed before any claims about effectiveness can be made. PMID:27616954

The third sector, user involvement and public service reform: a case study in the co-governance of health service provision.

PubMed

Martin, Graham P

2011-01-01

The ‘modernization’ of British public services seeks to broaden public sector governance networks, bringing the views of third sector organizations, the public and service users (among others) to the design, management and delivery of welfare. Building on previous analyses of the contradictions generated by these roles, this paper draws on longitudinal qualitative research to enunciate the challenges faced by one third-sector organization in facilitating service user influence in a UK National Health Service (NHS) pilot programme, alongside other roles in tension with this advocacy function. The analysis highlights limits in the extent to which lateral governance networks pluralize stakeholder involvement. The ‘framing’ of governance may mean that traditional concerns outweigh the views of new stakeholders such as the third sector and service users. Rather than prioritizing wider stakeholders' views in the design and delivery of public services, placing third sector organizations at the centre of governance networks may do more to co-opt these organizations in reproducing predominant priorities.

A multifractal detrended fluctuation analysis of financial market efficiency: Comparison using Dow Jones sector ETF indices

NASA Astrophysics Data System (ADS)

Tiwari, Aviral Kumar; Albulescu, Claudiu Tiberiu; Yoon, Seong-Min

2017-10-01

This study challenges the efficient market hypothesis, relying on the Dow Jones sector Exchange-Traded Fund (ETF) indices. For this purpose, we use the generalized Hurst exponent and multifractal detrended fluctuation analysis (MF-DFA) methods, using daily data over the timespan from 2000 to 2015. We compare the sector ETF indices in terms of market efficiency between short- and long-run horizons, small and large fluctuations, and before and after the global financial crisis (GFC). Our findings can be summarized as follows. First, there is clear evidence that the sector ETF markets are multifractal in nature. We also find a crossover in the multifractality of sector ETF market dynamics. Second, the utilities and consumer goods sector ETF markets are more efficient compared with the financial and telecommunications sector ETF markets, in terms of price prediction. Third, there are noteworthy discrepancies in terms of market efficiency, between the short- and long-term horizons. Fourth, the ETF market efficiency is considerably diminished after the global financial crisis.

Pharmacy benefit management contracting: an assessment from a recent public sector procurement experience.

PubMed

Bae, Jay P; Justice, Paul G

2002-01-01

In order to contain the cost of pharmaceuticals while preserving access to medically necessary drugs, Georgia state government competitively selected a single vendor in May of 2000 to manage combined pharmacy benefits under all of the state's health programs. By initiating this procedure, it intended to maximize the state's purchasing power and improve efficiency while streamlining the administrative structure. Synthesizing information from the request for proposal (RFP) and technical proposals submitted by 11 pharmacy benefit managers (PBMs) in response, we describe a model of public sector PBM contracting approach and present an assessment of the industry's service capability and performance statistics. Payers who have been using PBM services may find it interesting to compare their experience with the recent Georgia experience. Those who are considering contracting with a PBM will find the assessment of the PBM industry timely and informative.

Firm Efficiency and Returns-to-Scale in the Honey Bee Pollination Services Industry.

PubMed

Jones Ritten, Chian; Peck, Dannele; Ehmke, Mariah; Patalee, M A Buddhika

2018-04-03

While the demand for pollination services have been increasing, continued declines in honey bee, Apis mellifera L. (Hymenoptera: Apidae), colonies have put the cropping sector and the broader health of agro-ecosystems at risk. Economic factors may play a role in dwindling honey bee colony supply in the United States, but have not been extensively studied. Using data envelopment analysis (DEA), we measure technical efficiency, returns to scale, and factors influencing the efficiency of those apiaries in the northern Rocky Mountain region participating in the pollination services market. We find that, although over 25% of apiaries are technically efficient, many experience either increasing or decreasing returns to scale. Smaller apiaries (under 80 colonies) experience increasing returns to scale, but a lack of available financing may hinder them from achieving economically sustainable colony levels. Larger apiaries (over 1,000 colonies) experience decreasing returns to scale. Those beekeepers may have economic incentivizes to decrease colony numbers. Using a double bootstrap method, we find that apiary location and off-farm employment influence apiary technical efficiency. Apiaries in Wyoming are found to be more efficient than those in Utah or Montana. Further, engagement in off-farm employment increases an apiary's technical efficiency. The combined effects of efficiency gains through off-farm employment and diseconomies of scale may explain, in part, the historical decline in honey bee numbers.

Costs and utilization of public sector family planning services in Pakistan.

PubMed

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

Energy Efficiency Roadmap for Uganda, Making Energy Efficiency Count. Executive Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; Pudleiner, David; Jones, David

Like many countries in Sub-Saharan Africa, Uganda has focused its energy sector investments largely on increasing energy access by increasing energy supply. The links between energy efficiency and energy access, the importance of energy efficiency in new energy supply, and the multiple benefits of energy efficiency for the level and quality of energy available, have been largely overlooked. Implementing energy efficiency in parallel with expanding both the electricity grid and new clean energy generation reduces electricity demand and helps optimize the power supply so that it can serve more customers reliably at minimum cost. Ensuring efficient appliances are incorporated intomore » energy access efforts provides improved energy services to customers. Energy efficiency is an important contributor to access to modern energy. This Energy Efficiency Roadmap for Uganda (Roadmap) is a response to the important role that electrical energy efficiency can play in meeting Uganda’s energy goals. Power Africa and the United Nations Sustainable Energy for All (SEforALL) initiatives collaborated with more than 24 stakeholders in Uganda to develop this document. The document estimates that if the most efficient technologies on the market were adopted, 2,224 gigawatt hours could be saved in 2030 across all sectors, representing 31% of the projected load. This translates into 341 megawatts of peak demand reductions, energy access to an additional 6 million rural customers and reduction of carbon dioxide emissions by 10.6 million tonnes in 2030. The Roadmap also finds that 91% of this technical potential is cost-effective, and 47% is achievable under conservative assumptions. The Roadmap prioritizes recommendations for implementing energy efficiency and maximizing benefits to meet the goals and priorities established in Uganda’s 2015 SEforALL Action Agenda. One important step is to create and increase demand for efficiency through long-term enabling policies and financial incentives combined with development of technical expertise in the labor force to allow for the promotion of new business models, such as energy service companies. A combination of enabling policies, financial schemes, regulations, enforcement, and skill development are needed to open the energy efficiency market.« less

[Evaluation of financial performance of health services: reflections of operational policies in the hospital sector].

PubMed

Bonacim, Carlos Alberto Grespan; de Araujo, Adriana Maria Procópio

2011-01-01

Discussions about management manners and procedures has been relevant among organization managers in the health services. The health services economic evaluation approaches this theme and is taking an important role around the world, demanding the manager new challenges concerning the continuous search of activities efficiency and efficacy. The objective is to describe the consequences of operational changes in the economic-financial indicators of a Public Hospital. The methodology applied included besides the literature research, a case study in the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto--USP". The values found confirm the context of the hospital. One concludes that the average costs present similar behaviors with trend to stabilization, thus confirming improvements in efficiency. The importance of the rendering of accounts for the society related to the use of public resources and how this study can help in this way.

Evaluation of Immunization Knowledge, Practices, and Service-delivery in the Private Sector in Cambodia

PubMed Central

Soeung, Sann Chan; Grundy, John; Morn, Cheng; Samnang, Chham

2008-01-01

A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facilities; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. In terms of prevalence of private-sector provision of immunization services, 93% of the private inpatient clinics surveyed provided immunization services. The private sector demonstrated a lack of quality of care and management in terms of health workers’ knowledge of immunization schedules, waste and vaccine management practices, and exchange of health information with the public sector. Policy and operational guidelines are required for private-sector immunization practices that address critical subject areas, such as setting of standards, capacity-building, public-sector monitoring, and exchange of health information between the public and the private sector. Such public/private collaborations will keep pace with the trends towards the development of private-sector provision of health services in developing countries. PMID:18637533

Assessing National Employment Impacts of Investment in Residential and Commercial Sector Energy Efficiency: Review and Example Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anderson, David M.; Belzer, David B.; Livingston, Olga V.

Pacific Northwest National Laboratory (PNNL) modeled the employment impacts of a major national initiative to accelerate energy efficiency trends at one of two levels: • 15 percent savings by 2030. In this scenario, efficiency activities save about 15 percent of the Annual Energy Outlook (AEO) Reference Case electricity consumption by 2030. It is assumed that additional energy savings in both the residential and commercial sectors begin in 2015 at zero, and then increase in an S-shaped market penetration curve, with the level of savings equal to about 7.0 percent of the AEO 2014 U.S. national residential and commercial electricity consumptionmore » saved by 2020, 14.8 percent by 2025, and 15 percent by 2030. • 10 percent savings by 2030. In this scenario, additional savings begin at zero in 2015, increase to 3.8 percent in 2020, 9.8 percent by 2025, and 10 percent of the AEO reference case value by 2030. The analysis of the 15 percent case indicates that by 2030 more than 300,000 new jobs would likely result from such policies, including an annual average of more than 60,000 jobs directly supporting the installation and maintenance of energy efficiency measures and practices. These are new jobs resulting initially from the investment associated with the construction of more energy-efficient new buildings or the retrofit of existing buildings and would be sustained for as long as the investment continues. Based on what is known about the current level of building-sector energy efficiency jobs, this would represent an increase of more than 10 percent from the current estimated level of over 450,000 such jobs. The more significant and longer-lasting effect comes from the redirection of energy bill savings toward the purchase of other goods and services in the general economy, with its attendant influence on increasing the total number of jobs. This example analysis utilized PNNL’s ImSET model, a modeling framework that PNNL has used over the past two decades to assess the economic impacts of the U.S. Department of Energy’s (DOE’s) energy efficiency programs in the buildings sector.« less

76 FR 49434 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

..., Entertainment, and Recreation; and Other Services (Except Public Administration) Sectors. OMB Control Number... assistance; arts, entertainment, and recreation; and other services (except public administration) sectors..., hobby, or leisure time interests. The other services, except public administration sector comprises...

Framing the decision to contract out elderly care and primary health care services – perspectives of local level politicians and civil servants in Finland

PubMed Central

2012-01-01

Background In the literature there are only few empirical studies that analyse the decision makers’ reasoning to contract out health care and social services to private sector. However, the decisions on the delivery patterns of health care and social services are considered to be of great importance as they have a potential to influence citizens’ access to services and even affect their health. This study contributes to filling this cap by exploring the frames used by Finnish local authorities as they talk about contracting out of primary health care and elderly care services. Contracting with the private sector has gained increasing popularity, in Finland, during the past decade, as a practise of organising health care and social services. Methods Interview data drawn from six municipalities through thematic group interviews were used. The data were analysed applying frame analysis in order to reveal the underlying reasoning for the decisions. Results Five argumentation frames were found: Rational reasoning; Pragmatic realism; Promoting diversity among providers; Good for the municipality; Good for the local people. The interviewees saw contracting with the private sector mostly as a means to improve the performance of public providers, to improve service quality and efficiency and to boost the local economy. The decisions to contract out were mainly argued through the good for the municipal administration, political and ideological commitments, available resources and existing institutions. Conclusions This study suggests that the policy makers use a number of grounds to justify their decisions on contracting out. Most of the arguments were related to the benefits of the municipality rather than on what is best for the local people. The citizens were offered the role of active consumers who are willing to purchase services also out-of-pocket. This development has a potential to endanger the affordability of the services and lead to undermining some of the traditional principles of the Nordic welfare state. PMID:22805167

Framing the decision to contract out elderly care and primary health care services - perspectives of local level politicians and civil servants in Finland.

PubMed

Tynkkynen, Liina-Kaisa; Lehto, Juhani; Miettinen, Sari

2012-07-17

In the literature there are only few empirical studies that analyse the decision makers' reasoning to contract out health care and social services to private sector. However, the decisions on the delivery patterns of health care and social services are considered to be of great importance as they have a potential to influence citizens' access to services and even affect their health. This study contributes to filling this cap by exploring the frames used by Finnish local authorities as they talk about contracting out of primary health care and elderly care services. Contracting with the private sector has gained increasing popularity, in Finland, during the past decade, as a practise of organising health care and social services. Interview data drawn from six municipalities through thematic group interviews were used. The data were analysed applying frame analysis in order to reveal the underlying reasoning for the decisions. Five argumentation frames were found: Rational reasoning; Pragmatic realism; Promoting diversity among providers; Good for the municipality; Good for the local people. The interviewees saw contracting with the private sector mostly as a means to improve the performance of public providers, to improve service quality and efficiency and to boost the local economy. The decisions to contract out were mainly argued through the good for the municipal administration, political and ideological commitments, available resources and existing institutions. This study suggests that the policy makers use a number of grounds to justify their decisions on contracting out. Most of the arguments were related to the benefits of the municipality rather than on what is best for the local people. The citizens were offered the role of active consumers who are willing to purchase services also out-of-pocket. This development has a potential to endanger the affordability of the services and lead to undermining some of the traditional principles of the Nordic welfare state.

Role of the private sector in the provision of immunization services in low- and middle-income countries.

PubMed

Levin, Ann; Kaddar, Miloud

2011-07-01

The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization services in low- and middle-income countries.

Effects of recent energy system changes on CO2 projections for the United States.

PubMed

Lenox, Carol S; Loughlin, Daniel H

2017-09-21

Recent projections of future United States carbon dioxide (CO 2 ) emissions are considerably lower than projections made just a decade ago. A myriad of factors have contributed to lower forecasts, including reductions in end-use energy service demands, improvements in energy efficiency, and technological innovations. Policies that have encouraged these changes include renewable portfolio standards, corporate vehicle efficiency standards, smart growth initiatives, revisions to building codes, and air and climate regulations. Understanding the effects of these and other factors can be advantageous as society evaluates opportunities for achieving additional CO 2 reductions. Energy system models provide a means to develop such insights. In this analysis, the MARKet ALlocation (MARKAL) model was applied to estimate the relative effects of various energy system changes that have happened since the year 2005 on CO 2 projections for the year 2025. The results indicate that transformations in the transportation and buildings sectors have played major roles in lowering projections. Particularly influential changes include improved vehicle efficiencies, reductions in projected travel demand, reductions in miscellaneous commercial electricity loads, and higher efficiency lighting. Electric sector changes have also contributed significantly to the lowered forecasts, driven by demand reductions, renewable portfolio standards, and air quality regulations.

[On the issues of private-public partnership in health care: the case of organization of optometric service)].

PubMed

2011-01-01

The article deals with the issue of private-public partnership in health care. It is demonstrated that in many countries health care system condition is characterized by increase of problems in organization, financing and provision of medical sanitary care. The exponent up growth of aggregate costs of health care, medical services financing occurs. The system of public and municipal health care has no adequate resources to efficiently function without interaction with private organizations. The reason is that most of the suppliers of medical services are not public or municipal belonging. It is necessary to provide inter-financing of curative preventive care at the expense of funds of public and private economic sectors within a framework of full-scale implementation health care the mechanisms of private-public partnership. The studies in this field are to be organized on the example of organizational specificity of optometric service which is positioned concurrently in public and private sectors. This approach makes it possible to reveal feasible ways of implementation of the private-public partnership institution to enhance quality and accessibility of medical care to population in the conditions of concurrent model of health care and globalization challenges.

Assessing global resource utilization efficiency in the industrial sector.

PubMed

Rosen, Marc A

2013-09-01

Designing efficient energy systems, which also meet economic, environmental and other objectives and constraints, is a significant challenge. In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement. Energy analysis alone is inadequate, e.g., it yields energy efficiencies that do not provide limits to efficiency. To obtain meaningful and useful efficiencies for energy systems, and to clarify losses, exergy analysis is a beneficial and useful tool. Here, the global industrial sector and industries within it are assessed by using energy and exergy methods. The objective is to improve the understanding of the efficiency of global resource use in the industrial sector and, with this information, to facilitate the development, prioritization and ultimate implementation of rational improvement options. Global energy and exergy flow diagrams for the industrial sector are developed and overall efficiencies for the global industrial sector evaluated as 51% based on energy and 30% based on exergy. Consequently, exergy analysis indicates a less efficient picture of energy use in the global industrial sector than does energy analysis. A larger margin for improvement exists from an exergy perspective, compared to the overly optimistic margin indicated by energy. Copyright © 2012 Elsevier B.V. All rights reserved.

Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

PubMed

Longmore, Bruce; Ronnie, Linda

2014-03-26

Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

Primary care and reform of health systems: a framework for the analysis of Latin American experiences.

PubMed

Frenk, J; González-Block, M A

1992-03-01

The article first proposes a framework within which to assess the potential of health sector reforms in Latin America for primary health care (PHC). Two dimensions are recognized: the scope of the reforms, content, and the means of participation that are put into play. This framework is then complemented through a critique of the often-sought but little-analyzed PHC reform strategies of decentralization and health sector integration. The analytical framework is next directed to the financing of health services, a chief aspect of any reform aiming toward PHC. Two facets of health service finance are first distinguished: its formal aspect as a means for economic subsistence and growth, and its substantive aspect as a means to promote the rational use of services and thus improvement of health. Once finance is understood in this microeconomic perspective, the focus shifts to the analysis of health care reforms at the macro, health policy level. The article concludes by positing that PHC is in essence a new health care paradigm, oriented by the values of universality, redistribution, integration, plurality, quality, and efficiency.

Transitions to material efficiency in the UK steel economy.

PubMed

Allwood, Julian M

2013-03-13

Steel production is energy intensive so already has achieved impressive levels of energy efficiency. If the emissions associated with steel must be reduced in line with the requirements of the UK Climate Change Act, demand for new steel must be reduced. The strategies of 'material efficiency' aim to achieve such a reduction, while delivering the same final services. To meet the emissions targets set into UK law, UK consumption of steel must be reduced to 30 per cent of present levels by 2050. Previous work has revealed six strategies that could contribute to this target, and this paper presents an approximate analysis of the required transition. A macro-economic analysis of steel in the UK shows that while the steel industry is relatively small, the construction and manufacturing sectors are large, and it would be politically unacceptable to pursue options that lead to a major contraction in other sectors. Alternative business models are therefore required, and these are explored through four representative products--one for each final sector with particular emphasis given to options for reducing product weight, and extending product life. Preliminary evidence on the triggers that would lead to customers preferring these options is presented and organized in order to predict required policy measures. The estimated analysis of transitions explored in this paper is used to define target questions for future research in the area.

The quality of family planning services and client satisfaction in the public and private sectors in Kenya.

PubMed

Agha, Sohail; Do, Mai

2009-04-01

To compare the quality of family planning services delivered at public and private facilities in Kenya. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.

Utilization of skilled birth attendants in public and private sectors in Vietnam.

PubMed

Do, Mai

2009-05-01

The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

The Value of Open Geographical Data - The Danish Case

NASA Astrophysics Data System (ADS)

Colding, T. S.; Folner, M.; Krarup, S.; Kongsbak, J.

2013-12-01

Good basic data for everyone is part of the common public-sector digitization strategy for 2011 to 2015. The vision is that basic data is to be the high-quality common foundation for public sector administration; efficiently updated at one place, and used by everyone - including the private sector. Open basic data will benefit public-sector efficiency as well as innovation and value creation by Danish society in general. With basic data as a new digital raw material, commercial products can be developed and public information and services can be improved, providing for greater insight and stronger democracy. On the first of January 2013 Denmark released this digital raw material. As a general rule, all basic data is to be made freely available to all public authorities, private businesses and individuals. This makes basic data a common digital resource, which can be exploited freely for commercial as well as non-commercial purposes. A positive business case contributed in convincing Danish politicians to approve the basic data program. Once the initiatives have been fully implemented, the revenues for society are expected to be approx. DKK 800 million annually. Private-sector revenues will be up to DKK half a billion annually, and it is expected that e.g. the real estate, insurance, financial, and telecom sectors, as well as GPS (sat-nav) manufacturers, public companies and entrepreneurs will be among those to benefit hugely from the initiatives. The financial gain for the private sector of open geographical data alone is expected to be approx. 100 million DKK annually. As part of the Basic data program The Danish Geodata Agency (Ministry of the Environment) gave free access to all topographic data, cadastral maps and Digital Elevation Model on Jan. 1st, 2013. The Danish Geodata Agency has decided to measure the effect of the open geographic data in the public sector (efficiency) and in the private sector (growth). The effect will be measured by using reference data (baseline analysis) from 2012. The reference data will cover statistics about who was using which dataset, for what, and what was the value of the use of data. This presentation briefly introduces the process behind open geographical data in Denmark, including a presentation of the positive business case. The presentation focuses on the research design used for measuring the effect of open geographical data in Denmark. Finally, the preliminary responses of open geographical data in the private and the public sector will be presented.

Modelling inflation in transportation, comunication and financial services using B-Spline time series model

NASA Astrophysics Data System (ADS)

Suparti; Prahutama, Alan; Santoso, Rukun

2018-05-01

Inflation is an increase in the price of goods and services in general where the goods and services are the basic needs of society or the decline of the selling power of a country’s currency. Significant inflationary increases occurred in 2013. This increase was contributed by a significant increase in some inflation sectors / groups i.e transportation, communication and financial services; the foodstuff sector, and the housing, water, electricity, gas and fuel sectors. However, significant contributions occurred in the transportation, communications and financial services sectors. In the model of IFIs in the transportation, communication and financial services sector use the B-Spline time series approach, where the predictor variable is Yt, whereas the predictor is a significant lag (in this case Yt-1). In modeling B-spline time series determined the order and the optimum knot point. Optimum knot determination using Generalized Cross Validation (GCV). In inflation modeling for transportation sector, communication and financial services obtained model of B-spline order 2 with 2 points knots produce MAPE less than 50%.

Co-Optima Targets Maximum Transportation Sector Efficiency, Energy

Science.gov Websites

Independence and Industry Growth | News | NREL Co-Optima Targets Maximum Transportation Sector Efficiency, Energy Independence and Industry Growth Co-Optima Targets Maximum Transportation Sector Efficiency, Energy Independence and Industry Growth February 6, 2017 Report cover on Co-Optima Year in Review

Social service offices as a point of entry into substance abuse treatment for poor South Africans

PubMed Central

2012-01-01

Background In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. Despite this, little is known about the profile of people presenting with substance-related problems at these service points. This has a negative impact on treatment service planning. This paper begins to redress this gap through describing patterns of substance use and service needs among people using general social services in the Western Cape and comparing findings against the profile of persons attending specialist substance abuse treatment facilities in the region. Methods As part of a standard client information system, an electronic questionnaire was completed for each person seeking social assistance. Data on socio-demographic characteristics, the range of presenting problems, patterns of substance use, perceived consequences of substance use, as well as types of services provided were analysed for the 691 social welfare clients who reported substance use between 2007 and 2009. These data were compared against clients attending substance abuse treatment centres during the same time period. Results Findings indicate that social services offices are used as a way of accessing specialist services but are also used as a service point, especially by groups under-represented in the specialist treatment sector. Women, people from rural communities and people with alcohol-related problems are more likely to seek assistance at social service offices providing low threshold intervention services than from the specialist treatment sector. Conclusions The study provides evidence that social services are a point of entry and intervention for people from underserved communities in the Western Cape. If these low-threshold services can be supported to provide good quality services, they may be an effective and efficient way of improving access to treatment in a context of limited service availability. PMID:22642796

Equity and efficiency of medical service systems at the provincial level of China's mainland: a comparative study from 2009 to 2014.

PubMed

Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang

2018-02-05

The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems but minor across regions, and the score changed very little over time. More importantly, the central region held the lowest average efficiency score in the past 6 years, while the western region held the largest average efficiency score at the first 5 years, which should receive enough attention of the government and decision-makers. In practice, efficiency was related to many complicated factors, indicating that the improvement of efficiency is a complex and iterative process that requires the strong cooperation of many sectors.

Does the private sector have a role in Canadian healthcare?

PubMed

McGowan, Tom

2004-01-01

The current system of public pay with primarily public management for essential healthcare services has largely been successful. The Romanow and Kirby reports have made compelling arguments for expanding the definition of essential healthcare services to include, among other things, medications. The problem facing Canadians is that expanding services is not feasible under the current structure, as it is not affordable. The rigid adherence to a 45-year-old definition of system structure is hampering our ability to innovate. In an increasingly unresponsive system, the introduction of private management, through the judicious use of private contracts, can improve efficiency and increase accountability, while maintaining the important principle of public funding.

[Relations between official and private veterinary services in epidemiology and the control of contagious diseases].

PubMed

Moura, J A; Bedoya, M; Agudelo, M P

2004-04-01

Growing budget restrictions in many countries have meant that official Veterinary Services cannot assume responsibility for any new activities. The natural reaction is to turn to private veterinary services to provide the support needed to strengthen the control and surveillance of priority diseases and thereby support the development of the livestock sector and the establishment of safe international trade. In this context, official Veterinary Services must work together with private veterinarians, delegating various technical animal health activities, so that they may focus their efforts on those tasks that cannot be delegated: standardisation, control, auditing, general system co-ordination, epidemiological surveillance, etc., as well as organising veterinary policy in order to make best use of budget resources. For these relations to be efficient, a dynamic, two-way epidemiological information mechanism must be created, whereby private veterinarians periodically keep governments informed, on the basis of an agreed methodology. Moreover, the official Veterinary Services must systematically transmit information on List A and B diseases of the OIE (World organisation for animal health), and perform detailed analyses of epidemiologically significant events. The article proposes the establishment of relations between public and private veterinary services as a way in which to provide the livestock sector with the health and hygiene conditions that are necessary for effective disease control, which in turn provides greater security for international trade and increased consumer protection.

Incorporating Multifaceted Mental Health Prevention Services in Community Sectors-of-Care

ERIC Educational Resources Information Center

Gewirtz, Abigail H.; August, Gerald J.

2008-01-01

This article proposes a framework for embedding prevention services into community sectors-of-care. Community sectors-of-care include both formal and grassroot organizations distributed throughout a community that provide various resources and services to at-risk children and their families. Though the child population served by these…

Impact of Affirmative Action on Quality of Service Delivery in the Public Service Sector of Kenya: A Comparative Case Study of the Ministry of State in the Office of the President and Ministry of Higher Education

ERIC Educational Resources Information Center

Kilonzo, Evans Mbuthi; Ikamari, Lawrence

2015-01-01

This study was carried out to determine the impact of affirmative action policy on the quality service delivery in the public service sector of Kenya. The study was carried out on the premise that there is a relationship between affirmative Action implementation and the quality of service delivery in the public service sector of Kenya. A lot of…

Methods of Evaluating the Efficiency of Energy Saving Projects with Taking Risks into Account

ERIC Educational Resources Information Center

Kvon, Gulnara M.; Khamidullin, Farid F.; Samysheva, Ekaterina Y.; Vaks, Vera B.; Mararov, Nikita V.

2016-01-01

The relevance of the problem studied in the article is caused by the fact that now the process of reforming the housing and utilities sector in the Republic of Tatarstan continues. Its purpose is to increase the quality of service for public and to protect their legitimate rights and interests. That is why it is one of the aspects of social and…

Delivering Patient-Centered Care in a Fragile State: Using Patient-Pathway Analysis to Understand Tuberculosis-Related Care Seeking in Pakistan.

PubMed

Fatima, Razia; Haq, Mahboob Ul; Yaqoob, Aashifa; Mahmood, Nasir; Ahmad, Khawaja Laeeq; Osberg, Mike; Makayova, Julia; Hymoff, Aaron; Hanson, Christy

2017-11-06

Pakistan has the sixth largest population in the world and boasts the fifth greatest burden of tuberculosis. The Government of Pakistan has set the ambitious goal of zero deaths due to tuberculosis and universal access to tuberculosis care by 2020. Successfully reaching these goals is dependent on the country's capacity to diagnose and successfully treat an estimated 200000 unnotified or missing patients with tuberculosis. A patient-pathway analysis (PPA) was conducted at the national level, as well as for each of the 4 provinces, to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services. Almost 90% of patients initiated care in the private sector, which accounts for only 15% of facilities with the capacity for tuberculosis diagnosis and treatment. Across the country, nearly 50% of tuberculosis microscopy laboratories were located in public-sector-basic health units and regional health centers. However, very few patients initiated care in these facilities. Overall, tuberculosis case detection was high given the low likelihood of patients reaching facilities with the capacity for tuberculosis service delivery during their first visit. Improving the engagement of the informal sector and lower-level clinicians will improve the efficiency and timeliness of tuberculosis diagnosis for patients in Pakistan. Concurrently, the apparent strength of the referral networks connecting community-level workers and private clinicians to the public sector for tuberculosis diagnosis and treatment suggests that strengthening the capacity of the public sector could be valuable. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

High-Resolution Water Footprints of Production of the United States

NASA Astrophysics Data System (ADS)

Marston, Landon; Ao, Yufei; Konar, Megan; Mekonnen, Mesfin M.; Hoekstra, Arjen Y.

2018-03-01

The United States is the largest producer of goods and services in the world. Rainfall, surface water supplies, and groundwater aquifers represent a fundamental input to economic production. Despite the importance of water resources to economic activity, we do not have consistent information on water use for specific locations and economic sectors. A national, spatially detailed database of water use by sector would provide insight into U.S. utilization and dependence on water resources for economic production. To this end, we calculate the water footprint of over 500 food, energy, mining, services, and manufacturing industries and goods produced in the United States. To do this, we employ a data intensive approach that integrates water footprint and input-output techniques into a novel methodological framework. This approach enables us to present the most detailed and comprehensive water footprint analysis of any country to date. This study broadly contributes to our understanding of water in the U.S. economy, enables supply chain managers to assess direct and indirect water dependencies, and provides opportunities to reduce water use through benchmarking. In fact, we find that 94% of U.S. industries could reduce their total water footprint more by sourcing from more water-efficient suppliers in their supply chain than they could by converting their own operations to be more water-efficient.

Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

PubMed

Grépin, Karen A

2016-07-01

There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. Project HOPE—The People-to-People Health Foundation, Inc.

Expansion of environmental impact assessment for eco-efficiency evaluation of China's economic sectors: An economic input-output based frontier approach.

PubMed

Xing, Zhencheng; Wang, Jigan; Zhang, Jie

2018-09-01

Due to the increasing environmental burdens caused by dramatic economic expansion, eco-efficiency indicating how efficient the economic activity is with respect to its environmental impacts has become a topic of considerable interest in China. In this context, Economic Input-output Life Cycle Assessment (EIO-LCA) and Data Envelopment Analysis (DEA) are combined to assess the environmental impacts and eco-efficiency of China's 26 economic sectors. The EIO-LCA results indicate that Electricity Production and Supply sector is the largest net exporter in energy usage, CO 2 emission and exhaust emission categories, while Construction sector is the largest net importer for five impact categories except for water withdrawal. Moreover, Construction sector is found to be the destination of the largest sector-to-sector environmental impact flows for the five impact categories and make the most contributions to the total environmental impacts. Another key finding is that Agriculture sector is both the largest net exporter and the greatest contributor for water withdrawal category. DEA results indicate that seven sectors are eco-efficient while over 70% of China's economic sectors are inefficient and require significant improvements. The average target improvements range between 23.30% and 35.06% depending on the impact category. Further sensitivity analysis reveals that the average sensitivity ratios vary from 7.7% to 15.7% among the six impact categories, which are found to be negatively correlated with their improvement potentials. Finally, several policy recommendations are made to mitigate environmental impacts of China's economic sectors and improve their eco-efficiency levels. Copyright © 2018 Elsevier B.V. All rights reserved.

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

PubMed Central

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-01-01

Background: To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. Methods: We analyzed MSI’s social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008–2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011–2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI “Impact 2” model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Results: Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of them reporting having never previously used family planning at all. Analysis of age and poverty levels of clients indicate mixed results in bridging equity gaps: 57.4% of clients lived on under US$2.50/day in 2013 (95% CI = 54.9, 60.0) and 26.1% were 15–24 years old (95% CI = 23.8, 28.4), but only 15.1% lived on less than $1.25/day (95% CI = 13.8, 16.4) and 5.0% were 15–19 years old (95% CI = 3.9, 6.1). The services provided via social franchising are estimated to avert 4,958,000 unintended pregnancies and 7,150 maternal deaths. Conclusion: Social franchising through the existing private sector has the ability to rapidly scale-up access to high-quality family planning services, including LARCs, for the general population as well as young women and the poor, providing a promising model to help achieve the global FP2020 goal. PMID:26085018

Economic accounting of water: The Botswana experience

NASA Astrophysics Data System (ADS)

Setlhogile, T.; Arntzen, J.; Pule, O. B.

2017-08-01

Water accounts aim to capture the value of water resources and their use within the economy. The accounts complement the National Accounts as the latter's main indicator (GDP) does not reflect changes in natural capital. Botswana developed water accounts for the period 2010/11-2014/15 using the UN's standard System of Environmental Economic Accounting for water (SEEA-water). The article focuses both on the construction of physical flow accounts as well as on the policy implications for development planning and water resource management through the use of policy indicators. It also shows long-term trends in water abstraction and water use efficiency linking the SEEA water accounts with results of earlier (non-SEEA) water accounting projects in Botswana. The water accounts results show that water abstraction and consumption have been largely stable since 2010/11 despite population (1.9% p.a.) and economic growth (around 5% p.a.) likely due to a combination of water sector reforms and drought conditions in south eastern Botswana; the latter led to the drying up of several dams and the imposition of severe water restrictions. While public attention focuses mostly on water service providers, self-providers (mines and the agricultural sector) account for more than 50% of total water abstracted from the environment of water, demonstrating the need to pay more attention to self-providers in IWRM implementation. Water consumption is highest for the agricultural sector (70.2 Mm3) followed by households and mines at 41.2 and 39 Mm3 respectively in 2014/15. In terms of water use efficiency, value added per m3 has increased in time, showing (some) decoupling of water consumption and economic growth. This positive trend needs to be enhanced in the pursuit of economic diversification, which should focus on growth of water-efficient economic sectors. Finally, per capita water consumption has decreased over time; while this may indicate that people conserve water, it may also point at delivery problems associated with water sector reforms. This requires further analysis.

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2010 CFR

2010-10-01

... use of private sector temporaries. Contracting officers may enter into contracts with temporary help service firms for the brief or intermittent use of the skills of private sector temporaries. Services... part 300, subpart E, Use of Private Sector Temporaries, and agency procedures. [56 FR 55380, Oct. 25...

Awareness of occupational skin disease in the service sector.

PubMed

Holness, D L; Kudla, I; Brown, J; Miller, S

2017-06-01

Occupational skin disease (OSD) is a common occupational disease. Although primary prevention strategies are known, OSDs remain prevalent in a variety of work environments including the service sector (restaurant/food services, retail/wholesale, tourism/hospitality and vehicle sales and service). To obtain information about awareness and prevention of OSD in the service sector. Focus groups and a survey were conducted with two groups. The first consisted of staff of the provincial health and safety association for the service sector and the second group comprised representatives from sector employers. Focus groups highlighted key issues to inform the survey that obtained information about perceptions of awareness and prevention of OSD and barriers to awareness and prevention. Both provincial health and safety association staff and sector employer representatives highlighted low awareness and a low level of knowledge of OSD in the sector. Barriers to awareness and prevention included a low reported incidence of OSD, low priority, lack of training materials, lack of time and cost of training, lack of management support and workplace culture. A starting point for improving prevention of OSD in the service sector is increased awareness. Identification of the barriers to awareness and prevention will help to shape an awareness campaign and prevention strategies. Building on existing experience in Europe will be important. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Employment Profile of the Service Sector in Selected Countries.

ERIC Educational Resources Information Center

Bednarzik, Robert W.

The rise of the service sector is a major trend common to all western, industrialized countries. Employment in the service sector has increased in 1960-1986 in all 10 countries participating in the Organisation for Economic Cooperation and Development's Centre for Educational Research and Innovation Human Resources project (Japan, Belgium, France,…

Measuring energy efficiency in economics: Shadow value approach

NASA Astrophysics Data System (ADS)

Khademvatani, Asgar

For decades, academic scholars and policy makers have commonly applied a simple average measure, energy intensity, for studying energy efficiency. In contrast, we introduce a distinctive marginal measure called energy shadow value (SV) for modeling energy efficiency drawn on economic theory. This thesis demonstrates energy SV advantages, conceptually and empirically, over the average measure recognizing marginal technical energy efficiency and unveiling allocative energy efficiency (energy SV to energy price). Using a dual profit function, the study illustrates how treating energy as quasi-fixed factor called quasi-fixed approach offers modeling advantages and is appropriate in developing an explicit model for energy efficiency. We address fallacies and misleading results using average measure and demonstrate energy SV advantage in inter- and intra-country energy efficiency comparison. Energy efficiency dynamics and determination of efficient allocation of energy use are shown through factors impacting energy SV: capital, technology, and environmental obligations. To validate the energy SV, we applied a dual restricted cost model using KLEM dataset for the 35 US sectors stretching from 1958 to 2000 and selected a sample of the four sectors. Following the empirical results, predicted wedges between energy price and the SV growth indicate a misallocation of energy use in stone, clay and glass (SCG) and communications (Com) sectors with more evidence in the SCG compared to the Com sector, showing overshoot in energy use relative to optimal paths and cost increases from sub-optimal energy use. The results show that energy productivity is a measure of technical efficiency and is void of information on the economic efficiency of energy use. Decomposing energy SV reveals that energy, capital and technology played key roles in energy SV increases helping to consider and analyze policy implications of energy efficiency improvement. Applying the marginal measure, we also contributed to energy efficiency convergence analysis employing the delta-convergence and unconditional & conditional beta-convergence concepts, investigating economic energy efficiency differences across the four US sectors using panel data models. The results show that, in terms of technical and allocative energy efficiency, the energy-intensive sectors, SCG and textile mill products, tend to catch the energy extensive sectors, the Com and furniture & fixtures, being conditional on sector-specific characteristics. Conditional convergence results indicate that technology, capital and energy are crucial factors in determining energy efficiency differences across the US sectors, implying that environmental or energy policies, and technological changes should be industry specific across the US sectors. The main finding is that the marginal value measure conveys information on both technical and allocative energy efficiency and accounts for all costs and benefits of energy consumption including environmental and externality costs.

Economic Dependence of U.S. Industrial Sectors on Animal-Mediated Pollination Service.

PubMed

Chopra, Shauhrat S; Bakshi, Bhavik R; Khanna, Vikas

2015-12-15

Declining animal pollinator health and diversity in the U.S. is a matter of growing concern and has particularly gained attention since the emergence of colony collapse disorder (CCD) in 2006. Failure to maintain adequate animal-mediated pollination service to support increasing demand for pollination-dependent crops poses risks for the U.S. economy. We integrate the Economic Input-Output (EIO) model and network analysis with data on pollinator dependence of crops to understand the economic dependence of U.S. industrial sectors on animal-mediated pollination service. The novelty of this work lies in its ability to identify industrial sectors and industrial communities (groups of closely linked sectors) that are most vulnerable to scarcity of pollination service provided by various animal species. While the economic dependence of agricultural sectors on pollination service is significant (US$14.2-23.8 billion), the higher-order economic dependence of the rest of the U.S. industrial sectors is substantially high as well (US$10.3-21.1 billion). The results are compelling as they highlight the critical importance of animal-induced pollination service for the U.S. economy, and the need to account for the role of ecosystem goods and services in product life cycles.

Assessment of management approaches in a public water utility: A case study of the Namibia water corporation (NAMWATER)

NASA Astrophysics Data System (ADS)

Ndokosho, Johnson; Hoko, Zvikomborero; Makurira, Hodson

More than 90% of urban water supply and sanitation services in developing countries are provided by public organizations. However, public provision of services has been inherently inefficient. As a result a number of initiatives have emerged in recent years with a common goal to improve service delivery. In Namibia, the water sector reform resulted in the creation of a public utility called the Namibia Water Corporation (NAMWATER) which is responsible for bulk water supply countrywide. Since its inception in 1998, NAMWATER has been experiencing poor financial performance. This paper presents the findings of a case study that compared the management approaches of NAMWATER to the New Public Management (NPM) paradigm. The focus of the NPM approach is for the public water sector to mirror private sector methods of management so that public utilities can accrue the benefits of effectiveness, efficiency and flexibility often associated with private sector. The study tools used were a combination of literature review, interviews and questionnaires. It was found out that NAMWATER has a high degree of autonomy in its operations, albeit government approved tariffs and sourcing of external financing. The utility reports to government annually to account for results. The utility embraces a notion of good corporate culture and adheres to sound management practices. NAMWATER demonstrated a strong market-orientation indicated by the outsourcing of non-core functions but benchmarking was poorly done. NAMWATER’s customer-orientation is poor as evidenced by the lack of customer care facilities. NAMWATER’s senior management delegated operational authority to lower management to facilitate flexibility and eliminate bottlenecks. The lower management is in turn held accountable for performance by the senior management. There are no robust methods of ensuring sufficient accountability indicated by absence of performance contracts or service level agreements. It was concluded that NAMWATER’s management approaches adhere to the NPM paradigm but some NPM core-ideas such as customer orientation and external accountability (performance contracts) were visibly missing.

Public Sector/Private Sector Interaction in Providing Information Services. Report to the NCLIS from the Public Sector/Private Sector Task Force.

ERIC Educational Resources Information Center

National Commission on Libraries and Information Science, Washington, DC.

The results of a 2-year study on the interactions between government and private sector information activities are presented in terms of principles and guidelines for federal policy to support the development and use of information resources, products, and services, and to implement the principles. Discussions address sources of conflict between…

The Information Sector: Definition and Measurement.

ERIC Educational Resources Information Center

Porat, Marc U.

In the last 20 years the U.S. economy had changed as a result of the increase in production, processing, and distribution of information goods and services. Three information sectors--the primary sector producing information goods and services, the private bureaucracy, and the public bureaucracy--are part of a six-sector economy. Today,…

Incorporating Multifaceted Mental Health Prevention Services in Community Sectors-of-Care

PubMed Central

Gewirtz, Abigail H.; August, Gerald J.

2017-01-01

This article proposes a framework for embedding prevention services into community sectors-of-care. Community sectors-of-care include both formal and grassroots organizations distributed throughout a community that provide various resources and services to at-risk children and their families. Though the child population served by these organizations is often at elevated risk for mental health problems by virtue of children's exposure to difficult life circumstances (poverty, maltreatment, homelessness, domestic violence, etc) these children face many barriers to accessing evidence-based prevention or treatment services. We review evidence and propose a framework for integrating prevention services into community sectors-of-care that serve high-risk children and families. PMID:18196457

Community care: the independent sector.

PubMed Central

Barodawala, S.

1996-01-01

The independent sector, which consists of the voluntary and private sectors, is a vital element in supporting older people in the community. The voluntary sector, coordinated by the Council for Voluntary Service and the National Council for Voluntary Organisations, provides a variety of services, including practical help, reassurance and companionship, and advice, information, campaigning, and advocacy. The private sector owns all of the nursing homes and most of the residential homes and is gradually becoming more involved with the provision of services to help support older people in their own homes. With this increase in size and importance of the independent sector over recent years, there is now a real need for greater communication between the private, voluntary, and statutory agencies in any one region. In some areas, forums made up of representatives of these various sectors meet to discuss relevant issues and construct local policies, thus allowing a more coordinated approach to the delivery of services. Images p740-a p742-a PMID:8819449

Riverine ecosystem services and the thermoelectric sector: strategic issues facing the Northeastern United States

NASA Astrophysics Data System (ADS)

Miara, A.; Vorosmarty, C. J.; Stewart, R.; Wollheim, W. M.; Rosenzweig, B.

2013-12-01

Major strategic issues facing the global thermoelectric sector include environmental regulation, climate change and increasing electricity demand. We have addressed such issues by modeling thermoelectric generation in the Northeastern United States that is reliant on cooling under five sensitivity tests to evaluate losses/gains in power production, thermal pollution and suitable aquatic habitat, comparing the contemporary baseline (2000-2010) with potential future states. Integral to the analysis, we developed a methodology to quantify river water availability for cooling, which we define as an ecosystem service. Projected climate conditions reduce river water available for efficient power plant operations and the river's capacity to absorb waste heat, causing a loss of regional thermoelectric generation (RTG) (2.5%) in some summers that, compared to the contemporary baseline, is equal to the summertime electricity consumption of 1.3 million Northeastern US homes. Vulnerabilities to warm temperatures and thermal pollution can be alleviated through the use of more efficient natural gas (NG) power plants that have a reduced reliance on cooling water. Conversion of once-through (OT) to cooling tower (CT) systems and the Clean Water Act (CWA) temperature limit regulation, both of which reduce efficiencies at the single plant level, show potential to yield beneficial increases in RTG. This is achieved by obviating the need for large volumes of river water, thereby reducing plant-to-plant interferences through lowering the impact of upstream thermal pollution and preserving a minimum standard of cooling water. The results and methodology framework presented here, which can be extrapolated to other regional assessments with contrasting climates and thermoelectric profiles, can identify opportunities and support decision-making to achieve more efficient energy systems and riverine ecosystem protection.

Riverine ecosystem services and the thermoelectric sector: strategic issues facing the Northeastern United States

NASA Astrophysics Data System (ADS)

Miara, Ariel; Vörösmarty, Charles J.; Stewart, Robert J.; Wollheim, Wilfred M.; Rosenzweig, Bernice

2013-06-01

Major strategic issues facing the global thermoelectric sector include environmental regulation, climate change and increasing electricity demand. We have addressed such issues by modeling thermoelectric generation in the Northeastern United States that is reliant on cooling under five sensitivity tests to evaluate losses/gains in power production, thermal pollution and suitable aquatic habitat, comparing the contemporary baseline (2000-2010) with potential future states. Integral to the analysis, we developed a methodology to quantify river water availability for cooling, which we define as an ecosystem service. Projected climate conditions reduce river water available for efficient power plant operations and the river’s capacity to absorb waste heat, causing a loss of regional thermoelectric generation (RTG) (2.5%) in some summers that, compared to the contemporary baseline, is equal to the summertime electricity consumption of 1.3 million Northeastern US homes. Vulnerabilities to warm temperatures and thermal pollution can be alleviated through the use of more efficient natural gas (NG) power plants that have a reduced reliance on cooling water. Conversion of once-through (OT) to cooling tower (CT) systems and the Clean Water Act (CWA) temperature limit regulation, both of which reduce efficiencies at the single plant level, show potential to yield beneficial increases in RTG. This is achieved by obviating the need for large volumes of river water, thereby reducing plant-to-plant interferences through lowering the impact of upstream thermal pollution and preserving a minimum standard of cooling water. The results and methodology framework presented here, which can be extrapolated to other regional assessments with contrasting climates and thermoelectric profiles, can identify opportunities and support decision-making to achieve more efficient energy systems and riverine ecosystem protection.

Profiles of Regional Efficiency in Pakistan: Comparison of Public and Private Sector Manufacturing Firms

DTIC Science & Technology

1994-01-01

Public and Private Sector Manufacturing Firms 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...REGIONAL EFFICIENCY IN PAKISTAN: COMPARISON OF PUBLIC AND PRIVATE SECTOR MANUFACTURING FIRMS by Robert E. Looney In an examination of the relative...efficiency in public and private sector enter- prises should be explored in more detail. In this vein the purpose of the analysis below is to examine the

Three periods of health system reforms in the Republic of Macedonia (1991-2011).

PubMed

Lazarevik, V; Donev, D; Gudeva Nikovska, D; Kasapinov, B

2012-01-01

To investigate, describe and classify main health policies and reform activities within the healthcare system undertaken over the past twenty years in R. Macedonia. Desk research was conducted on scientific literature and relevant documentation (in English and Macedonian) about healthcare reforms. Relevant documents available at the Ministry of Health, Health Insurance Fund, World Bank and World Health Organization were reviewed. Official data on demographic and health status indicators were collected from the Institute of Public Health and the State Statistical Office. A working hypothesis, that the health system reforms were not continuous, was generated following the shifts in decision-making power over allocation of resources and political influences. Our study identified three periods of health system reforms in Macedonia: post-socialistic, pro-market and manifesto-driven. Throughout these periods poor maintenance, low efficiency and high operational costs increased out-of-pocket expenditures for health services and drugs and reflected on the deterioration of public hospital infrastructure. In parallel, liberal healthcare market regulation initiated commercialization of the healthcare services. Disappointed in the quality of healthcare services provided in the public health sector, many citizens opt to ask for services in private health care facilities, where social health insurance largely does not cover the costs. The pace of the reforms is not continuous and the influence of politics is highly visible over the whole period of transition in the Republic of Macedonia. The main problems of the healthcare system in the Republic of Macedonia are politicization of the health sector, high centralization and government control, and poor efficiency of public health institutions. Evaluation framework should be developed to further assess the impact of the health reforms.

Internationalisation and Changing Skill Needs in European Small Firms: The Services Sector. CEDEFOP Reference Series.

ERIC Educational Resources Information Center

Hassid, Joseph

A study explored questions on changing skill requirements of small firms in the services sector that are internationalizing their activities. These seven European Union (EU) member states were involved: Greece, Spain, Italy, Ireland, Austria, the Netherlands, and the United Kingdom. The services sector accounted for a significant part of the EU…

Autonomy and performance in the public sector: the experience of English NHS hospitals.

PubMed

Verzulli, Rossella; Jacobs, Rowena; Goddard, Maria

2018-05-01

Since 2004, English NHS hospitals have been given the opportunity to acquire a more autonomous status known as a Foundation Trust (FT), whereby regulations and restrictions over financial, management, and organizational matters were reduced in order to create incentives to deliver higher-quality services in the most efficient way. Using difference-in-difference models, we test whether achieving greater autonomy (FT status) improved hospital performance, as proxied by measures of financial management, quality of care, and staff satisfaction. Results provide little evidence that the FT policy per se has made any difference to the performance of hospitals in most of these domains. Our findings have implications for health policy and inform the trend towards granting greater autonomy to public-sector organizations.

Factors on green service industry: Case study at AirAsia

NASA Astrophysics Data System (ADS)

Abdullah, Muhammad-Azfar; Chew, Boon-Cheong; Hamid, Syaiful-Rizal

2017-03-01

Presently service organizations are challenged by fierce global competition, new technology and changing customer demands. These trends force service sectors to adapt environmental factors and places innovation at the core of their competitive strategy. On the other hand, service sectors challenge to deliver value memorable experiences and complete "service solutions" while lowering costs and keep sustainable. Despite, many studies have attempted to explore the factors that help toward environmental sustainability in the manufacturing sector, the service sector has not yet received a considerable attention in all world countries generally and in developing countries particularly. Thus, this paper aims to explore the factors that help to attain environmental sustainability in the service sector. A qualitative case study through semi-structured interview conducted with twenty managers from AirAsia to explore the factors that are related to environmental sustainability and green services. Besides, secondary data from document analysis was reviewed to gain more comprehensive understanding and triangulate the interview data. The finding of this paper emphasizes to three important factors namely institutional factors, process factors and result factors that each factor contain sustainability and innovations to promote competitive green service in the marketplace.

Contractor Past Performance Information (PPI) in Source Selection: A Comparison Study of Public and Private Sector

DTIC Science & Technology

2005-05-01

efficiencies similar to those in the private sector . However, along the way, Government and private sector industry have begun to disagree about how PPI is...double that of the private sector due to an evaluation process that is cumbersome, time-consuming, and lacking the efficiencies enjoyed by private

Quantitative option analysis for implementation and management of landfills.

PubMed

Kerestecioğlu, Merih

2016-09-01

The selection of the most feasible strategy for implementation of landfills is a challenging step. Potential implementation options of landfills cover a wide range, from conventional construction contracts to the concessions. Montenegro, seeking to improve the efficiency of the public services while maintaining affordability, was considering privatisation as a way to reduce public spending on service provision. In this study, to determine the most feasible model for construction and operation of a regional landfill, a quantitative risk analysis was implemented with four steps: (i) development of a global risk matrix; (ii) assignment of qualitative probabilities of occurrences and magnitude of impacts; (iii) determination of the risks to be mitigated, monitored, controlled or ignored; (iv) reduction of the main risk elements; and (v) incorporation of quantitative estimates of probability of occurrence and expected impact for each risk element in the reduced risk matrix. The evaluated scenarios were: (i) construction and operation of the regional landfill by the public sector; (ii) construction and operation of the landfill by private sector and transfer of the ownership to the public sector after a pre-defined period; and (iii) operation of the landfill by the private sector, without ownership. The quantitative risk assessment concluded that introduction of a public private partnership is not the most feasible option, unlike the common belief in several public institutions in developing countries. A management contract for the first years of operation was advised to be implemented, after which, a long term operating contract may follow. © The Author(s) 2016.

Analysis of Health Sector Budget of Nepal.

PubMed

Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

2014-01-01

Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.

International comparisons of the technical efficiency of the hospital sector: panel data analysis of OECD countries using parametric and non-parametric approaches.

PubMed

Varabyova, Yauheniya; Schreyögg, Jonas

2013-09-01

There is a growing interest in the cross-country comparisons of the performance of national health care systems. The present work provides a comparison of the technical efficiency of the hospital sector using unbalanced panel data from OECD countries over the period 2000-2009. The estimation of the technical efficiency of the hospital sector is performed using nonparametric data envelopment analysis (DEA) and parametric stochastic frontier analysis (SFA). Internal and external validity of findings is assessed by estimating the Spearman rank correlations between the results obtained in different model specifications. The panel-data analyses using two-step DEA and one-stage SFA show that countries, which have higher health care expenditure per capita, tend to have a more technically efficient hospital sector. Whether the expenditure is financed through private or public sources is not related to the technical efficiency of the hospital sector. On the other hand, the hospital sector in countries with higher income inequality and longer average hospital length of stay is less technically efficient. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

PubMed Central

Ron Levey, Ilana; Wang, Wenjuan

2014-01-01

Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. PMID:25012796

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

PubMed

Ron Levey, Ilana; Wang, Wenjuan

2014-07-01

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Welcome address by Chairman, Hospital Authority of Hong Kong: opening ceremony of the International Hospital Federation Congress--May 2001.

PubMed

Ka-Shui, L O

2001-01-01

One of the significant features of Hong Kong is its public healthcare system, which provides universal, easily accessible and heavily subsidized medical care for all. The governing policy has been to ensure that no one is denied adequate medical care because of insufficient means through the provision of a comprehensive range of healthcare services funded from the public purse at extremely low fees to users. Over the past decade, the public hospital sector has been able to provide efficient and quality health services comparable to those of the industrialised nations. However, the reality today is that the public hospitals are facing many challenges that must be overcome and ways must be sought to mitigate the growing strains on the healthcare system and rebalance the healthcare economics. The recently published Consultation Document on Healthcare Reform, by Dr E K Yeoh, Secretary for Health & Welfare, proposes the introduction of a comprehensive range of short-term and long-term initiatives to revitalize and transform the healthcare system into a community-focused, patient-centred and knowledge-based integrated healthcare service with improved interface between the public and private sectors.

Essential Concepts in Modern Health Services

PubMed Central

El Taguri, A

2008-01-01

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

PubMed

Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

2015-11-01

Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more useful frame than generalizable outcomes of effectiveness. Copyright © 2015 Elsevier Ltd. All rights reserved.

Advanced Traveler Information Service (ATIS) : private sector perceptions and public sector activities

DOT National Transportation Integrated Search

2000-01-01

This paper presents the results of a study by the United States Department of Transportation Volpe Center to determine the nature and extent of the data gap between the needs of private sector Advanced Traveler Information Service (ATIS) provid...

Third sector primary care for vulnerable populations.

PubMed

Crampton, P; Dowell, A; Woodward, A

2001-12-01

This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion insofar as the role of the welfare state is diminished.

Comparison Quality of Health Services between Public and Private Providers: The Iranian People's Perspective.

PubMed

Alijanzadeh, Mehran; Zare, Seyed Ali Moosaniaye; Rajaee, Roya; Fard, Seyed Mohammad Ali Mousavi; Asefzadeh, Saeed; Alijanzadeh, Mahnaz; Gholami, Soheyla

2016-09-01

Health services quality has been the most important criteria of judging, and its improvement causes people's satisfaction of health systems. In a health system, public and private sectors provide services and typically have been effective in promoting health services quality of community. The aim of this study was to compare the quality of health services in both public and private sectors from the perspective of residents in Qazvin (Iran). This cross-sectional study was conducted in 2014. The study population included all residents of Qazvin Province, and the sample size was estimated to 1002. The research tool was a perceptions of services quality standard questionnaire. Data were collected by trained interviewers visiting homes and were analyzed by IBM-SPSS software version 22 and t-test and linear regression. Cronbach's alpha coefficient was 0.91 and test-re-test coefficient was 83%. 741 people (74%) in their last visit to receive services were referred to the public sector. Between the perception of people participating in the study about medical equipment and supplies, welfare facilities, competence and experience of doctor, waiting time, rapid reception, and access to doctor in public and private sectors, significant differences were observed (p < 0.05). In the tangible realm in perception of health services, there was a significant difference in quality between the public and private sectors (p < 0.05). In addition, place of receiving services, waiting time, education, occupation, and type of received services were affecting factors in regards to perceptions of health services from the perspective of Iran's population (p < 0.05). The results showed the importance of a tangible realm on people's satisfaction of health services. It seems that the public sector should pay more attention to this issue.

Information Technology and the Training and Career Development of Women: The Case of Ireland. Training Discussion Paper No. 29.

ERIC Educational Resources Information Center

Barry, Ursula

This report concerns the training requirements of women workers arising from the introduction of new technology in the services sector of the Irish economy. Section 1 discusses the importance of the services sector as a source of employment for women workers. In Section 2, the structure of female employment in the services sector is explored with…

Characteristics of occupational musculoskeletal disorders of five sectors in service industry between 2004 and 2013.

PubMed

Choi, Hyun-Woo; Kim, Young-Ki; Kang, Dong-Mug; Kim, Jong-Eun; Jang, Bo-Young

2017-01-01

' Work related musculoskeletal disorders (WRMSDs)' have been mostly reported in the manufacturing industry but recently the occurrence of industrial injuries has been constantly increasing in the service industry. This research is going to analyze the data about workers' compensation for WRMSDs in five different service sectors and identify characteristics of occupations with the highest approved occupations. According to the data released from the Korea Worker's Compensation & Welfare Service, the overview of 12,730 cases of workers' compensation for WRMSDs in five service sectors from 2004 to 2013 is going to be analyzed and the source data is going to be classified by the Korean Standard Classification of Occupations to select the top five occupations that have the highest number of approval. After selecting each five occupations from the service sector that have work related musculoskeletal disorders, the result showed that the occupation with the highest number of approval in the health and social care sector were the early childhood educators, cooks in the school canteens in education services sector, garbage collectors in the sanitation and similar services sector, deliverymen in wholesale and retail, consumer goods repair and building cleaners in general management businesses such as those in building maintenance. The major event observed in the top five occupations was the overexertion and reaction as a cause of WRMSDs. The day when the WRMSDs mostly occurred was on Monday and the most likely time was 10 am. The median days away from work and lost working days are 29-90 days and 0-50 days respectively. The difference in each occupation was observed in year of service, age, and gender. 83.21% of the approved cases of workers' compensation for WRMSDs occurred in the top 25 occupations in all of the five service sectors, which meant that the approval of workers' compensation is concentrated in specific occupations. This research is going to suggest preventive measures for work related musculoskeletal disorders in the service industry and to help prioritize the preventive measures. Not applicable.

Customer and service profitability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballaban, M.; Kelly, K.; Wisniewski, L.

1996-03-01

The rapid pace of competitive change in the generation sector has pushed electric utilities to rethink the concept of being obligated to serve all customers and with this change, the notion of measuring customer profitability is also being redefined. Traditionally, uniform services were provided to all customers. Rates were based on each customer classes` contribution to average costs, and consequently return was equally allocated across all customer segments. Profitability was defined strictly on an aggregate basis. The increasing demand for choice by electric customers will require electricity providers to redefine if not who they serve, than certainly how they providemore » differentiated services tailored to specific customer segments. Utilities are beginning to analyze the value, or profitability, of offering these services. Aggregate data no longer provides an accurate assessment of how resources should be allocated most efficiently. As services are unbundled, so too must costs be disaggregated to effectively measure the profitability of various options.« less

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International.

PubMed

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-06-17

To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. We analyzed MSI's social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008-2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011-2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI "Impact 2" model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of them reporting having never previously used family planning at all. Analysis of age and poverty levels of clients indicate mixed results in bridging equity gaps: 57.4% of clients lived on under US$2.50/day in 2013 (95% CI = 54.9, 60.0) and 26.1% were 15-24 years old (95% CI = 23.8, 28.4), but only 15.1% lived on less than $1.25/day (95% CI = 13.8, 16.4) and 5.0% were 15-19 years old (95% CI = 3.9, 6.1). The services provided via social franchising are estimated to avert 4,958,000 unintended pregnancies and 7,150 maternal deaths. Social franchising through the existing private sector has the ability to rapidly scale-up access to high-quality family planning services, including LARCs, for the general population as well as young women and the poor, providing a promising model to help achieve the global FP2020 goal. © Munroe et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

[The impact of the economic crisis on health systems of OECD countries].

PubMed

Paris, Valérie

2014-10-01

This paper describes measures adopted by OECD countries in the health sector in response to the economic crisis which began in 2008: increase and diversification of revenues collected for health, increases in user charges, reductions in staff, salaries and prices of health goods and services; and policies aiming to increase health systems efficiency. It then reviews the impact of these policies on health spending trends. © 2014 médecine/sciences – Inserm.

The health maintenance organization strategy: a corporate takeover of health services delivery.

PubMed

Salmon, J W

1975-01-01

This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

Feasibility study of transportation management strategies in the Poplar Corridor, Memphis, Tennessee

DOE Office of Scientific and Technical Information (OSTI.GOV)

Siniard, D.

1990-02-01

This report documents the development and implementation of various transportation management strategies aimed at alleviating traffic congestion problems in the Poplar Corridor, a major transportation corridor located in a rapidly growing suburban area of Memphis, Tennessee. The project provided the opportunity for local governments to work with the private sector in a joint venture to address traffic congestion problems and to promote more efficient use of the area's transportation network. The project was carried out by the staff of Memphis Area Rideshare, a joint city/county agency which provides transit information and free carpool/vanpool computer matching services to area commuters. Publicmore » sector participants in the planning process included transportation and land use planners from the Office of Planning and Development, city traffic engineers, and representatives from the Memphis Area Transit Authority (MATA). Private sector input came from major developers and employers in the Poplar Corridor and from officials of schools located in the area.« less

[Plansalud: Decentralized and agreed sector plan for the capacity development in health, Peru 2010-2014].

PubMed

Huamán-Angulo, Lizardo; Liendo-Lucano, Lindaura; Nuñez-Vergara, Manuel

2011-06-01

Human resources are the backbone of health sector actions; however, they are not necessarily the area with the greatest attention, therefore, the Ministry of Health of Peru (MINSA) together with regional governments, led the Decentralized and Agreed Sector Plan for the Capacity Development in Health 2010-2014 (PLANSALUD) with the aim of strengthening the capacities of Human Resources for Health (HRH) and contribute to health care efficient development, quality, relevance, equity and multiculturalism, in the context of descentralization, the Universal Health Insurance (AUS) and health policies. To achieve this goal, they have proposed three components (technical assistance, joint training and education - health articulation) that bring together an important set of interventions, which are planned and defined according to the national, regional and local levels, thus contributing to improve the government capacity, capability management and delivery of health services. This paper presents a first approach of PLANSALUD, including aspects related to planning, management, financing, structure and functioning, as well as monitoring and evaluation measures.

The Application of Incentives and the Defense Business Operations Fund

DTIC Science & Technology

1993-12-01

The Defense Business Operations Fund (DBOF) is an attempt to incorporate private sector business incentives into the public sector. Truly efficient...or resources are missing an organization will not become more cost effective and efficient. The private sector goal is profit maximization. This goal

Assessment of district health system within inter-sectoral context in Nepal.

PubMed

Bhusal, C L; Singh, S P; Aryal, K K; Jha, B K; Ghimire, N; Shah, N; Khatiwada, D; Magar, A

2013-05-01

Inter-sectoral coordination has been one of the different factors in the district health system that produces efficient output which has been identified by the Alma Ata declaration as an essential component to achieve notion of 'Health for All'. This study was therefore aimed to describe the major four key functions of the health systems and to find out the situation of inter-sectoral coordination in Nepal. A mixed method with Focus Group Discussion (FGD) and In-Depth Interview with relevant personnel to collect the majority of the data was carried out from June 2012 to November 2012 from six districts selected purposively based on the health performance indicators. The major findings in relation to the key functions of district health systems showed that the overall management of the district health system happens under the leadership of chief of District Health Office of Public health office with the cooperation of all the personnel in different sections in a predetermined pattern and inter-sectoral coordination and collaboration exist only to a very limited extent. The major constraints for inter-sectoral coordination to be effective is lack of its planning and enforcement where inter-sectoral coordination could be important for both preventive and promotive health care, waste management, water supply and sanitation, health service utilization, pesticides and human health, agriculture and nutrition, air pollution. The main components in the district health system needs an immediate attention and inter-sectoral effort should be initiated from the central level and implemented in all the levels.

Family planning, antenatal and delivery care: cross-sectional survey evidence on levels of coverage and inequalities by public and private sector in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; MacLeod, David; Baggaley, Rebecca F; Rodrigues, Laura C; Hanson, Kara; Powell-Jackson, Timothy; Penn-Kekana, Loveday; Polonsky, Reen; Footman, Katharine; Vahanian, Alice; Pereira, Shreya K; Santos, Andreia Costa; Filippi, Veronique G A; Lynch, Caroline A; Goodman, Catherine

2016-04-01

The objective of this study was to assess the role of the private sector in low- and middle-income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000-2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio-economic position. We used data from 865 547 women aged 15-49, representing a total of 3 billion people. We defined 'met and unmet need for services' and 'use of appropriate service types' clearly and developed explicit classifications of source and sector of provision. Across the four regions (sub-Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private-sector share among users of family planning services was 37-39% across regions (overall mean: 37%; median across countries: 41%). The private-sector market share among users of ANC was 13-61% across regions (overall mean: 44%; median across countries: 15%). The private-sector share among appropriate deliveries was 9-56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care. The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision. © 2016 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Development of energy consumption and energy efficiency potential in the Brazilian industrial sector according to the Integrated Energy Planning Model (IEPM)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tolmasquim, M.T.; Szklo, A.S.; Cohen, C.

This paper presents the development of energy consumption in the Brazilian industrial sector and energy efficiency potential based on the analysis undertaken through a model developed in the Energy Planning Program at COPPE/UFRJ, known as the Integrated Energy Planning Model (IEPM). The study starts by presenting the IEPM, which is a technical and economic parameter-based model designed to forecast energy supplies and consumption for all economic sectors in Brazil, within three scenarios. Outlines of all three scenarios are presented, as they were constructed according to certain specific assumptions. The industrial sector was broken down into eleven sub-sectors: food and beverages,more » ceramics, cement, iron and steel, mining and pelletizing, ferroalloys, non-ferrous metals and others (metallurgy), chemicals, pulp and paper, textiles and other industries (MME, 1998). All these sub-sectors will also be presented as well as the results of the scenario forecasts. Results deriving from these forecasts come from very specific studies that analyze all process steps in each sub-sector in order to propose energy replacements, efficiency improvements of structural production alterations that result in major potential energy consumption reductions. Last but not least, this paper gives the development forecasts deriving from the three scenarios over ten years, with their contributions to energy efficiency in the Brazilian industrial sector, showing that the authors can reduce energy consumption in the Brazilian industrial sector by: substituting less efficient processes by more efficient ones, through the conversion of final energy into usable energy, basically, in the cement and aluminum industries; replacing equipment and energy sources; modifying product mix of several industries (pulp and paper), assigning top priority to producing goods with higher added value that are less energy intensive, and, finally, reducing the share held by some energy intensive sectors in the industrial output.« less

Spaces of care in the third sector: understanding the effects of professionalization.

PubMed

Carey, Gemma; Braunack-Mayer, Annette; Barraket, Jo

2009-11-01

Increasingly the health and welfare needs of individuals and communities are being met by third sector, or not-for-profit, organizations. Since the 1980s third sector organizations have been subject to significant, sector-wide changes, such as the development of contractual funding and an increasing need to collaborate with governments and other sectors. In particular, the processes of 'professionalization' and 'bureaucratization' have received significant attention and are now well documented in third sector literature. These processes are often understood to create barriers between organizations and their community groups and neutralize alternative forms of service provision. In this article we provide a case study of an Australian third sector organization undergoing professionalization. The case study draws on ethnographic and qualitative interviews with staff and volunteers at a health-based third sector organization involved in service provision to marginalized community groups. We examine how professionalization alters organizational spaces and dynamics and conclude that professionalized third sector spaces may still be 'community' spaces where individuals may give and receive care and services. Moreover, we suggest that these community spaces hold potential for resisting the neutralizing effects of contracting.

Changes in Work Patterns: A Synthesis of Five National Reports on the Service Sector. France, Germany, Japan, Sweden, the United States.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

An analysis of the service sector in five countries (France, Germany, Japan, Sweden, and the United States) was made through synthesis of earlier research on work patterns in the countries. Some of the findings and issues discovered concerned the following: (1) the heterogeneity of the service sector; (2) the progress of part-time work; (3)…

The Building Bridges project: Linking disconnected service networks in acquired brain injury and criminal justice.

PubMed

Kelly, Glenn; Brown, Suzanne; Simpson, Grahame K

2018-06-08

People with acquired brain injury (ABI) are overrepresented in prison populations across many countries. An effective service response to reduce this trend requires collaboration between the ABI and criminal justice (CJ) sectors. The Building Bridges project piloted a novel professional development model designed to increase cross-sectoral knowledge and collaboration between the ABI and CJ sectors. A total of 178 service providers from Victoria, Australia, participated in six professional development forums that included content about ABI, policing, disability and legal supports, and correctional/post-release services. Participants came from the disability, criminal justice, and health and community service sectors. Using a pre-test-post-test design with 6-month follow-up, data were obtained via a project-specific questionnaire evaluating knowledge and behaviour change among participants. Statistically significant gains in knowledge were shown at post-test and maintained at follow-up. Work-related behaviours addressing ABI/CJ issues had increased significantly within both sectors at follow-up compared to the 6 months prior to the forum. Carefully constructed professional forums improved cross-silo collaboration in the ABI/CJ sectors. This pilot project illustrates effective use of existing service resources, and highlights training as an important part of a raft of initiatives needed to address the overrepresentation of people with ABI in the CJ system.

77 FR 34110 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... Service Sector (OSX) is a price-weighted index composed of fifteen companies that provide oil drilling and... on the PHLX Oil Service Sector\\SM\\ (OSX\\SM\\), the PHLX Semiconductor Sector\\SM\\ (SOX\\SM\\), and the..., and HGX). [[Page 34111

Position paper: improving governance for effective veterinary services in developing countries--a priority for donor funding.

PubMed

Forman, S; Plante, C; Murray, G; Rey, B; Belton, D; Evans, B; Steinmetz, P

2012-08-01

Livestock contributes significantly to the world economy. However, animal diseases and food safety are still major constraints on livestock-sector productivity, economic growth, the reduction of poverty and food security. Efficient and effective governance of Veterinary Services throughout the world is a fundamental requirement for addressing the global animal health and related public health threats. Recent work by the World Organisation for Animal Health (OIE) through the application of the Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) and related Gap Analysis (both of which form part of the PVS Pathway) has indicated that a significant proportion of the national Veterinary Services worldwide do not meet the essential requirements for good governance. This shortcoming poses a significant risk for many developing countries and their trading partners when considered in the context of the growing trade in animal-source foods, and the burgeoning global livestock population. Well-managed, transparent and credible Veterinary Services, in both the public and private sector, are essential for mitigating animal disease risks and ensuring sustainable incomes for vulnerable producers. They are also vital for limiting the public health risks posed by zoonotic diseases. This paper is intended to highlight the impact of governance on the delivery of veterinary services in a development context and the benefits generated by improving veterinary governance. It recognises 'global public good' elements embedded in the good governance of Veterinary Services, and it could also provide an operational development investment roadmap that builds on the OIE PVS Pathway, and innovative financing options based on government commitments supported by donor programmes.

Energy efficiency of engines and appliances for transport on land, water, and in air.

PubMed

Furfari, Samuele

2016-01-01

The transport sector is fundamental for the economy but also for personal life. With a growing population and the globalization process, it is not surprising that the demand of transport is set to grow in the near future and certainly until 2050. This paper focuses on the huge potential of progress in the sector of technology for transport. As the principal sector for transport will remain on roads, the paper emphasizes the progress in the automotive sector. Since car manufacturers are investing massively into research and technology development to offer ever more efficient cars--not only energy efficient but also efficient in terms of safety and comfort--the car of tomorrow will be very different from the present one. The increasing role of electronics in cars will synergistically cooperate with that of so-called smart cities. The potential development of methane in the transport sector, mainly used for heavy transportation is discussed.

Electricity savings potentials in the residential sector of Bahrain

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akbari, H.; Morsy, M.G.; Al-Baharna, N.S.

1996-08-01

Electricity is the major fuel (over 99%) used in the residential, commercial, and industrial sectors in Bahrain. In 1992, the total annual electricity consumption in Bahrain was 3.45 terawatt-hours (TWh), of which 1.95 TWh (56%) was used in the residential sector, 0.89 TWh (26%) in the commercial sector, and 0.59 TWh (17%) in the industrial sector. Agricultural energy consumption was 0.02 TWh (less than 1%) of the total energy use. In Bahrain, most residences are air conditioned with window units. The air-conditioning electricity use is at least 50% of total annual residential use. The contribution of residential AC to themore » peak power consumption is even more significant, approaching 80% of residential peak power demand. Air-conditioning electricity use in the commercial sector is also significant, about 45% of the annual use and over 60% of peak power demand. This paper presents a cost/benefit analysis of energy-efficient technologies in the residential sector. Technologies studied include: energy-efficient air conditioners, insulating houses, improved infiltration, increasing thermostat settings, efficient refrigerators and freezers, efficient water heaters, efficient clothes washers, and compact fluorescent lights. We conservatively estimate a 32% savings in residential electricity use at an average cost of about 4 fils per kWh. (The subsidized cost of residential electricity is about 12 fils per kWh. 1000 fils = 1 Bahrain Dinar = US$ 2.67). We also discuss major policy options needed for implementation of energy-efficiency technologies.« less

Elements affecting food waste in the food service sector.

PubMed

Heikkilä, Lotta; Reinikainen, Anu; Katajajuuri, Juha-Matti; Silvennoinen, Kirsi; Hartikainen, Hanna

2016-10-01

Avoidable food waste is produced in the food service sector, with significant ecological and economical impacts. In order to understand and explain better the complex issue of food waste a qualitative study was conducted on the reasons for its generation in restaurants and catering businesses. Research data were collected during three participatory workshops for personnel from three different catering sector companies in Finland. Based on synthesized qualitative content analysis, eight elements influencing production and reduction of food waste were identified. Results revealed the diversity of managing food waste in the food service sector and how a holistic approach is required to prevent and reduce it. It is crucial to understand that food waste is manageable and should be an integral component of the management system. The model of eight factors provides a framework for recognition and management of food waste in the food service sector. Copyright © 2016 Elsevier Ltd. All rights reserved.

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.112 Government... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Government use of private... service firms for the brief or intermittent use of the skills of private sector temporaries. Services...

Pathways into and through Mental Health Services for Children and Adolescents.

ERIC Educational Resources Information Center

Farmer, Elizabeth M. Z.; Burns, Barbara J.; Phillips, Susan D.; Angold, Adrian; Costello, E. Jane

2003-01-01

Examined points of entry into mental health service system for children and adolescents and patterns of movement through five service sectors (specialty mental health services, education, general medicine, juvenile justice, child welfare). Education sector plays central role as point of entry. Interagency collaboration among education, specialty…

Health care costs: the other point of view.

PubMed

Beck, D F; Dempsey, J

1990-12-01

Health care delivery in America is not efficient. Hospitals are not efficient and many are still wasteful. Some of the most blatant wastes in hospitals are staffing patterns that developed during the years of cost reports. Spending patterns become the norm, rather than excess, when they continue unabated for years. There are many reasons for cost increases in health care and specifically in hospitals. However, it is difficult to make these reasons add up to the total cost increase. No one has the answers; observation can only be made of what has been occurring and what continues to occur. Whatever the reason for the increase in health care costs, the consumer will bear the burden because of the circular flow of income and expenditures between the business sector and the household sector. Increased health care costs are passed on to the consumer in the form of increased expenditures for household goods and services or taxes. Ford Motor Company President Mr. Peterson says that $1,500 of every new automobile represents employee health care costs. The American consumer created the demand for health care services, and only the consumer can control the demand. One solution would be to let the consumer bear health care costs directly and remove the inefficiencies created by third party insurance carriers. This hypothesizes that the health care consumer is the most efficient shopper for health care services, and that third party insurance carriers are an important source of inefficiency in the health care delivery system. Many other solutions have been proposed by the government and by the insurance and health care industries, but most have only increased the cost of health care. Perhaps some day the health care industry will learn how to control the dynamics of this four-party purchasing decision. Until then, costs will continue to grow dramatically, and the executives of the industries who compete in the two-party purchasing system will wonder why the process is so complicated.

Social Enterprises and Social Sector Workforces: Workforce Initiatives Discussion Paper #3

ERIC Educational Resources Information Center

Academy for Educational Development, 2011

2011-01-01

Increasing evidence shows that investing in social sector supply, service, and value chains has exponentially stronger development impact than investments in other sectors. There are often severely lacking social services such as child care, elder care, health care delivery, prescription drug distribution, home schooling, and private sector…

An Examination of Possible Relationships between Service Quality and Brand Equity in Online Higher Education

ERIC Educational Resources Information Center

Jarrell, Charles M.

2012-01-01

Researchers and marketers lack information about possible relationships between service quality and online brand equity in intangible and often undifferentiated service businesses. The services sector of the economy is large with 72% of the economic output and 80% of the workers in the United States in 2007. Within the services sector, Internet…

Working with the private sector for child health.

PubMed

Waters, Hugh; Hatt, Laurel; Peters, David

2003-06-01

Private sector providers are the most commonly consulted source of care for child illnesses in many countries, offering significant opportunities to expand the reach of essential child health services and products. Yet collaboration with private providers presents major challenges - the suitability and quality of the services they provide is often questionable and governments' capacity to regulate them is limited. This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors. Governments and international organizations can use a variety of strategies to collaborate with and influence private sector actors to improve child health - including contracting, regulating, financing and social marketing, training, coordinating and informing the public. These mutually reinforcing strategies can both improve the quality of services currently delivered in the private sector, and expand and rationalize the coverage of these services. One lesson from this review is that the private sector is very heterogeneous. At the country level, feasible strategies depend on the potential of the different components of the private sector and the capacity of governments and their partners for collaboration. To date, experience with private sector strategies offers considerable promise for children's health, but also raises many questions about the feasibility and impact of these strategies. Where possible, future interventions should be designed as experiments, with careful assessment of the intervention design and the environment in which they are implemented.

Ecological network analysis for a virtual water network.

PubMed

Fang, Delin; Chen, Bin

2015-06-02

The notions of virtual water flows provide important indicators to manifest the water consumption and allocation between different sectors via product transactions. However, the configuration of virtual water network (VWN) still needs further investigation to identify the water interdependency among different sectors as well as the network efficiency and stability in a socio-economic system. Ecological network analysis is chosen as a useful tool to examine the structure and function of VWN and the interactions among its sectors. A balance analysis of efficiency and redundancy is also conducted to describe the robustness (RVWN) of VWN. Then, network control analysis and network utility analysis are performed to investigate the dominant sectors and pathways for virtual water circulation and the mutual relationships between pairwise sectors. A case study of the Heihe River Basin in China shows that the balance between efficiency and redundancy is situated on the left side of the robustness curve with less efficiency and higher redundancy. The forestation, herding and fishing sectors and industrial sectors are found to be the main controllers. The network tends to be more mutualistic and synergic, though some competitive relationships that weaken the virtual water circulation still exist.

Impact of Financial Liberalization on Banking Sectors Performance from Central and Eastern European Countries

PubMed Central

Andries, Alin Marius; Capraru, Bogdan

2013-01-01

In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004–2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity. PMID:23555745

Impact of financial liberalization on banking sectors performance from central and eastern European countries.

PubMed

Andries, Alin Marius; Capraru, Bogdan

2013-01-01

In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004-2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity.

Consensus and contention in the priority setting process: examining the health sector in Uganda.

PubMed

Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

2015-06-01

Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals' views.

PubMed

Lee, Ping Yein; Lee, Yew Kong; Ng, Chirk Jenn

2012-04-30

The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system. In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients. The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals.

How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals’ views

PubMed Central

2012-01-01

Background The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public–private) health system. Methods In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010–11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Results Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients’ peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients. Conclusion The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals. PMID:22545648

Delivering Patient-Centered Care in a Fragile State: Using Patient-Pathway Analysis to Understand Tuberculosis-Related Care Seeking in Pakistan

PubMed Central

Fatima, Razia; Haq, Mahboob Ul; Yaqoob, Aashifa; Mahmood, Nasir; Ahmad, Khawaja Laeeq; Osberg, Mike; Makayova, Julia; Hymoff, Aaron; Hanson, Christy

2017-01-01

Abstract Background Pakistan has the sixth largest population in the world and boasts the fifth greatest burden of tuberculosis. The Government of Pakistan has set the ambitious goal of zero deaths due to tuberculosis and universal access to tuberculosis care by 2020. Successfully reaching these goals is dependent on the country’s capacity to diagnose and successfully treat an estimated 200000 unnotified or missing patients with tuberculosis. Methods A patient-pathway analysis (PPA) was conducted at the national level, as well as for each of the 4 provinces, to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services. Results Almost 90% of patients initiated care in the private sector, which accounts for only 15% of facilities with the capacity for tuberculosis diagnosis and treatment. Across the country, nearly 50% of tuberculosis microscopy laboratories were located in public-sector–basic health units and regional health centers. However, very few patients initiated care in these facilities. Overall, tuberculosis case detection was high given the low likelihood of patients reaching facilities with the capacity for tuberculosis service delivery during their first visit. Discussion Improving the engagement of the informal sector and lower-level clinicians will improve the efficiency and timeliness of tuberculosis diagnosis for patients in Pakistan. Concurrently, the apparent strength of the referral networks connecting community-level workers and private clinicians to the public sector for tuberculosis diagnosis and treatment suggests that strengthening the capacity of the public sector could be valuable. PMID:29117348

Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

PubMed

Nishtar, Sania

2003-01-01

This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

Economic constraints - the growing challenge for Western breast cancer centers.

PubMed

Seidel, Rene P; Lux, Michael P; Hoellthaler, Josef; Beckmann, Matthias W; Voigt, Wieland

2013-03-01

Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed 'trans-sectoral' care approach which could allow to shift unprofitable procedures to the outpatient sector - in the sense of a win-win situation for both sectors and without loss of care quality - seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed.

Dual practice by doctors working in South and East Asia: a review of its origins, scope and impact, and the options for regulation.

PubMed

Hipgrave, David Barry; Hort, Krishna

2014-09-01

Health professionals often undertake private work whilst also employed by government. Such dual practice (DP) is found in both high-income and lower- and middle-income countries (LMIC) around the world, with varying degrees of tolerance. This review focuses on DP in South and East Asia in the context of the rapidly expanding mixed health systems in this region. Although good data are lacking, health service uptake in South and East Asia is increasing, particularly in the private sector. Appropriately regulated, DP can improve health service access, the range of services offered and doctors' satisfaction. By contrast, weakly regulated DP can negatively affect public health service access, quality, efficiency and equity, as doctors often pursue the balance of public and private work that maximizes their income and other benefits. The environment for regulation of DP is changing rapidly, with improved communications opportunities, increasing literacy and rising civil society, particularly in this region. Currently, the options for regulating DP include (1) those which restrict the opportunities for dual practitioners to prioritize income and other benefits over their responsibility to the public; these require a level of regulatory capacity often missing in LMIC governments; and (2) those which not only tolerate public-sector doctors' private work but also encourage adequate health services for the general public. Growth of the private sector and weak regulation in South and East Asia increases the risk that dual practitioners will ignore the poor. Responsive and decentred regulation of doctors involving professional associations, civil society and other stakeholders is increasingly recommended. Moreover, as governments in LMIC strive for universal health coverage, market and financing opportunities for regulation of DP may arise, particularly involving insurers. This may also help to improve the current imbalance in the urban-rural distribution of doctors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Temporal Informative Analysis in Smart-ICU Monitoring: M-HealthCare Perspective.

PubMed

Bhatia, Munish; Sood, Sandeep K

2016-08-01

The rapid introduction of Internet of Things (IoT) Technology has boosted the service deliverance aspects of health sector in terms of m-health, and remote patient monitoring. IoT Technology is not only capable of sensing the acute details of sensitive events from wider perspectives, but it also provides a means to deliver services in time sensitive and efficient manner. Henceforth, IoT Technology has been efficiently adopted in different fields of the healthcare domain. In this paper, a framework for IoT based patient monitoring in Intensive Care Unit (ICU) is presented to enhance the deliverance of curative services. Though ICUs remained a center of attraction for high quality care among researchers, still number of studies have depicted the vulnerability to a patient's life during ICU stay. The work presented in this study addresses such concerns in terms of efficient monitoring of various events (and anomalies) with temporal associations, followed by time sensitive alert generation procedure. In order to validate the system, it was deployed in 3 ICU room facilities for 30 days in which nearly 81 patients were monitored during their ICU stay. The results obtained after implementation depicts that IoT equipped ICUs are more efficient in monitoring sensitive events as compared to manual monitoring and traditional Tele-ICU monitoring. Moreover, the adopted methodology for alert generation with information presentation further enhances the utility of the system.

The National Health Services of Brazil and Northern Europe: Universality, Equity, and Integrality-Time Has Come for the Latter.

PubMed

Gurgel, Garibaldi D; de Sousa, Islândia M Carvalho; de Araujo Oliveira, Sydia Rosana; de Assis da Silva Santos, Francisco; Diderichsen, Finn

2017-10-01

In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles of universality, equity, and integrality. While the reform in Brazil aimed at improving equity and effectiveness, reforms in Europe aimed at improving efficiency in order to contain costs. The European reforms increased supply and utilization but never provided the large increase in efficiency that was hoped for, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having chronic disorders and very unequal comorbidities, bring the issue of integrality in the forefront in all 3 countries, and neither the public purchaser provider markets nor the 2-tier system in Brazil delivers on that front. It will demand political leadership and strategic planning with population responsibility to deal with such challenges.

Specialization and production cost efficiency: evidence from ambulatory surgery centers.

PubMed

Carey, Kathleen; Mitchell, Jean M

2018-03-01

In the U.S. health care sector, the economic logic of specialization as an organizing principle has come under active debate in recent years. An understudied case is that of ambulatory surgery centers (ASCs), which recently have become the dominant provider of specific surgical procedures. While the majority of ASCs focus on a single specialty, a growing number are diversifying to offer a wide range of surgical services. We take a multiple output cost function approach to an empirical investigation that compares production economies in single specialty ASCs with those in multispecialty ASCs. We applied generalized estimating equation techniques to a sample of Pennsylvania ASCs for the period 2004-2014, including 73 ASCs that specialized in gastrointestinal procedures and 60 ASCs that performed gastrointestinal as well as other specialty procedures. Results indicated that both types of ASC had small room for expansion. In simulation analysis, production of GI services in specialized ASCs had a cost advantage over joint production of GI with other specialty procedures. Our results provide support for the focused factory model of production in the ASC sector.

Role of emerging private hospitals in a post-Soviet mixed health system: a mixed methods comparative study of private and public hospital inpatient care in Mongolia.

PubMed

Tsevelvaanchig, Uranchimeg; Gouda, Hebe; Baker, Peter; Hill, Peter S

2017-05-01

The collapse of the Soviet Union in 1990 severely impacted the health sector in Mongolia. Limited public funding for the post-Soviet model public system and a rapid growth of poorly regulated private providers have been pressing issues for a government seeking to re-establish universal health coverage. However, the evidence available on the role of private providers that would inform sector management is very limited. This study analyses the current contribution of private hospitals in Mongolia for the improvement of accessibility of health care and efficiency. We used mixed research methods. A descriptive analysis of nationally representative hospital admission records from 2013 was followed by semi-structured interviews that were carried out with purposively selected key informants (N = 45), representing the main actors in Mongolia's mixed health system. Private-for-profit hospitals are concentrated in urban areas, where their financial model is most viable. The result is the duplication of private and public inpatient services, both in terms of their geographical location and the range of services delivered. The combination of persistent inpatient-oriented care and perverse financial incentives that privilege admission over outpatient management, have created unnecessary health costs. The engagement of the private sector to improve population health outcomes is constrained by a series of issues of governance, regulation and financing and the failure of the state to manage the private sector as an integral part of its health system planning. For a mixed system like in Mongolia, a comprehensive policy and plan which defines the complementary role of private providers to optimize private public service mix is critical in the early stages of the private sector development. It further supports the importance of a system perspective that combines regulation and incentives in consistent policy, rather than an isolated approach to provide regulation. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Overview of devolution of health services in the Philippines.

PubMed

Grundy, J; Healy, V; Gorgolon, L; Sandig, E

2003-01-01

In 1991 the Philippines Government introduced a major devolution of national government services, which included the first wave of health sector reform, through the introduction of the Local Government Code of 1991. The Code devolved basic services for agriculture extension, forest management, health services, barangay (township) roads and social welfare to Local Government Units. In 1992, the Philippines Government devolved the management and delivery of health services from the National Department of Health to locally elected provincial, city and municipal governments. The aim of this review is to (i) Provide a background to the introduction of devolution to the health system in the Philippines and to (ii) describe the impact of devolution on the structure and functioning of the health system in defined locations. International literature was reviewed on the subjects of decentralization. Rapid appraisals of health management systems were conducted in both provinces. Additional data were accessed from the rural health information system and previous consultant reports. Subsequent to the introduction of devolution, quality and coverage of health services declined in some locations, particularly in rural and remote areas. It was found that in 1992-1997, system effects included a breakdown in management systems between levels of government, declining utilization particularly in the hospital sector, poor staff morale, a decline in maintenance of infrastructure and under financing of operational costs of services. The aim of decentralization is to widen decision-making space of middle level managers, enhance resource allocations from central to peripheral areas and to improve the efficiency and effectiveness of health services management. The findings of the historical review of devolution in the Philippines reveals some consistencies with the international literature, which describe some negative effects of decentralization, and provide a rationale for the Philippines in undertaking a second wave of reform in order to 'make devolution work'.

Rationing of hospital services in the Australian health system.

PubMed

Kovac, M

1998-09-01

This article reports on the rationing in the Australian hospital sector and explains why it has been undertaken. It also briefly overviews the Australian health system in order to provide a necessary background for the issue of rationing itself. Rationing of hospital services has occurred because governments in Australia have limited hospital sector resources trying to ensure the containment of their health budgets. The resources available to hospitals have been insufficient to ensure that the supply of services meets the demand for such services. Therefore, in order to contain hospital budgets rationing has been required. Medicare, the universal health insurance system, assures that access to public hospital services is on the basis of clinical needs. However, due to the federal nature of government in Australia, the available services are determined by health system structural interrelationships and direct government regulation. For example, services provided in the community sector, and funded by the Commonwealth government, are prime candidates for being removed from the hospital sector by State/Territory governments. Similarly, expensive services with a wide range of usage are candidates for regulation to contain costs.

Barriers and facilitators to partnership working between Early Intervention Services and the voluntary and community sector.

PubMed

Lester, Helen; Birchwood, Max; Tait, Lynda; Shah, Sonal; England, Elizabeth; Smith, Jo

2008-09-01

Partnership working between health and the voluntary and community sector has become an increasing political priority. This paper describes and explores the extent and patterns of partnership working between health and the voluntary and community sector in the context of Early Intervention Services for young people with a first episode of psychosis. Data were collected from 12 Early Intervention Services and through semistructured interviews with 47 voluntary and community sector leads and 42 commissioners across the West Midlands of England. Most partnerships were described as ad hoc and informal in nature although four formal partnerships between Early Intervention Services and voluntary and community sector organizations had been established. Shared agendas, the ability to refer clients onto an organization that could provide a service they could not and shared training facilitated partnership working in this context. Barriers to closer working included differences in culture such as managing risk, the time required to make and maintain relationships and recognition of the advantages of remaining a small and autonomous organization. The four more formal partnerships were also built on the organizations' experience of working together informally, in one case through a specific pilot project. The voluntary and community organizations involved were also branches of larger national organizations for whom finding sustainable funding was less of an issue. In theoretical terms, eight Early Intervention Service: voluntary and community sector partnerships were at a stage of 'pre-partnership collaboration', three at 'partnership creation and consolidation' and one at 'partnership programme delivery'. The empirical data viewed through the lens of the partnership life-cycle model could help early intervention services, and voluntary and community sector professionals better understand where they are, why they are there and the conditions needed to realise the full potential of partnership working.

Lean in healthcare: the unfilled promise?

PubMed

Radnor, Zoe J; Holweg, Matthias; Waring, Justin

2012-02-01

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Digital Revolution and Innovative Business Models in Healthcare: Global Trends and Russian Realities.

PubMed

Bereznoy, A V; Saygitov, R T

Digital revolution is one of the major global trends resulting in the unprecedented scale and depth of penetration of information and communication technologies into all sectors of national economy, including healthcare. The development of this trend brought about high expectations related to the improvement of quality of medical assistance, accessibility and economic efficiency of healthcare services. However, euphoria of the first steps of digital revolution is passing now, opening doors to more realistic analysis of opportunities and conditions of realization of the true potential hidden in the digital transformation of healthcare. More balanced perception of the peculiarities of innovation processes in the sector is coming together with understanding of the serious barriers, hampering implementation of the new ideas and practices due to complicated interweaving of social, economic, ethical and psychological factors. When taking into account the industry specifics it becomes evident that digital revolution cannot be a quick turnaround but rather would pass a number of phases and is likely to last more than one decade. In this context the article focuses on the prospects of the new business models, capable of making significant changes in today’s economic landscape of the sector (including uber-medicine, retail clinics, retainer medicine, network models of medical services). The authors also provide assessment of the current situation and perspectives of digital healthcare development in Russia.

Improvement of hospital performance through innovation: toward the value of hospital care.

PubMed

Dias, Casimiro; Escoval, Ana

2013-01-01

The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance, taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal, collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.

Improvement of hospital performance through innovation: toward the value of hospital care.

PubMed

Dias, Casimiro; Escoval, Ana

2013-01-01

The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance,taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal,collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.

Public-private partnerships in China's urban water sector.

PubMed

Zhong, Lijin; Mol, Arthur P J; Fu, Tao

2008-06-01

During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China's water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China.

A means to an end: a web-based client management system in palliative care.

PubMed

O'Connor, Margaret; Erwin, Trudy; Dawson, Linda

2009-03-01

Home-based palliative care (hospice) services require comprehensive and fully integrated information systems to develop and manage the various aspects of their business, incorporating client data and management information. These systems assist in maintaining the quality of client care as well as improved management efficiencies. This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project.

Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

PubMed Central

2011-01-01

Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs) staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are important providers. PHCC services are indeed free, with little evidence of informal payments to providers. PMID:22176866

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

PubMed Central

White, Julia N; Corker, Jamaica

2016-01-01

ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

Athletic Trainer Services in Public and Private Secondary Schools.

PubMed

Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

2017-01-01

 The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

PubMed

White, Julia N; Corker, Jamaica

2016-08-11

Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

Athletic Trainer Services in Public and Private Secondary Schools

PubMed Central

Pike, Alicia M.; Pryor, Riana R.; Vandermark, Lesley W.; Mazerolle, Stephanie M.; Casa, Douglas J.

2017-01-01

Context: The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored. Objective: To compare the level of AT services in public and private secondary schools. Design: Concurrent mixed-methods study. Setting: Public and private secondary schools in the United States. Patients or Other Participants: A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private). Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis. Results: A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators. Conclusions: Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector. PMID:28157403

The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

PubMed

Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

2010-11-01

Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions.

The medicine that might kill the patient: Structural Adjustment and its impacts on health care in Bangladesh.

PubMed

Hossen, Md Abul; Westhues, Anne

2012-01-01

Over the past decade, reforms of the health sector have evolved as a global phenomenon. There is, by now, a fair literature on the relationship between globalization and health. Within this literature, however, there is relatively little attention given to the Structural Adjustment Program (SAP), one aspect of globalization, and its impact on health. It can be observed that the SAP has had a dramatic impact on the status of education, health, the environment, and women and children in many developing countries. The restructuring of the health sector has led to the collapse of preventive and curative care due to the lack of medical equipment, supplies, poor working conditions, low pay of medical personnel, and the resulting low morale in Ghana, Philippines, and Zimbabwe. User fees in primary health care have led to the exclusion of a large section of the population from accessing health services as they are unable to pay. This article discusses the health specific impact of the SAP and the economic reforms initiated under it in Bangladesh. In particular, it will analyze how these policies affect the health care delivery system in Bangladesh in relation to geographic accessibility, affordability, quality of services, administrative efficiency, the rural urban service gap, public provision of health care, and donor influence on health policy.

Public and Private Interests in Networking Educational Services for Schools, Households, Communities.

ERIC Educational Resources Information Center

Sheekey, Arthur D.

1997-01-01

Discusses the networking of educational services for schools, homes, and communities. Highlights include equal access; the development of digital technologies; visions for electronic information services; the public sector; the private sector; creating learning communities; and future possibilities, including funding strategies. (LRW)

Lean health care: what can hospitals learn from a world-class automaker?

PubMed

Kim, Christopher S; Spahlinger, David A; Kin, Jeanne M; Billi, John E

2006-05-01

With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries. Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients. We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high-quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting. (c) 2006 Society of Hospital Medicine.

Family planning and sexual health organizations: management lessons for health system reform.

PubMed

Ambegaokar, Maia; Lush, Louisiana

2004-10-01

Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons. Copyright 2004 Oxford University Press

Substantial Air Quality and Climate Co-benefits Achievable Now with Industrial Efficiency Improvements in China

NASA Astrophysics Data System (ADS)

Mauzerall, D. L.; Peng, W.; Wagner, F.; Yang, J.

2016-12-01

China is the world's top carbon emitter and suffers from severe air pollution. It has recently made commitments to improve air quality and peak its carbon emissions by 2030. Here we examine near-term air quality and implications for CO2 emissions of various sector-based policies in China that are widely discussed and technically plausible for immediate implementation. For each sector, we consider the effect of a 20% increase in the installation rate of available air pollution control devices, along with the following sector-specific policies. Power sector (POW): 80% replacement of small coal power plants with larger more efficient ones; Industry sector (IND): 20% improvement in energy efficiency; Transport sector (TRA): replacement of high emitters with average vehicle fleet emissions; and Residential sector (RES): replacement of 20% of coal-based stoves with those using liquefied petroleum gas. We conduct an integrated assessment using the air pollution model WRF-Chem and epidemiological concentration-response relationships to evaluate a 2015 base case and various counterfactual scenarios. We find that the IND scenario would reduce both the total national air-pollution-related deaths and carbon emissions the most of the four sectorial scenarios examined. Benefits of addressing the industrial sector remain large even when efficiency improvements are smaller than 20%. Moreover, we find that simultaneously implementing all the measures in all four sectors (combined, COMB) leads to slightly larger air quality and health benefits than obtained by summing the benefits achieved from the four sectorial scenarios individually. This is because nonlinearity in atmospheric chemistry leads to a larger reduction in fine particulate concentrations when emissions from all sectors are reduced simultaneously. The resulting lower concentrations imply a lower position on the concave human premature mortality relative risk curve with fewer associated deaths. While much effort has focused on reducing emissions from the power and transportation sectors, our analysis highlights the importance of efficiency improvements in the industrial sector as a mechanism to simultaneously improve air quality and public health while reducing CO2 emissions.

A comparison between antenatal care quality in public and private sector in rural Hebei, China.

PubMed

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H M M T; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W

2013-04-01

To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. The quality of ANC in Hebei was poorer than required by China's national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

ICT and Web Technology Based Innovations in Education Sector

ERIC Educational Resources Information Center

Sangeeta Namdev, Dhamdhere

2012-01-01

ICT made real magic and drastic changes in all service sectors along with higher education and library practices and services. The academic environment is changing from formal education to distance and online learning mode because of ICT. Web technology and mobile technology has made great impact on education sector. The role of Open Access,…

Tree-based flood damage modeling of companies: Damage processes and model performance

NASA Astrophysics Data System (ADS)

Sieg, Tobias; Vogel, Kristin; Merz, Bruno; Kreibich, Heidi

2017-07-01

Reliable flood risk analyses, including the estimation of damage, are an important prerequisite for efficient risk management. However, not much is known about flood damage processes affecting companies. Thus, we conduct a flood damage assessment of companies in Germany with regard to two aspects. First, we identify relevant damage-influencing variables. Second, we assess the prediction performance of the developed damage models with respect to the gain by using an increasing amount of training data and a sector-specific evaluation of the data. Random forests are trained with data from two postevent surveys after flood events occurring in the years 2002 and 2013. For a sector-specific consideration, the data set is split into four subsets corresponding to the manufacturing, commercial, financial, and service sectors. Further, separate models are derived for three different company assets: buildings, equipment, and goods and stock. Calculated variable importance values reveal different variable sets relevant for the damage estimation, indicating significant differences in the damage process for various company sectors and assets. With an increasing number of data used to build the models, prediction errors decrease. Yet the effect is rather small and seems to saturate for a data set size of several hundred observations. In contrast, the prediction improvement achieved by a sector-specific consideration is more distinct, especially for damage to equipment and goods and stock. Consequently, sector-specific data acquisition and a consideration of sector-specific company characteristics in future flood damage assessments is expected to improve the model performance more than a mere increase in data.

Exploring SWAp's contribution to the efficient allocation and use of resources in the health sector in Zambia.

PubMed

Chansa, Collins; Sundewall, Jesper; McIntyre, Di; Tomson, Göran; Forsberg, Birger C

2008-07-01

Zambia introduced a sector-wide approach (SWAp) in the health sector in 1993. The goal was to improve efficiency in the use of domestic funds and externally sourced development assistance by integrating these into a joint sectoral framework. Over a decade into its existence, however, the SWAp remains largely unevaluated. This study explores whether the envisaged improvements have been achieved by studying developments in administrative, technical and allocative efficiency in the Zambian health sector from 1990-2006. A case study was conducted using interviews and analysis of secondary data. Respondents represented a cross-section of stakeholders in the Zambian health sector. Secondary data from 1990-2006 were collected for six indicators related to administrative, technical and allocative efficiency. The results showed small improvements in administrative efficiency. Transaction costs still appeared to be high despite the introduction of the SWAp. Indicators for technical efficiency showed a drop in hospital bed utilization rates and government share of funding for drugs. As for allocative efficiency, budget execution did not improve with the SWAp, although there were large variations between both donors and year. Funding levels had apparently improved at district level but declined for hospitals. Finally, the SWAp had not succeeded in bringing all external assistance together under a common framework. Despite strong commitment to implement the SWAp in Zambia, the envisaged efficiency improvements do not seem to have been attained. Possible explanations could be that the SWAp has not been fully developed or that not all parties have completely embraced it. SWAp is not ruled out as a coordination model, but the current setup in Zambia has not proved to be fully effective.

Three essays on U.S. electricity restructuring

NASA Astrophysics Data System (ADS)

Sergici, Sanem I.

2008-04-01

The traditional structure of the electricity sector in the U.S. has been that of large vertically integrated companies with sole responsibility for distributing power to end users within a franchise area. The restructuring of this sector that has occurred in the past 10-20 years has profoundly altered this picture. This dissertation examines three aspects of that restructuring process. First chapter of my dissertation investigates the impacts of divestitures of generation, an important part of the process of restructuring, on the efficiency of distribution systems. We find that while all divestitures as a group do not significantly affect distribution efficiency, those mandated by state public utility commissions have resulted in large and statistically significant adverse effects on distribution efficiency. Second chapter of my dissertation explores whether independent system operator (ISO) formation in New York has led to operating efficiencies at the unit and the system level. ISOs oversee the centralized management of the grid and the energy market and are expected to promote more efficient power generation. We test these efficiencies focusing on the generation units in New York ISO region from 1998 to 2004 and find that the NYISO formation has introduced limited efficiencies at the unit and the system level. Restructuring in the electricity industry has spawned a new wave of mergers, both raising questions and providing opportunities to examine these mergers. Third chapter of my dissertation investigates the drivers of electric utility mergers consummated between 1992 and 2004. My results provide support for disturbance theory of mergers, size hypothesis, and inefficient management hypothesis as drivers of electric utility mergers. I also find that the adjacency of the service territories is the most noteworthy determinant of the pairings between IOUs.

Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

PubMed

Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

2018-02-01

To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright © 2017 Elsevier Inc. All rights reserved.

Performance-based management and quality of work: an empirical assessment.

PubMed

Falzon, Pierre; Nascimento, Adelaide; Gaudart, Corinne; Piney, Cécile; Dujarier, Marie-Anne; Germe, Jean-François

2012-01-01

In France, in the private sector as in the public sector, performance-based management tends to become a norm. Performance-based management is supposed to improve service quality, productivity and efficiency, transparency of allotted means and achieved results, and to better focus the activity of employees and of the whole organization. This text reports a study conducted for the French Ministry of Budget by a team of researchers in ergonomics, sociology and management science, in order to assess the impact of performance-based management on employees, on teams and on work organization. About 100 interviews were conducted with employees of all categories and 6 working groups were set up in order to discuss and validate or amend our first analyses. Results concern several aspects: workload and work intensification, indicators and performance management and the transformation of jobs induced by performance management.

Health Resources in a 200,000 Urban Indian Population Argues the Need for a Policy on Private Sector Health Services

PubMed Central

Furtado, Kheya Melo; Kar, Anita

2014-01-01

Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals. PMID:24963226

Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

PubMed

Furtado, Kheya Melo; Kar, Anita

2014-04-01

There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services.

PubMed

Randall, Glen E

2008-07-01

Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of 'managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving.

Evaluation on the efficiency of the construction sector companies in Malaysia with data envelopment analysis model

NASA Astrophysics Data System (ADS)

Weng Hoe, Lam; Jinn, Lim Shun; Weng Siew, Lam; Hai, Tey Kim

2018-04-01

In Malaysia, construction sector is essential parts in driving the development of the Malaysian economy. Construction industry is an economic investment and its relationship with economic development is well posited. However, the evaluation on the efficiency of the construction sectors companies listed in Kuala Lumpur Stock Exchange (KLSE) with Data Analysis Envelopment (DEA) model have not been actively studied by the past researchers. Hence the purpose of this study is to examine the financial performance the listed construction sectors companies in Malaysia in the year of 2015. The results of this study show that the efficiency of construction sectors companies can be obtained by using DEA model through ratio analysis which defined as the ratio of total outputs to total inputs. This study is significant because the inefficient companies are identified for potential improvement.

Public-Private Partnerships in China’s Urban Water Sector

PubMed Central

Mol, Arthur P. J.; Fu, Tao

2008-01-01

During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China’s water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China. PMID:18256780

Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

PubMed

Ilukor, John; Birner, Regina; Nielsen, Thea

2015-11-01

Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries. Copyright © 2015 Elsevier B.V. All rights reserved.

CE: Original Research: Primary Care Providers and Screening for Military Service and PTSD.

PubMed

Mohler, Kristin Michelle; Sankey-Deemer, Cydnee

2017-11-01

: Background: Most veterans have the option of receiving their health care from the Veterans Health Administration or through primary care providers in the private sector. However, there is some evidence that fewer than half of community-based, private sector primary care and mental health providers screen their patients for military service, particularly in rural areas, leaving these veterans less likely to be screened for posttraumatic stress disorder (PTSD) and other military service-related conditions. To determine whether primary care providers in the private sector are screening patients for military service and subsequent PTSD. We designed and piloted a survey to determine whether primary care providers in a rural Pennsylvania region routinely screen for military service and service-related PTSD. We distributed the survey to a convenience sample of more than 250 primary care providers in central and western Pennsylvania through the U.S. Postal Service, via Facebook, and via work e-mails for those who worked in a local health system. Among 50 eligible respondents, only four (8%) said they screen all their patients for military service, and 20 (40%) reported screening none; only two respondents (4%) screened all their patients who have served in the military for PTSD, and 30 (60%) screened none. Veterans who rely on private sector providers may not receive evidence-based care for military service-related health problems, including PTSD. To improve care for these patients, providers in the private sector should be educated on why all patients should be screened for military service, how to conduct such screening properly, and veterans' general health concerns.

The Impact of Service Sector Growth on Changing Patterns of Stratification among Communities.

ERIC Educational Resources Information Center

Kassab, Cathy

This paper examines the impact of increasing service sector employment and decreasing manufacturing employment on the distribution of income across communities on the urban-rural continuum. Changes in the differential distribution of industries and family income across this continuum have important consequences for local services, including…

How Homeless Sector Workers Deal with the Death of Service Users: A Grounded Theory Study

ERIC Educational Resources Information Center

Lakeman, Richard

2011-01-01

Homeless sector workers often encounter the deaths of service users. A modified grounded theory methodology project was used to explore how workers make sense of, respond to, and cope with sudden death. In-depth interviews were undertaken with 16 paid homeless sector workers who had experienced the death of someone with whom they worked.…

Welfare policy and planning of oral health services.

PubMed

Helöe, L A

1988-04-01

The Scandinavian countries are commonly referred to as welfare states, i.e. liberal states which assume responsibility for their citizens through a range of interventions in the market economy. The principles of the welfare policy are: 1) universality of population coverage, 2) comprehensiveness of risks covered, 3) adequacy of benefits and 4) citizens' right to health and social services. The goals are usually expressed in brief slogans like solidarity, universality, equality of opportunity, quality, efficiency and pluralism/"freedom of choice". Our welfare model is thus based upon ideals deriving from both individualistic and collectivistic philosophies, just as Scandinavia's mixed economy is. Similar to other health sectors, dental care is an integral part of the welfare state, striving to attain its manifold goals. Planning of oral health services should therefore be directed toward these goals, considering the shifts in the disease and problem panorama.

An integrated data envelopment analysis-artificial neural network approach for benchmarking of bank branches

NASA Astrophysics Data System (ADS)

Shokrollahpour, Elsa; Hosseinzadeh Lotfi, Farhad; Zandieh, Mostafa

2016-06-01

Efficiency and quality of services are crucial to today's banking industries. The competition in this section has become increasingly intense, as a result of fast improvements in Technology. Therefore, performance analysis of the banking sectors attracts more attention these days. Even though data envelopment analysis (DEA) is a pioneer approach in the literature as of an efficiency measurement tool and finding benchmarks, it is on the other hand unable to demonstrate the possible future benchmarks. The drawback to it could be that the benchmarks it provides us with, may still be less efficient compared to the more advanced future benchmarks. To cover for this weakness, artificial neural network is integrated with DEA in this paper to calculate the relative efficiency and more reliable benchmarks of one of the Iranian commercial bank branches. Therefore, each branch could have a strategy to improve the efficiency and eliminate the cause of inefficiencies based on a 5-year time forecast.

Sectoral roles in greenhouse gas emissions and policy implications for energy utilization and carbon emissions trading: a case study of Beijing, China.

PubMed

Ge, Jianping; Lei, Yalin; Xu, Qun; Wang, Xibo

2016-01-01

In this study, a decomposition and emissions matrix is developed to identify the roles (giver or taker) played by the sectors in the greenhouse gas emissions for the economy of Beijing in China. Our results indicate that services were the most important emitter if we consider the total (direct and indirect) emissions. In addition to Construction, Scientific studies and technical services and Finance sectors of services were the largest takers. They have a large role in boosting greenhouse gas emissions throughout the economy of Beijing. As the basis and supporter of production activities, the electricity production and the transportation sectors were the greatest givers. More emphasis should be placed on using clean energy and carbon capture and storage technologies to reduce emissions within these sectors. Based on the roles played by these sectors in greenhouse gas emissions, some policy implications were proposed for energy utilization and carbon emissions trading.

Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

PubMed

Dyson, Kate; Kruger, Estie; Tennant, Marc

2012-12-01

This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Economic base determination and influence of several variables against contributions percentage of the GDRP in Aceh Besar district

NASA Astrophysics Data System (ADS)

Andayani, Keumala; Miftahuddin

2018-05-01

The percentage contribution of Gross Regional Domestic Product (GRDP) in Aceh Besar district is influenced by several leading sectors, such as agriculture, building sector, trade, hotel and restaurant sector, transport and communications, financial sector, leasing and business services, and services sector. Based on the use of Location Quotient (LQ) method and multiple regression model, the effect of labor variables and population to Gross Regional Domestic Product by 2000 constant prices for agriculture and trade. For each addition of one workforce in the trading sector, the trade sector contribution will increase by 0.000014157%. Thus, the trade sector contribution will increase by 0.0000013786% in every addition of one soul of the population. Whereas, for every addition of one human resource in the agricultural sector will be reduced by 0.0002%. In other words, for each addition of one soul of the population will reduce the contribution of the agricultural sector by 0.00008611%.

Health service delivery in China: a literature review.

PubMed

Eggleston, Karen; Ling, Li; Qingyue, Meng; Lindelow, Magnus; Wagstaff, Adam

2008-02-01

We report the results of a review of the Chinese- and English-language literatures on service delivery in China, asking how well China's health-care providers perform and what determines their performance. Although data and methodological limitations suggest caution in drawing conclusions, a critical reading of the available evidence suggests that current health service delivery in China leaves room for improvement, in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector or by simply encouraging providers -- public and private -- to compete with one another for individual patients. By contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid -- shifting away from fee-for-service and the distorted price schedule. Other elements of 'active purchasing' by insurers could further improve outcomes. Rigorous evaluations, based on richer micro-level data, could considerably strengthen the evidence base for service delivery policy in China.

Service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector.

PubMed

Ahmed, Selim; Tarique, Kazi Md; Arif, Ishtiaque

2017-06-12

Purpose The purpose of this paper is to investigate service quality, patient satisfaction and loyalty in Bangladesh's healthcare sector. It identifies healthcare quality conformance, patient satisfaction and loyalty based on demographics such as gender, age and marital status. It examines the differences between public and private healthcare sectors regarding service quality, patient satisfaction and loyalty. Design/methodology/approach The authors distributed 450 self-administered questionnaires to hospital patients resulting in 204 useful responses (45.3 per cent response rate). Data were analysed based on reliability analysis, exploratory factor analysis, independent samples t-tests, ANOVA and discriminant analysis using SPSS version 23. Findings Findings indicate that single patients perceive tangibles, reliability, empathy and loyalty higher compared to married patients. Young patients (⩽20 years) have a higher tangibles, empathy and loyalty scores compared to other age groups. The authors observed that private hospital patients perceive healthcare service quality performance higher compared to patients in public hospitals. Research limitations/implications The authors focussed solely on the Bangladesh health sector, so the results might not be applicable to other countries. Originality/value The findings provide guidelines for enhancing service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector and other countries.

The Australian health policy changes of 1999 and 2000: an evaluation.

PubMed

Hopkins, Sandra; Zweifel, Peter

2005-01-01

This article evaluates three measures introduced by the Australian Federal Government in 1999 and 2000 that were designed to encourage private health insurance and relieve financial pressure on the public healthcare sector. These policy changes were (i) a 30% premium rebate, (ii) health insurers offering lifetime enrolment on existing terms and the future relaxation of premium regulation by permitting premiums to increase with age, and (iii) a mandate for insurers to offer complementary coverage for bridging the gap between actual hospital billings and benefits paid. These measures were first evaluated in terms of expected benefits and costs at the individual level. In terms of the first criteria, the policy changes as a whole may have been efficiency-increasing. The Australian Government mandate to launch gap policies may well have created a spillover moral hazard effect to the extent that full insurance coverage encouraged policy holders to also use more public hospital services, thus undermining the government's stated objective to relieve public hospitals from demand pressure. Without this spillover moral hazard effect, there might have been a reduction in waiting times in the public sector. Secondly, the measures were evaluated in terms of additional benchmarks of the cost to the public purse, access and equity, and dynamic efficiency. Although public policy changes were found to be largely justifiable on the first set of criteria, they do not appear to be justifiable based on the second set. Uncertainties and doubts remain about the effect of the policy changes in terms of overall cost, access and equity, and dynamic efficiency. This is a common experience in countries that have considered shifts of their healthcare systems between the private and public sectors.

Outsourcing and benchmarking in a rural public hospital: does economic theory provide the complete answer?

PubMed

Young, S H

2003-01-01

The ideology and pronouncements of the Australian Government in introducing 'competitive neutrality' to the public sector has improved efficiency and resource usage. In the health sector, the Human Services Department directed that non-clinical and clinical areas be market tested through benchmarking services against the private sector, with the possibility of outsourcing. These services included car parking, computing, laundry, engineering, cleaning, catering, medical imaging (radiology), pathology, pharmacy, allied health and general practice. Managers, when they choose between outsourcing, and internal servicing and production, would thus ideally base their decision on economic principles. Williamson's transaction cost theory studies the governance mechanisms that can be used to achieve economic efficiency and proposes that the optimal organisation structure is that which minimises transaction costs or the costs of exchange. Williamson proposes that four variables will affect such costs, namely: (i) frequency of exchange; (ii) asset specificity; (iii) environmental uncertainty; and (iv) threat of opportunism. This paper provides evidence from a rural public hospital and examines whether Williamson's transaction cost theory is applicable. Case study research operates within the interpretivism paradigm and is used in this research to uncover why the outsourcing decision was made. Such research aims to study real-life experiences by examining the way people think and act and, in contrast to positivism, allows the interviewer to participate to better understand the details and features of the experiences. In the present research, individual interviews were conducted with managers of the hospital and owners and staff of the vendor organisations using semi- and unstructured questions to ascertain the extent of, and processes used in, outsourcing specific functional areas, and areas that were not outsourced. Pathology, radiology, dental technician services and lawn mowing were outsourced while food services was retained internally. The outsourcing of radiology was due to the hospital being unable (or unwilling) to finance new equipment and the problematical relationship between the existing radiologists, and hospital management and staff. Outsourcing resulted in increased staff morale, upgraded capital equipment and improved services. The outsourcing of pathology and dental technical services aimed to increase labour flexibility, thereby decreasing costs. Additional drivers in pathology were the changing nature of the funding arrangements rendering it profitable for the private sector to move into the provision of pathology and the increasing power of the medical scientists' union. The outsourcing of lawn mowing was simply to reduce costs. Food services was not outsourced because there was a lack of evidence that costs could be reduced. In addition, the existing relationships with food services staff were regarded as important because they had previously made immense changes to work practices, reduced staff numbers and decreased costs. Transaction costs are important when analysing how managers make the outsourcing decision, but the evidence from this case is that not all transaction costs are included in the decision, and that such costs are more complex than can be included in the type of analysis often undertaken by decision-makers. Taking into account Williamson's variables, the research shows that the outsourcing of services did not comply solely with the levels of transaction frequency or the requirement of asset specificity. In addition, opportunistic behaviour was evident on the part of all parties and was used in some cases as a reason for outsourcing, and in others to sway the decision to the manager's predisposed choice. A variety of arrangements were used to reduce environmental uncertainty, such as the transfer of staff to the contractor and the use of long-term contracts. Indeed the case shows that relationships between the hospital, its staff and the vendor are an important consideration that may not always be factored into an analysis that relies solely on transaction costs.

Efficiency in the Community College Sector: Stochastic Frontier Analysis

ERIC Educational Resources Information Center

Agasisti, Tommaso; Belfield, Clive

2017-01-01

This paper estimates technical efficiency scores across the community college sector in the United States. Using stochastic frontier analysis and data from the Integrated Postsecondary Education Data System for 2003-2010, we estimate efficiency scores for 950 community colleges and perform a series of sensitivity tests to check for robustness. We…

A comparison between antenatal care quality in public and private sector in rural Hebei, China

PubMed Central

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

2013-01-01

Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

Utilization of HIV-related services from the private health sector: A multi-country analysis.

PubMed

Wang, Wenjuan; Sulzbach, Sara; De, Susna

2011-01-01

Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Food loss rate in food supply chain using material flow analysis.

PubMed

Ju, Munsol; Osako, Masahiro; Harashina, Sachihiko

2017-03-01

The food loss rate is a factor that represents food consumption efficiency. To improve food consumption efficiency, we need to fundamentally quantify food loss at national and global levels. This study examines food and food waste flow and calculates the food loss rate in the food supply chain by targeting Japan. We analyzed inedible food waste and avoidable food losses in wholesale, manufacturing, retail, food services, and households and considered different supply chain pathways, different food categories representing whole Japanese meals, and weight changes after cooking. The results are as follows: (1) Japan has an overall rate of avoidable food losses of approximately 15% for meals (excluding agricultural losses), (2) the supply sector with the highest food loss rate is food services, and (3) the food category with the highest food loss rate is vegetables. Finally, we proposed a model for calculating food loss rates that could be used for future analysis in Japan or other countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Report To The Secretary Of Defense-Task Group On A Culture Of Savings: Implementing Behavior Change In DoD

DTIC Science & Technology

2011-01-01

Shared Services in the Public Sector - Accenture Shared Services in Government - AT Kearney – 2009 Global Shared Services Survey Results - Deloitte... Shared Services - a Benchmark Study - The Johnson Group – Economics of Business Process Outsourcing - Technology Association of Georgia – State of... Shared Services and Business Process Outsourcing - Accenture – Public Sector Outsourcing Surge in 2010 - National Outsourcing Association – Naval

Women's experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study.

PubMed

Gerdts, Caitlin; Raifman, Sarah; Daskilewicz, Kristen; Momberg, Mariette; Roberts, Sarah; Harries, Jane

2017-10-02

In settings where abortion is legally restricted, or permitted but not widely accessible, women face significant barriers to abortion access, sometimes leading them to seek services outside legal facilities. The advent of medication abortion has further increased the prevalence of informal sector abortion. This study investigates the reasons for attempting self-induction, methods used, complications, and sources of information about informal sector abortion, and tests a specific recruitment method which could lead to improved estimates of informal sector abortion prevalence among an at-risk population. We recruited women who have sought informal sector abortion services in Cape Town, South Africa using respondent driven sampling (RDS). An initial seed recruiter was responsible for initiating recruitment using a structured coupon system. Participants completed face-to-face questionnaires, which included information about demographics, informal sector abortion seeking, and safe abortion access needs. We enrolled 42 women, nearly one-third of whom reported they were sex workers. Thirty-four women (81%) reported having had one informal sector abortion within the past 5 years, 14% reported having had two, and 5% reported having had three. These women consumed home remedies, herbal mixtures from traditional healers, or tablets from an unregistered provider. Twelve sought additional care for potential warning signs of complications. Privacy and fear of mistreatment at public sector facilities were among the main reported reasons for attempting informal sector abortion. Most women (67%) cited other community members as their source of information about informal sector abortion; posted signs and fliers in public spaces also served as an important source of information. Women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities. Some were unaware how or where to seek formal sector services, or believed the cost was too high. Many informal methods are ineffective and unsafe, leading to potential warning signs of complications and continued pregnancy. Sex workers may be at particular risk of unsafe abortion. Based on these results, it is essential that future studies sample women outside of the formal health sector. The use of innovative sampling methods would greatly improve our knowledge about informal sector abortion in South Africa.

Services for Adults With an Autism Spectrum Disorder

PubMed Central

Shattuck, Paul T; Roux, Anne M; Hudson, Laura E; Taylor, Julie Lounds; Maenner, Matthew J; Trani, Jean-Francois

2012-01-01

The need for useful evidence about services is increasing as larger numbers of children identified with an autism spectrum disorder (ASD) age toward adulthood. The objective of this review was to characterize the topical and methodological aspects of research on services for supporting success in work, education, and social participation among adults with an ASD and to propose recommendations for moving this area of research forward. We reviewed the literature published in English from 2000 to 2010 and found that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Extant research does not reflect the demographic or impairment heterogeneity of the population, the range of services that adults with autism require to function with purposeful lives in the community, and the need for coordination across service systems and sectors. Future studies must examine issues related to cost and efficiency, given the broader sociopolitical and economic context of service provision. Further, future research needs to consider how demographic and impairment heterogeneity have implications for building an evidence base that will have greater external validity. PMID:22546060

The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

PubMed Central

2010-01-01

Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions. PMID:21040539

Ecosystem services: foundations, opportunities, and challenges for the forest products sector

Treesearch

Trista M. Patterson; Dana L. Coelho

2009-01-01

The ecosystem service concept has been proposed as a meaningful framework for natural resource management. In theory, it holds concomitant benefit and consequence for the forest product sector. However, numerous barriers impede practitioners from developing concrete and enduring responses to emerging ecosystem service markets, policies, and initiatives. Principal among...

The Medicaid School Program: An Effective Public School and Private Sector Partnership

ERIC Educational Resources Information Center

Mallett, Christopher A.

2013-01-01

Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…

Public Service Motivation as a Predictor of Attraction to the Public Sector

ERIC Educational Resources Information Center

Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.

2012-01-01

According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring public sector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…

Sectoral transitions - modeling the development from agrarian to service economies

NASA Astrophysics Data System (ADS)

Lutz, Raphael; Spies, Michael; Reusser, Dominik E.; Kropp, Jürgen P.; Rybski, Diego

2013-04-01

We consider the sectoral composition of a country's GDP, i.e the partitioning into agrarian, industrial, and service sectors. Exploring a simple system of differential equations we characterise the transfer of GDP shares between the sectors in the course of economic development. The model fits for the majority of countries providing 4 country-specific parameters. Relating the agrarian with the industrial sector, a data collapse over all countries and all years supports the applicability of our approach. Depending on the parameter ranges, country development exhibits different transfer properties. Most countries follow 3 of 8 characteristic paths. The types are not random but show distinct geographic and development patterns.

Implementation of Advanced Warehouses in a Hospital Environment - Case study

NASA Astrophysics Data System (ADS)

Costa, J.; Sameiro Carvalho, M.; Nobre, A.

2015-05-01

In Portugal, there is an increase of costs in the healthcare sector due to several factors such as the aging of the population, the increased demand for health care services and the increasing investment in new technologies. Thus, there is a need to reduce costs, by presenting the effective and efficient management of logistics supply systems with enormous potential to achieve savings in health care organizations without compromising the quality of the provided service, which is a critical factor, in this type of sector. In this research project the implementation of Advanced Warehouses has been studied, in the Hospital de Braga patient care units, based in a mix of replenishment systems approaches: the par level system, the two bin system and the consignment model. The logistics supply process is supported by information technology (IT), allowing a proactive replacement of products, based on the hospital services consumption records. The case study was developed in two patient care units, in order to study the impact of the operation of the three replenishment systems. Results showed that an important inventory holding costs reduction can be achieved in the patient care unit warehouses while increasing the service level and increasing control of incoming and stored materials with less human resources. The main conclusion of this work illustrates the possibility of operating multiple replenishment models, according to the types of materials that healthcare organizations deal with, so that they are able to provide quality health care services at a reduced cost and economically sustainable. The adoption of adequate IT has been shown critical for the success of the project.

The Service Sector and Rural America: Issues for Public Policy and Topics for Research.

ERIC Educational Resources Information Center

Menchik, Mark David

An examination of trends in the service industries, as determined by U.S. Bureau of the Census figures (1970-77), reveals it to be the fastest growing sector in the economy, both nationally and rurally. Employment in this sector increased 24% nationally and accounted for 74% of the net gain in nonmetropolitan employment; growth was at least 65%…

Do the stars align? Distribution of high-quality ratings of healthcare sectors across US markets.

PubMed

Figueroa, Jose; Feyman, Yevgeniy; Blumenthal, Daniel; Jha, Ashish

2018-04-01

The US government created five-star rating systems to evaluate hospital, nursing homes, home health agency and dialysis centre quality. The degree to which quality is a property of organisations versus geographical markets is unclear. To determine whether high-quality healthcare service sectors are clustered within US healthcare markets. Using data from the Centers for Medicare and Medicaid Services' Hospital, Dialysis, Nursing Home and Home Health Compare databases, we calculated the mean star ratings of four healthcare sectors in 304 US hospital referral regions (HRRs). For each sector, we ranked HRRs into terciles by mean star rating. Within each HRR, we assessed concordance of tercile rank across sectors using a multirater kappa. Using t-tests, we compared characteristics of HRRs with three to four top-ranked sectors, one to two top-ranked sectors and zero top-ranked sectors. Six HRRs (2.0% of HRRs) had four top-ranked healthcare sectors, 38 (12.5%) had three top-ranked health sectors, 71 (23.4%) had two top-ranked sectors, 111 (36.5%) had one top-ranked sector and 78 (25.7%) HRRs had no top-ranked sectors. A multirater kappa across all sectors showed poor to slight agreement (K=0.055). Compared with HRRs with zero top-ranked sectors, those with three to four top-ranked sectors had higher median incomes, fewer black residents, lower mortality rates and were less impoverished. Results were similar for HRRs with one to two top-ranked sectors. Few US healthcare markets exhibit high-quality performance across four distinct healthcare service sectors, suggesting that high-quality care in one sector may not be dependent on or improve care quality in other sectors. Policies that promote accountability for quality across sectors (eg, bundled payments and shared quality metrics) may be needed to systematically improve quality across sectors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

PubMed Central

2012-01-01

Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

Labor markets and employment insecurity: impacts of globalization on service and healthcare-sector workforces.

PubMed

Ostry, Aleck S; Spiegel, Jerry M

2004-01-01

Global changes in the economies of most developed nations have impacted the way healthcare is organized, even within largely public systems, and the working conditions of healthcare workers. Since the acceleration of globalization in the 1970s, service-sector workers in developed nations have faced high unemployment, increased skill requirements for most jobs, and a rise in non-traditional work arrangements. These secular shifts in service-sector labor markets have occurred against the background of an erosion of the welfare state and growing income inequality. As well, many healthcare systems, including Canada's, were severely downsized and restructured in the 1990s, exacerbating the underlying negative secular trends in the service sector, and worsening the working conditions for many healthcare workers. Globalization has altered the labor market and shifted working conditions in ways that have been unfavorable to many healthcare workers.

Intelligent Transport Systems in the Management of Road Transportation

NASA Astrophysics Data System (ADS)

Kalupová, Blanka; Hlavoň, Ivan

2016-11-01

Extension of European Union causes increase of free transfer of people and goods. At the same time they raised the problems associated with the transport, e.g. congestion and related accidents on roads, air traffic delays and more. To increase the efficiency and safety of transport, the European Commission supports the introduction of intelligent transport systems and services in all transport sectors. Implementation of intelligent transport systems and services in the road transport reduces accident frequency, increases the capacity of existing infrastructure and reduces congestions. Use of toll systems provides resources needed for the construction and operation of a new road network, improves public transport, cycling transport and walking transport, and also their multimodal integration with individual car transport.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Sha; Evans, Meredydd; Shi, Qing

China will account for about half of the new construction globally in the coming decade. Its floorspace doubled from 1996 to 2011, and Chinese rural buildings alone have as much floorspace as all of U.S. residential buildings. Building energy consumption has also grown, increasing by over 40% since 1990. To curb building energy demand, the Chinese government has launched a series of policies and programs. Combined, this growth in buildings and renovations, along with the policies to promote green buildings, are creating a large market for energy efficiency products and services. This report assesses the impact of China’s policies onmore » building energy efficiency and on the market for energy efficiency in the future. The first chapter of this report introduces the trends in China, drawing on both historical analysis, and detailed modeling of the drivers behind changes in floorspace and building energy demand such as economic and population growth, urbanization, policy. The analysis describes the trends by region, building type and energy service. The second chapter discusses China’s policies to promote green buildings. China began developing building energy codes in the 1980s. Over time, the central government has increased the stringency of the code requirements and the extent of enforcement. The codes are mandatory in all new buildings and major renovations in China’s cities, and they have been a driving force behind the expansion of China’s markets for insulation, efficient windows, and other green building materials. China also has several other important policies to encourage efficient buildings, including the Three-Star Rating System (somewhat akin to LEED), financial incentives tied to efficiency, appliance standards, a phasing out of incandescent bulbs and promotion of efficient lighting, and several policies to encourage retrofits in existing buildings. In the third chapter, we take “deep dives” into the trends affecting key building components. This chapter examines insulation in walls and roofs; efficient windows and doors; heating, air conditioning and controls; and lighting. These markets have seen significant growth because of the strength of the construction sector but also the specific policies that require and promote efficient building components. At the same time, as requirements have become more stringent, there has been fierce competition, and quality has at time suffered, which in turn has created additional challenges. Next we examine existing buildings in chapter four. China has many Soviet-style, inefficient buildings built before stringent requirements for efficiency were more widely enforced. As a result, there are several specific market opportunities related to retrofits. These fall into two or three categories. First, China now has a code for retrofitting residential buildings in the north. Local governments have targets of the number of buildings they must retrofit each year, and they help finance the changes. The requirements focus on insulation, windows, and heat distribution. Second, the Chinese government recently decided to increase the scale of its retrofits of government and state-owned buildings. It hopes to achieve large scale changes through energy service contracts, which creates an opportunity for energy service companies. Third, there is also a small but growing trend to apply energy service contracts to large commercial and residential buildings. This report assesses the impacts of China’s policies on building energy efficiency. By examining the existing literature and interviewing stakeholders from the public, academic, and private sectors, the report seeks to offer an in-depth insights of the opportunities and barriers for major market segments related to building energy efficiency. The report also discusses trends in building energy use, policies promoting building energy efficiency, and energy performance contracting for public building retrofits.« less

Theory of Constraints for Services: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Ricketts, John A.

Theory of constraints (TOC) is a thinking process and a set of management applications based on principles that run counter to conventional wisdom. TOC is best known in the manufacturing and distribution sectors where it originated. Awareness is growing in some service sectors, such as Health Care. And it's been adopted in some high-tech industries, such as Computer Software. Until recently, however, TOC was barely known in the Professional, Scientific, and Technical Services (PSTS) sector. Professional services include law, accounting, and consulting. Scientific services include research and development. And Technical services include development, operation, and support of various technologies. The main reason TOC took longer to reach PSTS is it's much harder to apply TOC principles when services are highly customized. Nevertheless, with the management applications described in this chapter, TOC has been successfully adapted for PSTS. Those applications cover management of resources, projects, processes, and finances.

[The Unified National Health System and the third sector: Characterization of non-hospital facilities providing basic health care services in Belo Horizonte, Minas Gerais, Brazil].

PubMed

Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal

2007-01-01

In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.

Reducing Demand through Efficiency and Services: Impacts and Opportunities in Buildings Sector (Carbon Cycle 2.0)

ScienceCinema

Piette, Mary Ann

2018-05-03

Mary Ann Piette, Deputy of LBNL's Building Technologies Department and Director of the Demand Response Research Center, speaks at the Carbon Cycle 2.0 kick-off symposium Feb. 2, 2010. We emit more carbon into the atmosphere than natural processes are able to remove - an imbalance with negative consequences. Carbon Cycle 2.0 is a Berkeley Lab initiative to provide the science needed to restore this balance by integrating the Labs diverse research activities and delivering creative solutions toward a carbon-neutral energy future.

Reducing Demand through Efficiency and Services: Impacts and Opportunities in Buildings Sector (Carbon Cycle 2.0)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piette, Mary Ann

Mary Ann Piette, Deputy of LBNL's Building Technologies Department and Director of the Demand Response Research Center, speaks at the Carbon Cycle 2.0 kick-off symposium Feb. 2, 2010. We emit more carbon into the atmosphere than natural processes are able to remove - an imbalance with negative consequences. Carbon Cycle 2.0 is a Berkeley Lab initiative to provide the science needed to restore this balance by integrating the Labs diverse research activities and delivering creative solutions toward a carbon-neutral energy future.

Substantial air quality and climate co-benefits achievable now with sectoral mitigation strategies in China.

PubMed

Peng, Wei; Yang, Junnan; Wagner, Fabian; Mauzerall, Denise L

2017-11-15

China is the world's top carbon emitter and suffers from severe air pollution. We examine near-term air quality and CO 2 co-benefits of various current sector-based policies in China. Using a 2015 base case, we evaluate the potential benefits of four sectoral mitigation strategies. All scenarios include a 20% increase in conventional air pollution controls as well as the following sector-specific fuel switching or technology upgrade strategies. Power sector (POW): 80% replacement of small coal power plants with larger more efficient ones; Industry sector (IND): 10% improvement in energy efficiency; Transport sector (TRA): replacement of high emitters with average vehicle fleet emissions; and Residential sector (RES): replacement of 20% of coal-based stoves with stoves using liquefied petroleum gas (LPG). Conducting an integrated assessment using the regional air pollution model WRF-Chem, we find that the IND scenario reduces national air-pollution-related deaths the most of the four scenarios examined (27,000, 24,000, 13,000 and 23,000 deaths reduced annually in IND, POW, TRA and RES, respectively). In addition, the IND scenario reduces CO 2 emissions more than 8times as much as any other scenario (440, 53, 0 and 52Mt CO 2 reduced in IND, POW, TRA and RES, respectively). We also examine the benefits of an industrial efficiency improvement of just 5%. We find the resulting air quality and health benefits are still among the largest of the sectoral scenarios, while the carbon mitigation benefits remain more than 3 times larger than any other scenario. Our analysis hence highlights the importance of even modest industrial energy efficiency improvements and air pollution control technology upgrades for air quality, health and climate benefits in China. Copyright © 2017 Elsevier B.V. All rights reserved.

A Sector Capacity Assessment Method Based on Airspace Utilization Efficiency

NASA Astrophysics Data System (ADS)

Zhang, Jianping; Zhang, Ping; Li, Zhen; Zou, Xiang

2018-02-01

Sector capacity is one of the core factors affecting the safety and the efficiency of the air traffic system. Most of previous sector capacity assessment methods only considered the air traffic controller’s (ATCO’s) workload. These methods are not only limited which only concern about the safety, but also not accurate enough. In this paper, we employ the integrated quantitative index system proposed in one of our previous literatures. We use the principal component analysis (PCA) to find out the principal indicators among the indicators so as to calculate the airspace utilization efficiency. In addition, we use a series of fitting functions to test and define the correlation between the dense of air traffic flow and the airspace utilization efficiency. The sector capacity is then decided as the value of the dense of air traffic flow corresponding to the maximum airspace utilization efficiency. We also use the same series of fitting functions to test the correlation between the dese of air traffic flow and the ATCOs’ workload. We examine our method with a large amount of empirical operating data of Chengdu Controlling Center and obtain a reliable sector capacity value. Experiment results also show superiority of our method against those only consider the ATCO’s workload in terms of better correlation between the airspace utilization efficiency and the dense of air traffic flow.

[Analysis of grey correlation between energy consumption and economic growth in Liaoning Province, China.

PubMed

Wang, Li; Xi, Feng Ming; Wang, Jiao Yue

2016-03-01

The contradiction between energy consumption and economic growth is increasingly prominent in China. Liaoning Province as one of Chinese heavy industrial bases, consumes a large amount of energy. Its economic development has a strong dependence on energy consumption, but the energy in short supply become more apparent. In order to further understand the relationship between energy consumption and economic growth and put forward scientific suggestions on low carbon development, we used the grey correlation analysis method to separately examine the relevance of economic growth with energy consumption industries and energy consumption varieties through analy sis of energy consumption and economic growth data in Liaoning Province from 2000 to 2012. The results showed that the wholesale and retail sector and hotel and restaurant sector were in the minimum energy consumption in all kinds of sectors, but they presented the closest connection with the economic growth. Although industry energy consumption was the maximum, the degree of connection between industry energy consumption and economic growth was weak. In all types of energy consumption, oil and hydro-power consumption had a significant connection with economic growth. However, the degree of connection of coal consumption with economic growth was not significant, which meant that coal utilization efficiency was low. In order to achieve low carbon and sustainable development, Liaoning Province should transform the economic growth mode, adjust industry structure, optimize energy structure, and improve energy utilization efficiency, especially promote producer services and develop clean and renewable energy.

Health sector reform and public sector health worker motivation: a conceptual framework.

PubMed

Franco, Lynne Miller; Bennett, Sara; Kanfer, Ruth

2002-04-01

Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms may have differential impacts on various cadres of health workers.

Defending Critical Infrastructure as Cyber Key Terrain

DTIC Science & Technology

2016-08-01

and food sector (meat, poultry, egg products); • Health and Human Services -- public health and healthcare sector and the food sector (other than...meat, poultry, egg products); • Environmental Protection Agency -- drinking water and water treatment systems sector; • Department of Energy

Towards greener environment: Energy efficient pathways for the transportation sector in Malaysia

NASA Astrophysics Data System (ADS)

Indati, M. S.; Ghate, A. T.; Leong, Y. P.

2013-06-01

Transportation sector is the second most energy consuming sector after industrial sector, accounting for 40% of total energy consumption in Malaysia. The transportation sector is one of the most energy intensive sectors in the country and relies primarily on petroleum products, which in total account for nearly 98% of the total consumption in the sector. Since it is heavily reliant on petroleum based fuels, the sector contributes significantly to the greenhouse gas (GHG) emissions. The need to reduce the greenhouse gas emission is paramount as Malaysia at Conference of the Parties (COP15) pledged to reduce its carbon intensity by 40% by 2020 from 2005 level subject to availability of technology and finance. Transport sector will be among the first sectors that need to be addressed to achieve this goal, as two-thirds of the emissions come from fuel combustion in transport sector. This paper will analyse the factors influencing the transport sector's growth and energy consumption trends and discuss the key issues and challenges for greener environment and sustainable transportation in Malaysia. The paper will also discuss the policy and strategic options aimed towards energy efficient pathways in Malaysia.

After Abitur, First an Apprenticeship and then University? Why German Abitur Holders Are Taking Vocational Training in the Financial Services Sector

ERIC Educational Resources Information Center

Pilz, Matthias

2009-01-01

In the financial services sector in Germany the proportion of trainees qualified to go on to university is particularly high. But what induces school leavers not to go (straight) to university? A written survey of over 500 trainees in the banking and insurance sectors examined the motivations for the choice of educational pathway. Only some of the…

A mathematical/physics model to measure the role of information and communication technology in some economies: the Chinese case

NASA Astrophysics Data System (ADS)

Lin, Xuchen; Lu, Ting-Jie; Chen, Xia

2017-03-01

Since the Reform and Opening-up in 1978, China has experienced a huge sustainable growth of gross domestic product (GDP) and an incredible development in Information and Communication Technology (ICT). This study aims to utilize an input-output (I-O) approach to explore the role of ICT in Chinese national economy. Specifically, we employ a static I-O framework, and analyze three topics in its application: the inter-industry linkage effect, the production inducing effect, and the supply shortage effect. We pay particular attention to the ICT manufacturing sector and ICT service-providing sector by taking the sectors as exogenous and investigating their economic impacts, respectively. The results suggest that (1) the ICT manufacturing sector has a high backward linkage effect, an intermediate forward linkage effect, a relatively low production inducing effect, and a low supply shortage effect, it suggests that ICT manufacturing sector has a powerful capacity for pulling the production activities of the whole economy. (2) The inter-industry linkage effect and supply shortage effect of ICT service-providing is low, but the production inducing effect of ICT service-providing is high, which suggests that the impact of an increase in ICT service-providing investment on the total output of all other sectors is large.

Study on the context-aware middleware for ubiquitous greenhouses using wireless sensor networks.

PubMed

Hwang, Jeonghwang; Yoe, Hyun

2011-01-01

Wireless Sensor Network (WSN) technology is one of the important technologies to implement the ubiquitous society, and it could increase productivity of agricultural and livestock products, and secure transparency of distribution channels if such a WSN technology were successfully applied to the agricultural sector. Middleware, which can connect WSN hardware, applications, and enterprise systems, is required to construct ubiquitous agriculture environment combining WSN technology with agricultural sector applications, but there have been insufficient studies in the field of WSN middleware in the agricultural environment, compared to other industries. This paper proposes a context-aware middleware to efficiently process data collected from ubiquitous greenhouses by applying WSN technology and used to implement combined services through organic connectivity of data. The proposed middleware abstracts heterogeneous sensor nodes to integrate different forms of data, and provides intelligent context-aware, event service, and filtering functions to maximize operability and scalability of the middleware. To evaluate the performance of the middleware, an integrated management system for ubiquitous greenhouses was implemented by applying the proposed middleware to an existing greenhouse, and it was tested by measuring the level of load through CPU usage and the response time for users' requests when the system is working.

The economics of soil C sequestration

NASA Astrophysics Data System (ADS)

Alexander, P.; Paustian, K.; Smith, P.; Moran, D.

2014-12-01

Carbon is a critical component of soil vitality and of our ability to produce food. Carbon sequestered in soils also provides a further regulating ecosystem service, valued as the avoided damage from global climate change. We consider the demand and supply attributes that underpin and constrain the emergence of a market value for this vital global ecosystem service: markets being what economists regard as the most efficient institutions for allocating scarce resources to the supply and consumption of valuable goods. This paper considers how a potentially large global supply of soil carbon sequestration is reduced by economic and behavioural constraints that impinge on the emergence of markets, and alternative public policies that can efficiently transact demand for the service from private and public sector agents. In essence this is a case of significant market failure. In the design of alternative policy options we consider whether soil carbon mitigation is actually cost-effective relative to other measures in agriculture and elsewhere in the economy, and the nature of behavioural incentives that hinder policy options. We suggest that reducing cost and uncertainties of mitigation through soil-based measures is crucial for improving uptake. Monitoring and auditing processes will also be required to eventually facilitate wide-scale adoption of these measures.

Trends in Private Sector Development in World Bank Education Projects. Policy Research Working Paper Series.

ERIC Educational Resources Information Center

Sosale, Shobhana

The private sector is playing an increasingly important role in financing and providing educational services in many countries. (Often the term "private sector" encompasses households' out-of-pocket expenses rather than describing for-profit or not-for-profit sectors.) Private sector development has not arisen primarily through public…

Crossing the public-private sector divide with reproductive health in Cambodia: out-patient services in a local NGO and the national MCH clinic.

PubMed

Huff-Rousselle, M; Pickering, H

2001-01-01

Set within the context of recent literature on the private-public divide in the health sector of developing countries generally and Asia specifically, this study considers the major government and the major indigenous non-government clinics offering out-patient reproductive health services in Phnom Penh, Cambodia. Reproductive health is of critical importance in Cambodia, which has one of the highest levels of unmet need for family planning in the developing world and suffers from what is arguably the most severe STD and HIV/AIDS problem in Asia. The study is unusual in that it examines and compares aspects of service delivery and pricing along with the socio-economic profile and health-seeking behaviour of clients self-selecting services in the two settings. The socio-economic status of clients was much higher than the norm in Cambodia but did not differ significantly between the two clinics. A few service indicators suggested that the quality of care was better in the NGO clinic. Underlying variables--such as the broader mandate of the public sector institution and the significant discrepancy between public and private sector salaries--offer an obvious explanation for these differences. The Ministry of Health in Cambodia has been developing policies related to the NGO sector, which has expanded rapidly in Cambodia during the 1990s, and it is struggling to increase staff remuneration within the public sector.

Urban Nexus Science for Future Cities: Focus on the Energy-Water-Food-X Nexus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sperling, Joshua B.; Berke, Philip R.

Rapid urban expansion of the world's cities is placing unprecedented demands on the energy, water, food, and other (X) systems (e.g., mobility) that each offer multiple life-supporting services. Coordination that considers inter-sectoral connections among these urban systems and services remains nascent in practice, yet are critical to the future well-being, resource/operational efficiency, and resilience of urban areas. This paper therefore proposes an applied 'urban nexus science' framework to identify integrated and synergistic pathways toward achieving urban sustainability. The design, planning, and operation of urban W-E-F systems can benefit from integrated analyses to accelerate infrastructure, land use, and hazard mitigation planningmore » and decision-making. New knowledge quantifying the key effects of W-E-F systems designed in isolation versus an increasingly integrated systems, especially when exposed to hazards, health risks, or extreme events, are a critical need. Interactive system modeling and participatory technologies are needed to support stakeholder engagement and two-way (and multi-directional) information flow, for exploring outcomes of alternative solutions for integrating W-E-F sectors. To support such important efforts, research is needed to fill critical gaps in data, identify tradeoffs, and develop synergistic solutions that measure sustainability co-benefits based on different levels of urban integration among W-E-F systems and services.« less

Urban Nexus Science for Future Cities: Focus on the Energy-Water-Food-X Nexus

DOE PAGES

Sperling, Joshua B.; Berke, Philip R.

2017-08-25

Rapid urban expansion of the world's cities is placing unprecedented demands on the energy, water, food, and other (X) systems (e.g., mobility) that each offer multiple life-supporting services. Coordination that considers inter-sectoral connections among these urban systems and services remains nascent in practice, yet are critical to the future well-being, resource/operational efficiency, and resilience of urban areas. This paper therefore proposes an applied 'urban nexus science' framework to identify integrated and synergistic pathways toward achieving urban sustainability. The design, planning, and operation of urban W-E-F systems can benefit from integrated analyses to accelerate infrastructure, land use, and hazard mitigation planningmore » and decision-making. New knowledge quantifying the key effects of W-E-F systems designed in isolation versus an increasingly integrated systems, especially when exposed to hazards, health risks, or extreme events, are a critical need. Interactive system modeling and participatory technologies are needed to support stakeholder engagement and two-way (and multi-directional) information flow, for exploring outcomes of alternative solutions for integrating W-E-F sectors. To support such important efforts, research is needed to fill critical gaps in data, identify tradeoffs, and develop synergistic solutions that measure sustainability co-benefits based on different levels of urban integration among W-E-F systems and services.« less

Towards a climate service for the Tunisian tourism industry

NASA Astrophysics Data System (ADS)

Henia, Latifa; Hlaoui, Zouhaier

2013-04-01

Until today's Tunisia, there is little communication between generators of meteorological or climatological data and stakeholders in the tourism sector. However: - A recent survey shows that professionals in the tourism sector are aware of the importance of integrating relevant climate information in their tourism management and development strategies. - Tunisia has expertise in the field of meteorology and climatology which meets the demand of the tourism sector in relevant climate information. The program CLIM RUN has created a framework allowing the introduction of a climate service in the Tunisian tourism sector. It identified the needs of the sector in climate information as well as examined together with specialized services and trained researchers the possibility of responding to these needs. The "GREVACHOT" research unit based at the University of Tunis and partner of the CLIM RUN program has developed one of the products for which great demand was formulated by tourism stakeholders: this is climate-tourism comfort indices (ICT) at regional and local scales. We here present: - The Tunisian experience in identifying climate information needs of the tourism sector, - The approach method to the development, study, mapping of ICT and results.

Public and private sector in the health care system of the Federation bosnia and herzegovina: policy and strategy.

PubMed

Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other.

Public and Private Sector in the Health Care System of the Federation Bosnia and Herzegovina: Policy and Strategy

PubMed Central

Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other. PMID:23678309

Cross-Sector Service Use Among High Health Care Utilizers In Minnesota After Medicaid Expansion.

PubMed

Vickery, Katherine Diaz; Bodurtha, Peter; Winkelman, Tyler N A; Hougham, Courtney; Owen, Ross; Legler, Mark S; Erickson, Erik; Davis, Matthew M

2018-01-01

Childless adults in the Medicaid expansion population have complex social and behavioral needs. This study compared the cross-sector involvement of Medicaid expansion enrollees who were high health care utilizers to that of other expansion enrollees in Hennepin County, Minnesota. We examined forty-six months of annualized utilization and cost data for expansion-eligible residents with at least twelve months of enrollment (N = 70,134) across health care, housing, criminal justice, and human service sectors. High health care utilizers, approximately 7 percent of our sample, were disproportionately American Indian, younger, and significantly more likely than other expansion enrollees to have mental health (88.1 percent versus 48.0 percent) or substance use diagnoses (79.2 percent versus 29.6 percent). Total cross-sector public spending was nearly four times higher for high health care users ($25,337 versus $6,786), and their non-health care expenses were 2.4 times higher ($7,476 versus $3,108). High levels of cross-sector service use suggest that there are opportunities for collaboration that may result in cost savings across sectors.

An MIP model to schedule the call center workforce and organize the breaks

NASA Astrophysics Data System (ADS)

Türker, Turgay; Demiriz, Ayhan

2016-06-01

In modern economies, companies place a premium on managing their workforce efficiently especially in labor intensive service sector, since the services have become the significant portion of the economies. Tour scheduling is an important tool to minimize the overall workforce costs while satisfying the minimum service level constraints. In this study, we consider the workforce management problem of an inbound call-center while satisfying the call demand within the short time periods with the minimum cost. We propose a mixed-integer programming model to assign workers to the daily shifts, to determine the weekly off-days, and to determine the timings of lunch and other daily breaks for each worker. The proposed model has been verified on the weekly demand data observed at a specific call center location of a satellite TV operator. The model was run on both 15 and 10 minutes demand estimation periods (planning time intervals).

The imperative for systems thinking to promote access to medicines, efficient delivery, and cost-effectiveness when implementing health financing reforms: a qualitative study.

PubMed

Achoki, Tom; Lesego, Abaleng

2017-03-21

Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana. The objective was to determine the potential health system impacts that would result from expanding the health insurance scheme covering public sector employees. Study participants were selected through purposeful sampling, stakeholder mapping, and snowballing. We thematically synthesized their views, focusing on the key health system areas of access to medicines, efficiency and cost-effectiveness, as intermediate milestones towards universal health coverage. Participants suggested that expansion of health insurance would be characterized by increased financial resources for health and catalyze an upsurge in utilization of health services particularly among those with health insurance cover. As a result, the health system, particularly within the private sector, would be expected to see higher demand for medicines and other health technologies. However, majority of the respondents cautioned that, realizing the full benefits of improved population health, equitable distribution and financial risk protection, would be wholly dependent on having sound policies, regulations and functional accountability systems in place. It was recommended that, health system stewards should embrace efficient and cost-effective delivery, in order to make progress towards universal health coverage. Despite the prospects of increasing financial resources available for health service delivery, expansion of health insurance also comes with many challenges. Decision-makers keen to achieve universal health coverage, must view health financing reform through the holistic lens of the health system and its interactions with the population, in order to anticipate its potential benefits and risks. Failure to embrace this comprehensive approach, would potentially lead to counterproductive results.

Promoting successful collaborations between domestic violence and substance abuse treatment service sectors: a review of the literature.

PubMed

Macy, Rebecca J; Goodbourn, Melissa

2012-10-01

Women who experience intimate partner violence (IPV) victimization are more likely to struggle with substance abuse problems than are women who do not experience IPV. Given the connection between IPV victimization and substance abuse, recommended practices urge collaboration between domestic violence service agencies and substance abuse treatment agencies to provide comprehensive services for women with these co-occurring problems. However, domestic violence and substance abuse services have unique histories of development that have led to distinct ways of service delivery. To promote successful collaborations, service providers and researchers are developing strategies to foster relationships across the two service sectors. The authors conducted a review of this emerging body of knowledge with the aim of assembling recommendations for strategies to foster collaboration between domestic violence and substance abuse services. The authors identified 15 documents for review inclusion and our analysis established 5 categories of documents. Findings yield key collaboration strategies and recommended service models. In addition, the review determined the existence of considerable challenges to promoting collaborative relationships between domestic violence and substance abuse treatment service sectors.

76 FR 14702 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NASDAQ OMX PHLX LLC To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... index composed of fifteen companies that provide oil drilling and production services, oil field... Number of Components in the PHLX Oil Service Sector\\SM\\ Known as OSX \\SM\\, on Which Options Are Listed... Commission a proposal to expand the number of components in the PHLX Oil Service Sector\\SM\\ (the ``Index'' or...

Educational Services (Except Elementary and Secondary Schools, and Colleges and Universities): 2002. 2002 Economic Census Educational Services Industry Series. EC02-61I-01.

ERIC Educational Resources Information Center

US Department of Commerce, 2004

2004-01-01

In this report, information is provided about the Educational Services sector (sector 61), which comprises establishments that provide instruction and training in a wide variety of subjects. This instruction and training is provided by specialized establishments, such as schools, colleges, universities, and training centers. These establishments…

Commercial sector solid oxide fuel cell business assessment. Interim report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schafer, P.

Estimates for the commercial potential of solid oxide fuel cells (SOFCs) from the year 2001 to 2015 is 4 billion MWh. Their quiet operation, low cost, efficiency, and small size could make SOFCs ideal power sources for commercial customers. To better understand the market, this study had three main objectives: (1) identify the extent of the commercial market potential; (2) describe the most likely commercial segments and locations for SOFCs to be competitive; and, (3) determine the most appropriate product sizes. To profile commercial sectors by energy use, investigators conducted a market segmentation analysis. They classified markets within sectors asmore » cogeneration and electric-only applications. Investigators then performed a market analysis to estimate the cost competitiveness of SOFC energy production by state, segment, and operating mode (cogeneration or electric-only). To determine which locations and sectors would be competitive with current utility retail rates, they used the cost per kWh of electrical energy produced by SOFC technology. Study results indicated that three sizes of SOFCs would meet most market capacity requirements: 20, 100, and 250 kW. The largest number of potential SOFC building applications fell into these sectors: education, health care, food service, and skilled nursing. In terms of competitive building applications, California, New York, Illinois, Texas, and Michigan were the top states. The potential market for SOFCs, however, could be much smaller if the pressures of deregulation decrease commercial retail rates or if the rates themselves increase more slowly than expected.« less

31 CFR 31.201 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... agency agreement between a private sector entity and the Treasury for services under the TARP, other than... Economic Stabilization Act of 2008, as amended. Key individual means an individual providing services to a private sector entity who participates personally and substantially, through, for example, decision...

31 CFR 31.201 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... agency agreement between a private sector entity and the Treasury for services under the TARP, other than... Economic Stabilization Act of 2008, as amended. Key individual means an individual providing services to a private sector entity who participates personally and substantially, through, for example, decision...

31 CFR 31.201 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... agency agreement between a private sector entity and the Treasury for services under the TARP, other than... Economic Stabilization Act of 2008, as amended. Key individual means an individual providing services to a private sector entity who participates personally and substantially, through, for example, decision...

Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

PubMed

Peters, David H; Mirchandani, Gita G; Hansen, Peter M

2004-10-01

The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research designs, key questions regarding their feasibility and impact remain unanswered. Copyright 2004 Oxford University Press

Sector strength and efficiency on developed and emerging financial markets

NASA Astrophysics Data System (ADS)

Fiedor, Paweł

2014-11-01

In this paper we analyse the importance of sectors and market efficiency on developed and emerging financial markets. To perform this we analyse New York Stock Exchange between 2004 and 2013 and Warsaw Stock Exchange between 2000 and 2013. To find out the importance of sectors we construct minimal spanning trees for annual time series consisting of daily log returns and calculate centrality measures for all stocks, which we then aggregate by sectors. Such analysis is of interest to analysts for whom the knowledge of the influence of particular groups of stocks to the market behaviour is crucial. We also analyse the predictability of price changes on those two markets formally, using the information-theoretic concept of entropy rate, to find out the differences in market efficiency between a developed and an emerging market, and between sectors themselves. We postulate that such analysis is important to the study of financial markets as it can contribute to the profitability of investments, particularly in the case of algorithmic trading.

Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis.

PubMed

Green, Anna; DiGiacomo, Michelle; Luckett, Tim; Abbott, Penelope; Davidson, Patricia Mary; Delaney, Joanne; Delaney, Patricia

2014-12-18

Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice. A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework. Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level. The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

[The creation of the informal sector in urban areas].

PubMed

Papayungan, M M

1984-12-01

The development of the informal sector of the economy in urban areas of Indonesia is analyzed. The author notes that this sector is dominated by high rates of migration from rural areas, limited employment opportunities for the unskilled in the modern sector, and a demand for low-priced services and products from the informal sector. (summary in ENG)

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

[Is a strategy of bio-socio-ethic necessary?].

PubMed

Alonso Trujillo, Federico; López Medel, Raquel; Asensio Fernández, Inmaculada; Pinzón Pulido, Sandra; González Montero, M Carmen

2016-01-01

The aim of this paper is to assess the need for a common ethics strategy shared by 2 of the cornerstones of human welfare: the healthcare and social services sectors. An observational cross-sectional descriptive study was performed by surveying social services and healthcare professionals. A purposive sampling technique was used. The questionnaire consisted of 10 questions about ethical conflicts in professional practice and respondents' views on a proposed shared approach to bioethics and ethics in social intervention. 124 professionals completed the questionnaire, 56% of the health sector and 44% of the social services sector. About 90% professionals surveyed had had to make difficult ethical decisions in their work and would welcome a common approach to ethics in the social services and healthcare sectors. 75% said that conflicts are occurring more frequently in both sectors simultaneously and that they were resolved preferably individually and independently. The survey respondents believe that a common approach to tackling ethical conflicts in professional practice is required. Nevertheless, it is still rare for ethics committees to intervene in the conflict resolution process and for decision-making support and evaluation tools to be used. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

[Organization and technology in the catering sector].

PubMed

Tinarelli, Arnaldo

2014-01-01

The catering industry is a service characterized by a contract between customer and supplier. In institutional catering industry, the customer is represented by public administration; in private catering industry, the customer is represented by privates. The annual catering trades size is about 6.74 billions of euros, equally distributed between health sector (hospitals, nursing homes), school sector and business sector (ivorkplace food service), with the participation of nearly 1.200 firms and 70.000 workers. Major services include off-premises catering (food prepared away from the location where it's served) and on-premises catering (meals prepared and served at the same place). Several tools and machineries are used during both warehousing and food refrigerating operations, and during preparation, cooking, packaging and transport of meals. In this sector, injuries, rarely resulting serious or deadly, show a downward trend in the last years. On the contrary, the number of occupational diseases shows an upward trend. About the near future, the firms should become global outsourcer, able to provide other services as cleaning, transport and maintenance. In addition, they should invest in innovation: from tools and machineries technology to work organization; from factory lay-out to safely and health in the workplaces.

Economic planning and equilibrium growth of human resources and capital in health-care sector: Case study of Iran.

PubMed

Mahboobi-Ardakan, Payman; Kazemian, Mahmood; Mehraban, Sattar

2017-01-01

During different planning periods, human resources factor has been considerably increased in the health-care sector. The main goal is to determine economic planning conditions and equilibrium growth for services level and specialized workforce resources in health-care sector and also to determine the gap between levels of health-care services and specialized workforce resources in the equilibrium growth conditions and their available levels during the periods of the first to fourth development plansin Iran. In the study after data collection, econometric methods and EViews version 8.0 were used for data processing. The used model was based on neoclassical economic growth model. The results indicated that during the former planning periods, although specialized workforce has been increased significantly in health-care sector, lack of attention to equilibrium growth conditions caused imbalance conditions for product level and specialized workforce in health-care sector. In the past development plans for health services, equilibrium conditions based on the full employment in the capital stock, and specialized labor are not considered. The government could act by choosing policies determined by the growth model to achieve equilibrium level in the field of human resources and services during the next planning periods.

DSM Electricity Savings Potential in the Buildings Sector in APP Countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

McNeil, MIchael; Letschert, Virginie; Shen, Bo

2011-01-12

The global economy has grown rapidly over the past decade with a commensurate growth in the demand for electricity services that has increased a country's vulnerability to energy supply disruptions. Increasing need of reliable and affordable electricity supply is a challenge which is before every Asia Pacific Partnership (APP) country. Collaboration between APP members has been extremely fruitful in identifying potential efficiency upgrades and implementing clean technology in the supply side of the power sector as well established the beginnings of collaboration. However, significantly more effort needs to be focused on demand side potential in each country. Demand side managementmore » or DSM in this case is a policy measure that promotes energy efficiency as an alternative to increasing electricity supply. It uses financial or other incentives to slow demand growth on condition that the incremental cost needed is less than the cost of increasing supply. Such DSM measures provide an alternative to building power supply capacity The type of financial incentives comprise of rebates (subsidies), tax exemptions, reduced interest loans, etc. Other approaches include the utilization of a cap and trade scheme to foster energy efficiency projects by creating a market where savings are valued. Under this scheme, greenhouse gas (GHG) emissions associated with the production of electricity are capped and electricity retailers are required to meet the target partially or entirely through energy efficiency activities. Implementation of DSM projects is very much in the early stages in several of the APP countries or localized to a regional part of the country. The purpose of this project is to review the different types of DSM programs experienced by APP countries and to estimate the overall future potential for cost-effective demand-side efficiency improvements in buildings sectors in the 7 APP countries through the year 2030. Overall, the savings potential is estimated to be 1.7 thousand TWh or 21percent of the 2030 projected base case electricity demand. Electricity savings potential ranges from a high of 38percent in India to a low of 9percent in Korea for the two sectors. Lighting, fans, and TV sets and lighting and refrigeration are the largest contributors to residential and commercial electricity savings respectively. This work presents a first estimates of the savings potential of DSM programs in APP countries. While the resulting estimates are based on detailed end-use data, it is worth keeping in mind that more work is needed to overcome limitation in data at this time of the project.« less

Production and cost functions and their application to the port sector : a literature survey

DOT National Transportation Integrated Search

2003-08-25

Seaports provide multiple services to ships, cargo, and passengers. These services can be performed by a combination of public and private initiatives. Usually, the role of public sector institutions is to regulate and supervise private firms. In per...

The Impact on Growth of Higher Efficiency of Public Spending on Schools. OECD Economics Department Working Papers No. 547

ERIC Educational Resources Information Center

Gonand, Frederic

2007-01-01

This paper assesses the impact on economic growth of increased efficiency of public spending in primary and lower-secondary education. Higher efficiency in public spending in schools can bolster growth through two main channels. On the one hand, it can allow a transfer of labour from the public sector to the business sector at unchanged…

Food waste in the Swiss food service industry - Magnitude and potential for reduction.

PubMed

Betz, Alexandra; Buchli, Jürg; Göbel, Christine; Müller, Claudia

2015-01-01

Food losses occur across the whole food supply chain. They have negative effects on the economy and the environment, and they are not justifiable from an ethical point of view. The food service industry was identified by Beretta et al. (2013) as the third largest source of food waste based on food input at each stage of the value added chain. The total losses are estimated 18% of the food input, the avoidable losses 13.5%. However, these estimations are related with considerable uncertainty. To get more reliable and detailed data of food losses in this sector, the waste from two companies (in the education and business sectors) was classified into four categories (storage losses, preparation losses, serving losses, and plate waste) and seven food classes and measured for a period of five days. A questionnaire evaluated customer reaction, and a material flow analysis was used to describe the mass and monetary losses within the process chain. The study found that in company A (education sector) 10.73% and in company B (business sector) 7.69% of the mass of all food delivered was wasted during the process chain. From this, 91.98% of the waste in company A and 78.14% in company B were classified as avoidable. The highest proportion of waste occurred from serving losses with starch accompaniments and vegetables being the most frequently wasted items. The quantities of waste per meal were 91.23 g (value CHF 0.74) and 85.86 g (value CHF 0.44) for company A and company B, respectively. The annual loss averaged 10.47 tonnes (value CHF 85,047) in company A and 16.55 tonnes (value CHF 85,169) in company B. The customer survey showed that 15.79% (n=356) of the respondents in company A and 18.32% (n=382) in company B produced plate waste. The main causes of plate waste cited were 'portion served by staff too large' and 'lack of hunger'. Sustainable measures need to be implemented in the food service industry to reduce food waste and to improve efficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

Providing Personalized Energy Management and Awareness Services for Energy Efficiency in Smart Buildings.

PubMed

Fotopoulou, Eleni; Zafeiropoulos, Anastasios; Terroso-Sáenz, Fernando; Şimşek, Umutcan; González-Vidal, Aurora; Tsiolis, George; Gouvas, Panagiotis; Liapis, Paris; Fensel, Anna; Skarmeta, Antonio

2017-09-07

Considering that the largest part of end-use energy consumption worldwide is associated with the buildings sector, there is an inherent need for the conceptualization, specification, implementation, and instantiation of novel solutions in smart buildings, able to achieve significant reductions in energy consumption through the adoption of energy efficient techniques and the active engagement of the occupants. Towards the design of such solutions, the identification of the main energy consuming factors, trends, and patterns, along with the appropriate modeling and understanding of the occupants' behavior and the potential for the adoption of environmentally-friendly lifestyle changes have to be realized. In the current article, an innovative energy-aware information technology (IT) ecosystem is presented, aiming to support the design and development of novel personalized energy management and awareness services that can lead to occupants' behavioral change towards actions that can have a positive impact on energy efficiency. Novel information and communication technologies (ICT) are exploited towards this direction, related mainly to the evolution of the Internet of Things (IoT), data modeling, management and fusion, big data analytics, and personalized recommendation mechanisms. The combination of such technologies has resulted in an open and extensible architectural approach able to exploit in a homogeneous, efficient and scalable way the vast amount of energy, environmental, and behavioral data collected in energy efficiency campaigns and lead to the design of energy management and awareness services targeted to the occupants' lifestyles. The overall layered architectural approach is detailed, including design and instantiation aspects based on the selection of set of available technologies and tools. Initial results from the usage of the proposed energy aware IT ecosystem in a pilot site at the University of Murcia are presented along with a set of identified open issues for future research.

Providing Personalized Energy Management and Awareness Services for Energy Efficiency in Smart Buildings

PubMed Central

Fotopoulou, Eleni; Tsiolis, George; Gouvas, Panagiotis; Liapis, Paris; Fensel, Anna; Skarmeta, Antonio

2017-01-01

Considering that the largest part of end-use energy consumption worldwide is associated with the buildings sector, there is an inherent need for the conceptualization, specification, implementation, and instantiation of novel solutions in smart buildings, able to achieve significant reductions in energy consumption through the adoption of energy efficient techniques and the active engagement of the occupants. Towards the design of such solutions, the identification of the main energy consuming factors, trends, and patterns, along with the appropriate modeling and understanding of the occupants’ behavior and the potential for the adoption of environmentally-friendly lifestyle changes have to be realized. In the current article, an innovative energy-aware information technology (IT) ecosystem is presented, aiming to support the design and development of novel personalized energy management and awareness services that can lead to occupants’ behavioral change towards actions that can have a positive impact on energy efficiency. Novel information and communication technologies (ICT) are exploited towards this direction, related mainly to the evolution of the Internet of Things (IoT), data modeling, management and fusion, big data analytics, and personalized recommendation mechanisms. The combination of such technologies has resulted in an open and extensible architectural approach able to exploit in a homogeneous, efficient and scalable way the vast amount of energy, environmental, and behavioral data collected in energy efficiency campaigns and lead to the design of energy management and awareness services targeted to the occupants’ lifestyles. The overall layered architectural approach is detailed, including design and instantiation aspects based on the selection of set of available technologies and tools. Initial results from the usage of the proposed energy aware IT ecosystem in a pilot site at the University of Murcia are presented along with a set of identified open issues for future research. PMID:28880227

Big data analysis framework for healthcare and social sectors in Korea.

PubMed

Song, Tae-Min; Ryu, Seewon

2015-01-01

We reviewed applications of big data analysis of healthcare and social services in developed countries, and subsequently devised a framework for such an analysis in Korea. We reviewed the status of implementing big data analysis of health care and social services in developed countries, and strategies used by the Ministry of Health and Welfare of Korea (Government 3.0). We formulated a conceptual framework of big data in the healthcare and social service sectors at the national level. As a specific case, we designed a process and method of social big data analysis on suicide buzz. Developed countries (e.g., the United States, the UK, Singapore, Australia, and even OECD and EU) are emphasizing the potential of big data, and using it as a tool to solve their long-standing problems. Big data strategies for the healthcare and social service sectors were formulated based on an ICT-based policy of current government and the strategic goals of the Ministry of Health and Welfare. We suggest a framework of big data analysis in the healthcare and welfare service sectors separately and assigned them tentative names: 'health risk analysis center' and 'integrated social welfare service network'. A framework of social big data analysis is presented by applying it to the prevention and proactive detection of suicide in Korea. There are some concerns with the utilization of big data in the healthcare and social welfare sectors. Thus, research on these issues must be conducted so that sophisticated and practical solutions can be reached.

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

Primary care perceptions of neurology and neurology services.

PubMed

Loftus, Angela M; Wade, Carrie; McCarron, Mark O

2016-06-01

Neurophobia (fear of neural sciences) and evaluation of independent sector contracts in neurology have seldom been examined among general practitioners (GPs). A questionnaire determined GPs' perceptions of neurology compared with other medical specialties. GP experiences of neurology services with independent sector companies and the local National Health Service (NHS) were compared. Areas of potential improvement in NHS neurology services were recorded from thematic analyses. Among 76 GPs neurology was perceived to be as interesting as other medical specialties. GPs reported less knowledge, more difficulty and less confidence in neurology compared with other medical specialties. There was a preference for a local NHS neurology service (p<0.001), which was easier to contact (p<0.001) and provided better follow-up. GPs reported that local neurology services provided better patient satisfaction. GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery.

PubMed

Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark

2014-01-01

LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.

Health care inequities in north India: role of public sector in universalizing health care.

PubMed

Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

2012-09-01

Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

Health care inequities in north India: Role of public sector in universalizing health care

PubMed Central

Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

2012-01-01

Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Results: Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Interpretation & conclusions: Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure. PMID:23041735

Roundtable discussion: what is the future role of the private sector in health?

PubMed

Stallworthy, Guy; Boahene, Kwasi; Ohiri, Kelechi; Pamba, Allan; Knezovich, Jeffrey

2014-06-24

The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage.This roundtable discussion offers diverse perspectives from a range of stakeholders--a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company--on what the future may hold for the private sector in health. The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a 'both/and' approach rather than an 'either/or' when it comes to talking about health service provision in low- and middle-income countries.The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term.Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind.Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector.

75 FR 53939 - Magnuson-Stevens Act Provisions; Fisheries of the Northeastern United States; Northeast...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

... increase interactions with protected species. However, if additional nets result in greater efficiency... throughout the year, thus potentially reducing interactions with protected species. Sector vessels utilizing... Port Clyde Community Groundfish Sector, the GB Cod Fixed Gear Sector and the Tri-State Sector. 2...

Who, What, Where: an analysis of private sector family planning provision in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; Macleod, David; Goodman, Catherine; Footman, Katharine; Pereira, Audrey L; Lynch, Caroline A

2015-12-01

Family planning service delivery has been neglected; rigorous analyses of the patterns of contraceptive provision are needed to inform strategies to address this neglect. We used 57 nationally representative Demographic and Health Surveys in low- and middle-income countries (2000-2013) in four geographic regions to estimate need for contraceptive services, and examined the sector of provision, by women's socio-economic position. We also assessed method mix and whether women were informed of side effects. Modern contraceptive use among women in need was lowest in sub-Saharan Africa (39%), with other regions ranging from 64% to 72%. The private sector share of the family planning market was 37-39% of users across the regions and 37% overall (median across countries: 41%). Private sector users accessed medical providers (range across regions: 30-60%, overall mean: 54% and median across countries 23%), specialised drug sellers (range across regions: 31-52%, overall mean: 36% and median across countries: 43%) and retailers (range across regions: 3-14%, overall mean: 6% and median across countries: 6%). Private retailers played a more important role in sub-Saharan Africa (14%) than in other regions (3-5%). NGOs and FBOs served a small percentage. Privileged women (richest wealth quintile, urban residents or secondary-/tertiary-level education) used private sector services more than the less privileged. Contraceptive method types with higher requirements (medical skills) for provision were less likely to be acquired from the private sector, while short-acting methods/injectables were more likely. The percentages of women informed of side effects varied by method and provider subtype, but within subtypes were higher among public than private medical providers for four of five methods assessed. Given the importance of private sector providers, we need to understand why women choose their services, what quality services the private sector provides, and how it can be improved. However, when prioritising one of the two sectors (public vs. private), it is critical to consider the potential impact on contraceptive prevalence and equity of met need. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Retirement before Age 65 Is a Growing Trend in the Private Sector. Report to the Chairman, Subcommittee on Civil Service, Post Office and General Services, Committee on Governmental Affairs, United States Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The General Accounting Office examined retirement age trends in the private sector to assist the Congress in its effort to devise a retirement system for Federal employees. The Census Bureau's Current Population Survey (CPS) was identified as a source of information about private sector retirement patterns. March 1974, 1979, and 1984 data were…

Have out-of-pocket health care payments risen under free health care policy? The case of Sri Lanka.

PubMed

Pallegedara, Asankha; Grimm, Michael

2018-04-26

Compared to its neighbors, Sri Lanka performs well in terms of health. Health care is provided for free in the public sector, yet households' out-of-pocket health expenditures are steadily increasing. We explore whether this increase can be explained by supply shortages and insufficient public health care financing or whether it is rather the result of an income-induced demand for supplementary and higher quality services from the private sector. We focus on total health care expenditures and health care expenditures for specific services such as expenses on private outpatient treatments and expenses on laboratory and other diagnostic services. Overall, we find little indication that limited supply of public health care per se pushes patients into the private sector. Yet income is identified as one key driver of rising health care expenditures, ie, as households get richer, they spend an increasing amount on private services suggesting a dissatisfaction with the quality offered by the public sector. Hence, quality improvements in the public sector seem to be necessary to ensure sustainability of the public health care sector. If the rich and the middle class increasingly opt out of public health care, the willingness to pay taxes to finance the free health care policy will certainly shrink. Copyright © 2018 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

PubMed

Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

2010-10-01

This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

Moving into the 'patient-centred medical home': reforming Australian general practice.

PubMed

Hayes, Paul; Lynch, Anthony; Stiffe, Jenni

2016-09-01

The Australian healthcare system is a complex network of services and providers funded and administered by federal, state and territory governments, supplemented by private health insurance and patient contributions. The broad geographical range, complexity and increasing demand within the Australian healthcare sector mean health expenditure is high. Aspects of current funding for the healthcare system have attracted criticism from medical practitioners, patients, representative organisations and independent statutory agencies. In response to the problems in primary care funding in Australia, The Royal Australian College of General Practitioners developed the Vision for general practice and a sustainable healthcare system (the Vision). The Vision presents a plan to improve healthcare delivery in Australia through greater quality, access and efficiency by reorienting how general practice services are funded based on the 'patient-centred medical home' model.

Efficiency, ownership, and financing of hospitals: the case of Austria.

PubMed

Czypionka, Thomas; Kraus, Markus; Mayer, Susanne; Röhrling, Gerald

2014-12-01

While standard economic theory posits that privately owned hospitals are more efficient than their public counterparts, no clear conclusion can yet be drawn for Austria in this regard. As previous Austrian efficiency studies rely on data from the 1990s only and are based on small hospital samples, the generalizability of these results is questionable. To examine the impact of ownership type on efficiency, we apply a Data Envelopment Analysis which extends the existing literature in two respects: first, it evaluates the efficiency of the Austrian acute care sector, using data on 128 public and private non-profit hospitals from the year 2010; second, it additionally focusses on the inpatient sector alone, thus increasing the comparability between hospitals. Overall, the results show that in Austria, private non-profit hospitals outperform public hospitals in terms of technical efficiency. A multiple regression analysis confirms the significant association between efficiency and ownership type. This conclusive result contrasts some international evidence and can most likely be attributed to differences in financial incentives for public and private non-profit hospitals in Austria. Therefore, by drawing on the example of the Austrian acute care hospital sector and existing literature on the German acute care hospital sector, we also discuss the impact of hospital financing systems and their incentives on efficiency. This paper thus also aims at providing a proof of principle, pointing out the importance of the respective market conditions when internationally comparing hospital efficiency by ownership type.

Effective/efficient mental health programs for school-age children: a synthesis of reviews.

PubMed

Browne, Gina; Gafni, Amiram; Roberts, Jacqueline; Byrne, Carolyn; Majumdar, Basanti

2004-04-01

The prevalence of mental health problems, some of which seem to be occurring among younger cohorts, leads researchers and policy-makers to search for practical solutions to reduce the burden of suffering on children and their families, and the costs to society both immediate and long term. Numerous programs are in place to reduce or alleviate problem behaviour or disorders and/or assist positive youth development. Evaluated results are dispersed throughout the literature. To assess findings and determine common elements of effective children's services, a literature search was undertaken for evidence-based evaluations of non-clinical programs for school-age children. Prescriptive comments aim to inform service-providers, policy-makers and families about best practices for effective services such as: early, long-term intervention including reinforcement, follow-up and an ecological focus with family and community sector involvement; consistent adult staffing; and interactive, non-didactic programming adapted to gender, age and cultural needs. Gaps are identified in our understanding of efficiencies that result from effective programs. Policy implications include the need to develop strategies for intersectoral interventions, including: new financing arrangements to encourage (not penalize) interagency cooperation and, to ensure services reach appropriate segments of the population; replication of best practices; and publicizing information about benefits and cost savings. In many jurisdictions legislative changes could create incentives for services to collaborate on service delivery. Joint decision-making would require intersectoral governance, pooling of some funding, and policy changes to retain savings at the local level. Savings could finance expansion of services for additional youth.

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

PubMed Central

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2008-01-01

Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

New Technologies to Assist Training in Hospitality Sector

ERIC Educational Resources Information Center

Balta, Sabah

2007-01-01

Hospitality sector needs new technological training tools, which can assist to improve sector employees' skills and services quality. The sector might be more interactive when these technological training tools used on the job-training program. This study addresses to issue of illumination of new technologic tools that enforce training in which…

Adult mental health needs and expenditure in Australia.

PubMed

Burgess, Philip; Pirkis, Jane; Buckingham, Bill; Burns, Jane; Eagar, Kathy; Eckstein, Gary

2004-06-01

Relatively little international work has examined whether mental health resource allocation matches need. This study aimed to determine whether adult mental health resources in Australia are being distributed equitably. Individual measures of need were extrapolated to Australian Areas, and Area-based proxies of need were considered. Particular attention was paid to the prevalence of mental health problems, since this is arguably the most objective measure of need. The extent to which these measures predicted public sector, private sector and total adult mental health expenditure at an Area level was examined. In the public sector, 41.6% of expenditure variation was explained by the prevalence of affective disorders, personality disorders, cognitive impairment and psychosis, as well as the Area's level of economic resources and State/Territory effects. In the private sector, 72.4% of expenditure variation was explained by service use and State/Territory effects (with an alternative model incorporating service use and State/Territory supply of private psychiatrists explaining 69.4% of expenditure variation). A relatively high proportion (58.7%) of total expenditure variation could be explained by service utilisation and State/Territory effects. For services to be delivered equitably, the majority of variation in expenditure would have to be accounted for by appropriate measures of need. The best model for public sector expenditure included an appropriate measure of need but had relatively poor explanatory power. The models for private sector and total expenditure had greater explanatory power, but relied on less appropriate measures of need. It is concluded that mental health services in Australia are not yet being delivered equitably.

A framework for linking cybersecurity metrics to the modeling of macroeconomic interdependencies.

PubMed

Santos, Joost R; Haimes, Yacov Y; Lian, Chenyang

2007-10-01

Hierarchical decision making is a multidimensional process involving management of multiple objectives (with associated metrics and tradeoffs in terms of costs, benefits, and risks), which span various levels of a large-scale system. The nation is a hierarchical system as it consists multiple classes of decisionmakers and stakeholders ranging from national policymakers to operators of specific critical infrastructure subsystems. Critical infrastructures (e.g., transportation, telecommunications, power, banking, etc.) are highly complex and interconnected. These interconnections take the form of flows of information, shared security, and physical flows of commodities, among others. In recent years, economic and infrastructure sectors have become increasingly dependent on networked information systems for efficient operations and timely delivery of products and services. In order to ensure the stability, sustainability, and operability of our critical economic and infrastructure sectors, it is imperative to understand their inherent physical and economic linkages, in addition to their cyber interdependencies. An interdependency model based on a transformation of the Leontief input-output (I-O) model can be used for modeling: (1) the steady-state economic effects triggered by a consumption shift in a given sector (or set of sectors); and (2) the resulting ripple effects to other sectors. The inoperability metric is calculated for each sector; this is achieved by converting the economic impact (typically in monetary units) into a percentage value relative to the size of the sector. Disruptive events such as terrorist attacks, natural disasters, and large-scale accidents have historically shown cascading effects on both consumption and production. Hence, a dynamic model extension is necessary to demonstrate the interplay between combined demand and supply effects. The result is a foundational framework for modeling cybersecurity scenarios for the oil and gas sector. A hypothetical case study examines a cyber attack that causes a 5-week shortfall in the crude oil supply in the Gulf Coast area.

Collaborating with community-based services to promote evidence-based practice: Process description of a national initiative to improve services for youth with mental health and substance use problems.

PubMed

Henderson, Joanna L; Chaim, Gloria; Brownlie, E B

2017-08-01

Many youth with significant mental health (MH) and/or substance use (SU) difficulties do not receive specialized services. Collaboration between service providers, researchers, and other stakeholders is essential to improve youth service system capacity to provide evidence-based services to meet the complex array of needs of youth. Facilitators and barriers of implementing evidence-based practice have been identified, but few studies provide examples of the processes of collaboration and implementation for youth MH services. This study explicates the design features and implementation processes of a project to improve screening activities in youth services. These processes supported the building of 16 collaborative networks of service providers from diverse youth-serving sectors (e.g., MH, youth justice, child welfare) in urban, rural, suburban, and remote Canadian communities. These cross-sectoral networks implemented an evidence-based practice (screening youth aged 12-24 years for MH and SU problems using the Global Assessment of Individual Needs-Short Screener [GAIN-SS]) across their services. Materials and resources were provided by a centralized research team. Core project components were standardized and adherence to these components was monitored. Over 800 service providers participated in cross-sectoral networks, capacity-building events, joint data analysis, or interpretation and recommendation sessions. Across the 89 participating agencies, service providers for 84% of participating youth implemented the evidence-based practice accurately in accordance with project protocols, with 98% of positive screens reviewed and addressed according to organizational protocols. Service provider feedback is reported. Facilitators, barriers, and implications of promoting implementation of evidence-based practices across sites and sectors are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Outward Efficiency of Schools.

ERIC Educational Resources Information Center

Wadeskog, Anders

1987-01-01

The public sector in Sweden is under pressure to augment its productivity and cut costs, and the education sector is faced with the same demands. Most people believe that adequately proportioned, efficiently operating schools are essential to Sweden's long-term economic development, but this is seldom mentioned in connection with spending cuts. In…

Better and more efficient care through ICT-enabled integration of social care and healthcare services: experiences from two European projects

PubMed Central

Müller, Sonja; Meyer, Ingo; Kubitschke, Lutz; Delaney, Sarah

2012-01-01

Unsynchronised social and health care service delivery leads to inefficiencies, duplication of resources and reduced levels of quality of care. Older people are particularly affected by this situation. They often need both types of services, such as support with daily living activities and chronic disease management. ICT has the potential to support integrated service delivery to achieve high quality independent living and wellbeing for older people across Europe and elsewhere. Against this background, the presentation will demonstrate experiences and results derived from the development and piloting of ICT-supported integrated care services in eight sites across Europe, namely Dublin, Hull, Milton Keynes, Malaga, Veldhoven, Geldrop, Eindhoven and Bielefeld. Through innovative usage of ICT, current ‘silos’ in service delivery are broken up to allow for cooperation across relevant care sectors and participation of family members. The integrated services are to support the effective management of chronic diseases, and to address issues which affect independence, such as reduced agility, vision or hearing, in order to significantly improve the quality of life for older people and their carers. A dedicated programme of service process innovation complemented by adaptation of technology is being pursued in order to develop an integrated digital support infrastructure and related services: using appropriate existing technology to provide as many older people as possible with digital access to support services they needaugmenting and opening sectoral care platforms to enable coordinated cross-sector support deliveryadopting a clearly demand-driven inclusive approach and avoiding a technology ‘push’. Wider deployment of the services is supported by a dedicated programme of socio-economic service evaluation. The evaluation framework utilises a multi-method and multi-perspective approach, involving end users, family carers, service provider staff and key informants at corporate level. Triangulation is used to cross-reference data from different sources in order to maximize the reliability and robustness of conclusions drawn from the evaluation. Based on an overall framework taking into account themes such as integration, user outcomes, staff impact, organisational impact, technology, implementation and overall satisfaction, the specifics of each site are taken into account in operationally applying the overall framework in each case. The designs to be employed at each site have been developed to be as robust as possible, taking into account the constraints of the realities of the interventions. The evaluation is accompanied by a business case modelling approach that builds largely on a cost-benefit analysis covering the service development and implementation activities as well as the pilots and modelling the further deployment of services in each of the pilot sites. The presentation builds upon experiences gained within the framework of two European projects, CommonWell and INDEPENDENT. They are both co-funded under the EU’s Competitiveness and Innovation Framework Programme (CIP) focus on better joining-up of formal social/healthcare services and strengthening participation of the so-called ‘third sector’.

Trends in cataract surgical rate and resource utilisation in Egypt.

PubMed

Elbieh, Islam; Bascaran, Covadonga; Blanchet, Karl; Foster, Allen

2018-06-08

To describe cataract services in Egypt and explore resources and practices in public and private sectors. The study was conducted between June and August 2015. All facilities in the country providing cataract services were contacted to obtain information on surgeries performed in 2014. Hospitals performing eye surgery in Quena, Sharkia, and Fayoum regions were visited and a questionnaire on resources for cataract surgery was completed. Cataract surgery was offered in the public sector by 64 government and 16 university teaching hospitals and in the private sector by 101 hospitals. Over 90% of all facilities in the country contacted participated in the study. In 2014, the national cataract surgical rate (CSR) was 3674 varying in governorates from 7579 in Ismailia to 402 in Suez. The private sector performed 70% of cataract surgeries. Analysis of three regions showed an 11.7% increase in cataract output between 2010 and 2014. The average number of cataract surgeries per unit in 2014 was 2272 in private, 1633 in university, and 824 in government hospitals. Private hospitals had 60% of human resources for eye care. Phacoemulsification was the surgical technique in 85.6% of private, 72.1% of university, and 41% of government hospitals. Reasons explaining the differences in output between public and private sectors were the lack of trainers, supervisors, and incentives. The private sector provides most of the cataract services in Egypt, resulting in inadequate services for the poor. There is a 15-fold variation in CSR between the best and least served regions. The public sector could increase cataract output by improving training, supervision, and incentives.

Costs and cost-effectiveness of HIV community services: quantity and quality of studies published 1986-2011.

PubMed

Beck, Eduard J; Fasawe, Olufunke; Ongpin, Patricia; Ghys, Peter; Avilla, Carlos; De Lay, Paul

2013-06-01

Community services comprise an important part of a country's HIV response. English language cost and cost-effectiveness studies of HIV community services published between 1986 and 2011 were reviewed but only 74 suitable studies were identified, 66% of which were performed in five countries. Mean study scores by continent varied from 42 to 69% of the maximum score, reflecting variation in topics covered and the quality of coverage: 38% of studies covered key and 11% other vulnerable populations - a country's response is most effective and efficient if these populations are identified given they are key to a successful response. Unit costs were estimated using different costing methods and outcomes. Community services will need to routinely collect and analyze information on their use, cost, outcome and impact using standardized costing methods and outcomes. Cost estimates need to be disaggregated into relevant cost items and stratified by severity and existing comorbidities. Expenditure tracking and costing of services are complementary aspects of the health sector 'resource cycle' that feed into a country's investment framework and the development and implementation of national strategic plans.

Tricks and Clicks: How Low-Cost Carriers Ply Their Trade Through Self-Service Websites

NASA Astrophysics Data System (ADS)

Barry, Chris; Torres, Ann M.

Ethics on the Internet has been a widely debated topic in recent years covering issues that range from privacy to security to fraud. Little, however, has been written on more subtle ethical questions, such as the exploitation of web technologies to inhibit or avoid customer service. Increasingly some firms are using websites to create distance between them and their customer base in specific areas of their operations, while simultaneously developing excellence in sales transaction committal via self-service. This chapter takes a magnifying glass with an ethical lens to one sector - the low-cost, web-based, self-service airline industry, specifically in Ireland. It is noted that the teaching of information systems development (ISD) and, for the most part its practice, assumes ethicality. Similarly, marketing courses focus on satisfying customer needs more effectively and efficiently within the confines of an acceptable ethos. This chapter observes that while these business disciplines are central to the success of self-service websites, there is a disconnect between the normative view and the actuality of practice.

31 CFR 31.201 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Stabilization Act of 2008. Key individual means an individual providing services to a private sector entity who... agency agreement between a private sector entity and the Treasury for services under the TARP, other than... arrangement with the Treasury. For purposes of the definition of key individual, the words “personally and...

78 FR 10136 - Magnuson-Stevens Act Provisions; Fisheries of the Northeastern United States; Northeast...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

.... NE multispecies sectors are required to design and implement independent, third-party at-sea... NE Multispecies Fishery Management Plan (Amendment 16) require third-party monitoring service... in order to be eligible to provide dockside and/or at-sea monitoring services to sectors. ADDRESSES...

Research Shared Services: A Case Study in Implementation

ERIC Educational Resources Information Center

Squilla, Brian; Lee, Jenna; Steil, Andrew

2017-01-01

The private sector has been moving toward the idea of consolidating administrative functions within organizations since the 1980s. While this sector has traditionally implemented shared services with cost reduction in mind, traditionally through economies of scale, many universities across the country have begun to explore the concept of managing…

5 CFR 300.503 - Conditions for using private sector temporaries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... temporaries. 300.503 Section 300.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... help service firm for the brief or intermittent use of the skills of private sector temporaries, when... through the direct appointment of temporary employees within the time available by the date, and for the...

Sedentary behaviour and health at work: an investigation of industrial sector, job role, gender and geographical differences.

PubMed

Kazi, Aadil; Haslam, Cheryl; Duncan, Myanna; Clemes, Stacy; Twumasi, Ricardo

2018-06-21

This article presents baseline data from 1120 employees across 10 worksites enrolled in a workplace physical activity intervention. The study provides new data on physical activity, sedentary behaviour and health and highlights gender, geographical, job type and industrial sector differences. Sitting at work accounted for more than 60% of participants' total daily sitting time on work days. Weekly and monthly hours worked, body mass index (BMI) and waist circumference were significantly higher for workers in the private sector compared to the public sector. Employees in sales and customer services had significantly higher BMI scores and significantly lower scores for workability index (WAI), job satisfaction, organisational commitment and job motivation, compared to other groups. This study provides further evidence that work is a major contributor to sedentary behaviour and supports the pressing need for interventions particularly targeting private sector industries and sales and customer service sectors.

Job Demands, Job Resources, Burnout, Work Engagement, and Their Relationships: An Analysis Across Sectors.

PubMed

Van den Broeck, Anja; Elst, Tinne Vander; Baillien, Elfi; Sercu, Maarten; Schouteden, Martijn; De Witte, Hans; Godderis, Lode

2017-04-01

The aim of this study was to gain insight in the importance of job demands and resources and the validity of the Job Demands Resources Model across sectors. We used one-way analyses of variance to examine mean differences, and multi-group Structural Equation Modeling analyses to test the strength of the relationships among job demands, resources, burnout, and work engagement across the health care, industry, service, and public sector. The four sectors differed in the experience of job demands, resources, burnout, and work engagement, but they did not vary in how (strongly) job demands and resources associated with burnout and work engagement. More attention is needed to decrease burnout and increase work engagement, particularly in industry, service, and the public sector. The Job Demands-Resources model may be helpful in this regard, as it is valid across sectors.

Introduction of Energy and Climate Mitigation Policy Issues in Energy - Environment Model of Latvia

NASA Astrophysics Data System (ADS)

Klavs, G.; Rekis, J.

2016-12-01

The present research is aimed at contributing to the Latvian national climate policy development by projecting total GHG emissions up to 2030, by evaluating the GHG emission reduction path in the non-ETS sector at different targets set for emissions reduction and by evaluating the obtained results within the context of the obligations defined by the EU 2030 policy framework for climate and energy. The method used in the research was bottom-up, linear programming optimisation model MARKAL code adapted as the MARKAL-Latvia model with improvements for perfecting the integrated assessment of climate policy. The modelling results in the baseline scenario, reflecting national economic development forecasts and comprising the existing GHG emissions reduction policies and measures, show that in 2030 emissions will increase by 19.1 % compared to 2005. GHG emissions stabilisation and reduction in 2030, compared to 2005, were researched in respective alternative scenarios. Detailed modelling and analysis of the Latvian situation according to the scenario of non-ETS sector GHG emissions stabilisation and reduction in 2030 compared to 2005 have revealed that to implement a cost effective strategy of GHG emissions reduction first of all a policy should be developed that ensures effective absorption of the available energy efficiency potential in all consumer sectors. The next group of emissions reduction measures includes all non-ETS sectors (industry, services, agriculture, transport, and waste management).

Interaction of Airspace Partitions and Traffic Flow Management Delay

NASA Technical Reports Server (NTRS)

Palopo, Kee; Chatterji, Gano B.; Lee, Hak-Tae

2010-01-01

To ensure that air traffic demand does not exceed airport and airspace capacities, traffic management restrictions, such as delaying aircraft on the ground, assigning them different routes and metering them in the airspace, are implemented. To reduce the delays resulting from these restrictions, revising the partitioning of airspace has been proposed to distribute capacity to yield a more efficient airspace configuration. The capacity of an airspace partition, commonly referred to as a sector, is limited by the number of flights that an air traffic controller can safely manage within the sector. Where viable, re-partitioning of the airspace distributes the flights over more efficient sectors and reduces individual sector demand. This increases the overall airspace efficiency, but requires additional resources in some sectors in terms of controllers and equipment, which is undesirable. This study examines the tradeoff of the number of sectors designed for a specified amount of traffic in a clear-weather day and the delays needed for accommodating the traffic demand. Results show that most of the delays are caused by airport arrival and departure capacity constraints. Some delays caused by airspace capacity constraints can be eliminated by re-partitioning the airspace. Analyses show that about 360 high-altitude sectors, which are approximately today s operational number of sectors of 373, are adequate for delays to be driven solely by airport capacity constraints for the current daily air traffic demand. For a marginal increase of 15 seconds of average delay, the number of sectors can be reduced to 283. In addition, simulations of traffic growths of 15% and 20% with forecasted airport capacities in the years 2018 and 2025 show that delays will continue to be governed by airport capacities. In clear-weather days, for small increases in traffic demand, increasing sector capacities will have almost no effect on delays.

Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.

PubMed

Balakrishnan, Ramkrishnan; Gopichandran, Vijayaprasad; Chaturvedi, Sharadprakash; Chatterjee, Rahul; Mahapatra, Tanmay; Chaudhuri, Indrajit

2016-07-07

Mobile phone technology is utilized for better delivery of health services worldwide. In low-and-middle income countries mobile phones are now ubiquitous. Thus leveraging mHealth applications in health sector is becoming popular rapidly in these countries. To assess the effectiveness of the Continuum of Care Services (CCS) mHealth platform in terms of strengthening the delivery of maternal and child health (MCH) services in a district in Bihar, a resource-poor state in India. The CommCare mHealth platform was customized to CCS as one of the innovations under a project funded by the Bill and Melinda Gates Foundation to improve the maternal and newborn health services in Bihar. The intervention was rolled out in one project district in Bihar, during July 2012. More than 550 frontline workers out of a total of 3000 including Accredited Social Health Activists, Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were trained to use the mHealth platform. The service delivery components namely early registration of pregnant women, three antenatal visits, tetanus toxoid immunization of the mother, iron and folic acid tablet supply, institutional delivery, postnatal home visits and early initiation of breastfeeding were used as indicators for good quality services. The resultant coverage of these services in the implementation area was compared with rest of Bihar and previous year statistics of the same area. The time lag between delivery of a service and its record capture in the maternal and child tracking system (MCTS) database was computed in a random sample of 16,000 beneficiaries. The coverage of services among marginalized and non-marginalized castes was compared to indicate equity of service delivery. Health system strengthening was viewed from the angle of coverage, quality, equity and efficiency of services. The implementation blocks had higher coverage of all the eight indicator services compared to rest of Bihar and the previous year. There was equity of services across castes for all the indicators. Timely capture of data was also ensured compared to paper-based reporting. By virtue of its impact on quality, efficiency and equity of service delivery, health care manpower efficiency and governance, the mHealth inclusion at service provision level can be one of the potential strategy to strengthen the health system.

Service quality in health care setting.

PubMed

Rashid, Wan Edura Wan; Jusoff, Hj Kamaruzaman

2009-01-01

This paper attempts to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector. The paper also discusses several service quality dimensions and service quality problems in order to provide a more holistic conception of hospital service quality. The paper finds that service quality in health care is very complex as compared to other services because this sector highly involves risk. The paper adds a new perspective towards understanding how the concept of service quality is adopted in a health care setting.

Energy efficiency business options for industrial end users in Latin American competitive energy markets: The case of Colombia

NASA Astrophysics Data System (ADS)

Botero, Sergio

2002-01-01

Energy markets today in Latin America and worldwide are being restructured from monopolies, either state-owned or privately-owned, to be more openly competitive and incorporate more participation from the private sector. Thus, the schemes that were formerly developed to foster end use energy efficiency are no longer applicable because they were based on mandatory regulations made with political decisions, without sufficiently considering economic feasibility. A consensus exists that the only way energy efficiency could survive in this new paradigm is by being market oriented, giving better services, and additional options to users. However; there is very little information on what end users prefer, and which options would most satisfy customers. Using Colombia as a case study, this research determines and categorizes the energy efficiency business options for large energy end users that can freely participate in the competitive energy market. The energy efficiency market is understood as a market of services aiming to increase efficiency in energy use. These services can be grouped into seven business options. A survey, following the descriptive method, was sent to energy end users in order to determine their preferences for specific energy efficiency business options, as well as the decision-making criteria taken into account for such options. This data was categorized in ten industry groups. As a conclusion, energy efficiency providers should adapt not only to the economic activity or processes of each customer, but also to the potential business options. It was also found that not all industries consider performance contracting as their most preferred option, as a matter of fact, some industries show much higher preference for conventional business options. Among end users, the divergence in option preferences contrasted with the convergence in decision-making criteria. The decision-making criteria "cost-benefit ratio" overwhelmed all other criterion. End users appear to chose a specific energy efficiency option based mostly on obtaining better economic returns, giving low consideration to other criterion that feature differences among the energy efficiency options.

Using Patient Pathway Analysis to Design Patient-centered Referral Networks for Diagnosis and Treatment of Tuberculosis: The Case of the Philippines

PubMed Central

Garfin, Celine; Mantala, Mariquita; Yadav, Rajendra; Hanson, Christy L; Osberg, Mike; Hymoff, Aaron; Makayova, Julia

2017-01-01

Abstract Background Tuberculosis (TB) is the 8th leading cause of death in the Philippines. A recent prevalence survey found that there were nearly 70% more cases of tuberculosis than previously estimated. Given these new data, the National TB Program (NTP), operating through a decentralized health system, identified about 58% of the estimated new drug-sensitive (DS) TB patients in 2016. However, the NTP only identified and commenced treatment for around 17% of estimated new drug-resistant patients. In order to reach the remaining 42% of drug-sensitive patients and 83% of drug-resistant patients, it is necessary to develop a better understanding of where patients seek care. Methods National and regional patient pathway analyses (PPAs) were undertaken using existing national survey and NTP data. The PPA assessed the alignment between patient care seeking and the availability of TB diagnostic and treatment services. Results Systemic referral networks from the community-level Barangay Health Stations (BHSs) to diagnostic facilities have enabled more efficient detection of drug-sensitive tuberculosis in the public sector. Approximately 36% of patients initiated care in the private sector, where there is limited coverage of appropriate diagnostic technologies. Important differences in the alignment between care seeking patterns and diagnostic and treatment availability were found between regions. Conclusions The PPA identified opportunities for strengthening access to care for all forms of tuberculosis and for accelerating the time to diagnosis by aligning services to where patients initiate care. Geographic variations in care seeking may guide prioritization of some regions for intensified engagement with the private sector. PMID:29117352

Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh

PubMed Central

Hotchkiss, David R; Godha, Deepali; Do, Mai

2014-01-01

Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality—Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. PMID:25012794

Parents' and professionals' perceptions of family-centered care for children with autism spectrum disorder across service sectors.

PubMed

Hodgetts, Sandra; Nicholas, David; Zwaigenbaum, Lonnie; McConnell, David

2013-11-01

Family-centered care (FCC) has been linked with improved parent and child outcomes, yet its implementation can be challenging due to family, professional, organizational and systemic factors and policies. This study aims to increase knowledge and understanding of how families with children with autism spectrum disorder (ASD) experience FCC in Alberta, Canada. 152 parents with a child with ASD completed the Measure of Processes of Care, separately for each utilized service sector, and 146 professionals working with persons with ASD completed the Measure of Processes of Care - Service Providers. Additionally, in-depth interviews were conducted with a sub-sample of 19 parents, purposefully sampled for diversity in child and family characteristics. Data were collected in 2011. Descriptive and inferential statistics were used to analyze quantitative data. Interview transcripts were analyzed using grounded theory constant comparison methods, yielding a data generated theoretical model depicting families' experiences with FCC over time and across service sectors. There were no statistically significant differences in FCC scores across service sectors, but statistically significant differences in FCC scores between parents' and professionals' were found. Qualitative data revealed positive experiences and perceptions of receiving FCC from professionals "on the ground" across sectors, but negative experiences and perceptions of FCC at the systems level (i.e., administration, funders). These broad experiences emerged as a core theme "System of Exclusion", which integrated the key themes: (1) "The Fight", (2) "Roles and Restrictions of Care", and (3) "Therapeutic Rapport". Professionals and service providers can use findings to ensure that services reflect current conceptualizations of FCC, and decision and policy makers can use findings to recognize systemic barriers to implementing FCC and inform policy change. Copyright © 2013 Elsevier Ltd. All rights reserved.

Urban water infrastructure asset management - a structured approach in four water utilities.

PubMed

Cardoso, M A; Silva, M Santos; Coelho, S T; Almeida, M C; Covas, D I C

2012-01-01

Water services are a strategic sector of large social and economic relevance. It is therefore essential that they are managed rationally and efficiently. Advanced water supply and wastewater infrastructure asset management (IAM) is key in achieving adequate levels of service in the future, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution. This paper presents a methodology for supporting the development of urban water IAM, developed during the AWARE-P project as well as an appraisal of its implementation in four water utilities. Both water supply and wastewater systems were considered. Due to the different contexts and features of the utilities, the main concerns vary from case to case; some problems essentially are related to performance, others to risk. Cost is a common deciding factor. The paper describes the procedure applied, focusing on the diversity of drivers, constraints, benefits and outcomes. It also points out the main challenges and the results obtained through the implementation of a structured procedure for supporting urban water IAM.

Small enterprise opportunities in municipal solid waste management.

PubMed

Grierson, J P; Brown, A

1999-02-01

Most developing countries are rapidly urbanizing, with growing urban populations fueling demand for more and better urban services which many cities simply cannot provide given the current financial constraints. With the public sector unable to service the needs of expanding cities, small businesses are moving in to fill the vacuum. Such fledgling private sector initiatives have often prevented problems from becoming crises, while also demonstrating that private sector enterprises have an important role to play in meeting the demand for municipal services. Waste collection and processing is an area which could benefit from private sector involvement and greater public-private coordination. The authors examine the progress to date of an action-research initiative led by the Collaborative Group on Municipal Solid Waste Management in Low-income Countries which is developing best practice guidelines for expanding the involvement of micro- and small enterprises in municipal solid waste management.

Food waste volume and origin: Case studies in the Finnish food service sector.

PubMed

Silvennoinen, Kirsi; Heikkilä, Lotta; Katajajuuri, Juha-Matti; Reinikainen, Anu

2015-12-01

We carried out a project to map the volume and composition of food waste in the Finnish food service sector. The amount, type and origin of avoidable food waste were investigated in 51 food service outlets, including schools, day-care centres, workplace canteens, petrol stations, restaurants and diners. Food service outlet personnel kept diaries and weighed the food produced and wasted during a one-week or one-day period. For weighing and sorting, the food waste was divided into two categories: originally edible (OE) food waste was separated from originally inedible (OIE) waste, such as vegetable peelings, bones and coffee grounds. In addition, food waste (OE) was divided into three categories in accordance with its origins: kitchen waste, service waste and customer leftovers. According to the results, about 20% of all food handled and prepared in the sector was wasted. The findings also suggest that the main drivers of wasted food are buffet services and overproduction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrated power sector efficiency analysis: A case study of Costa Rica

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waddle, D.B.; MacDonald, J.M.

1990-03-01

In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 2 figs., 5 tabs.« less

Public sector energy management: A strategy for catalyzing energy efficiency in Malaysia

NASA Astrophysics Data System (ADS)

Roy, Anish Kumar

To date the public sector role in facilitating the transition to a sustainable energy future has been envisaged mainly from a regulatory perspective. In such a role, the public sector provides the push factors---enforcing regulations and providing incentives---to correct market imperfections that impede energy transitions. An alternative and complementary role of the public sector that is now gaining increasing attention is that of catalyzing energy transitions through public sector energy management initiatives. This dissertation offers a conceptual framework to rationalize such a role for the public sector by combining recent theories of sustainable energy transition and public management. In particular, the framework identifies innovative public management strategies (such as performance contracting and procurement) for effectively implementing sustainable energy projects in government facilities. The dissertation evaluates a model of sustainable public sector energy management for promoting energy efficiency in Malaysia. The public sector in Malaysia can be a major player in leading and catalyzing energy efficiency efforts as it is not only the largest and one of the most influential energy consumers, but it also plays a central role in setting national development strategy. The dissertation makes several recommendations on how a public sector energy management strategy can be implemented in Malaysia. The US Federal Energy Management Program (FEMP) is used as a practical model. The analysis, however, shows that in applying the FEMP model to the Malaysian context, there are a number of limitations that will have to be taken into consideration to enable a public sector energy management strategy to be effectively implemented. Overall the analysis of this dissertation contributes to a rethinking of the public sector role in sustainable energy development that can strengthen the sector's credibility both in terms of governance and institutional performance. In addition, it links theory with practice by offering a strategy that can effectively address critical issues arising from the energy-development-policy nexus of the sustainable energy development debate.

Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

PubMed

Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

2016-09-01

India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low income states with the largest birth cohorts. We recommend future studies to identify strengths and limitations of the public and private health sectors in each Indian state. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Three Dimensional Sector Design with Optimal Number of Sectors

NASA Technical Reports Server (NTRS)

Xue, Min

2010-01-01

In the national airspace system, sectors get overloaded due to high traffic demand and inefficient airspace designs. Overloads can be eliminated in some cases by redesigning sector boundaries. This paper extends the Voronoi-based sector design method by automatically selecting the number of sectors, allowing three-dimensional partitions, and enforcing traffic pattern conformance. The method was used to design sectors at Fort-Worth and Indianapolis centers for current traffic scenarios. Results show that new designs can eliminate overloaded sectors, although not in all cases, reduce the number of necessary sectors, and conform to major traffic patterns. Overall, the new methodology produces enhanced and efficient sector designs.

Using a new incentive mechanism to improve wastewater sector performance: the case study of Italy.

PubMed

De Gisi, Sabino; Petta, Luigi; Farina, Roberto; De Feo, Giovanni

2014-01-01

The system of "Service Objectives", introduced by the Italian National Strategic Framework 2007-2013, is an innovative results-oriented programme concerning 4 thematic areas (education, care for the elderly and children, management of municipal solid wastes and integrated water service) in which the Ministry of Economic Development and eight Southern Italy districts are involved. The system was initially associated to an incentive mechanism which provided subsidies for a total amount of EUR 3 billion from the national Underdeveloped Areas Fund, according to the achievement of specific targets set for 11 service indicators in 2013. The indicators used for the integrated water service refer to the efficiency in water supply service as well as the coverage of wastewater treatment service. The aim of the study is to describe the activities carried out in Italy by the ENEA Agency in order to define a new performance indicator for wastewater treatment service taking into account the appropriateness and efficiency of existing plants equipment and, consequently, evaluating economic incentives. The proposed procedure takes into account both wastewater treatment demand and quality of wastewater treatment service offered to citizens. Input data, provided by the National Institute of Statistics (ISTAT), were elaborated in order to define appropriate parameters, with a multi-criteria analysis being used to define the new performance indicator. The applicability of the proposed procedure was verified considering all the 8 Southern Italy and Island districts (Abruzzo, Molise, Campania, Apulia, Basilicata, Calabria, Sicily and Sardinia) involved in the programme. The obtained results show that the quality of municipal wastewater may influence the calculation of the incentive amount. The performance indicators defined in this work might be conveniently extended to other contexts similar to the assessed geographical area (Southern Italy and Islands). Copyright © 2013 Elsevier Ltd. All rights reserved.

Pharmaceutical care in community pharmacies: practice and research in the US.

PubMed

Christensen, Dale B; Farris, Karen B

2006-01-01

To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research has been conducted, but there is no national research agenda or infrastructure. Reimbursement for cognitive services remains an infrequent, but growing, activity.

[Economic Crisis and Portuguese National Health Service Physicians: Findings from a Descriptive Study of Their Perceptions and Reactions from Health Care Units in the Greater Lisbon Area].

PubMed

Rego, Inês; Russo, Giuliano; Gonçalves, Luzia; Perelman, Julian; Pita Barros, Pedro

2017-04-28

In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians reported a decrease in public remuneration (- 30.5%) and a small increase of public sector hours. A general reduction in living standard was identified as the main adaptation strategy to the crisis. Passion for the profession, its independence and flexibility, were the most frequently mentioned compensating factors. A percentage of 15% of physicians declared considering migration as a possibility for the near future. The crisis has brought non-negligible changes to physicians' working conditions and to the wider market for medical services in Portugal. The physicians' intrinsic motivation for the professions helped counterbalance salary cuts and deteriorating working conditions.

Big Data Analysis Framework for Healthcare and Social Sectors in Korea

PubMed Central

Song, Tae-Min

2015-01-01

Objectives We reviewed applications of big data analysis of healthcare and social services in developed countries, and subsequently devised a framework for such an analysis in Korea. Methods We reviewed the status of implementing big data analysis of health care and social services in developed countries, and strategies used by the Ministry of Health and Welfare of Korea (Government 3.0). We formulated a conceptual framework of big data in the healthcare and social service sectors at the national level. As a specific case, we designed a process and method of social big data analysis on suicide buzz. Results Developed countries (e.g., the United States, the UK, Singapore, Australia, and even OECD and EU) are emphasizing the potential of big data, and using it as a tool to solve their long-standing problems. Big data strategies for the healthcare and social service sectors were formulated based on an ICT-based policy of current government and the strategic goals of the Ministry of Health and Welfare. We suggest a framework of big data analysis in the healthcare and welfare service sectors separately and assigned them tentative names: 'health risk analysis center' and 'integrated social welfare service network'. A framework of social big data analysis is presented by applying it to the prevention and proactive detection of suicide in Korea. Conclusions There are some concerns with the utilization of big data in the healthcare and social welfare sectors. Thus, research on these issues must be conducted so that sophisticated and practical solutions can be reached. PMID:25705552

Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

PubMed

Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

2007-01-01

Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

Economic planning and equilibrium growth of human resources and capital in health-care sector: Case study of Iran

PubMed Central

Mahboobi-Ardakan, Payman; Kazemian, Mahmood; Mehraban, Sattar

2017-01-01

CONTEXT: During different planning periods, human resources factor has been considerably increased in the health-care sector. AIMS: The main goal is to determine economic planning conditions and equilibrium growth for services level and specialized workforce resources in health-care sector and also to determine the gap between levels of health-care services and specialized workforce resources in the equilibrium growth conditions and their available levels during the periods of the first to fourth development plansin Iran. MATERIALS AND METHODS: In the study after data collection, econometric methods and EViews version 8.0 were used for data processing. The used model was based on neoclassical economic growth model. RESULTS: The results indicated that during the former planning periods, although specialized workforce has been increased significantly in health-care sector, lack of attention to equilibrium growth conditions caused imbalance conditions for product level and specialized workforce in health-care sector. CONCLUSIONS: In the past development plans for health services, equilibrium conditions based on the full employment in the capital stock, and specialized labor are not considered. The government could act by choosing policies determined by the growth model to achieve equilibrium level in the field of human resources and services during the next planning periods. PMID:28616419

Association of job sectors with type 2 diabetes mellitus, hypercholesterolemia and obesity: a cross-sectional study from the Malaysian Cohort (TMC) project.

PubMed

Borhanuddin, Boekhtiar; Ahmad, Norfazilah; Shah, Shamsul Azhar; Murad, Nor Azian Abdul; Zakaria, Syed Zulkifli Syed; Kamaruddin, Mohd Arman; Jalal, Nazihah Abd; Yusuf, Nurul Ain Mhd; Patah, Afzan Effiza Abdul; Dauni, Andri; Sallam, Wan Ahmad Faisal Wan; Jamal, Rahman

2018-02-15

The investigation of risk factors of cardiovascular disease (e.g., major endocrine, nutritional and metabolic diseases) across job sectors is useful for targeted public health intervention. This study examined the occurrence of type 2 diabetes mellitus (T2DM), hypercholesterolemia and obesity in 21 job sectors in the general population. A baseline cross-sectional analysis of the Malaysian Cohort was conducted, which included 105 391 adults. Multiple logistic regression analyses were conducted for these three diseases across 20 job sectors compared with the unemployed/homemaker sector. The prevalence of T2DM, hypercholesterolemia and obesity was 16.7%, 38.8% and 33.3%, respectively. The Accommodation & Food Service Activities and Transportation & Storage sectors had significantly higher odds for T2DM (adjusted [adj.] prevalence odds ratio [POR] 1.18, p=0.007 and adj. POR 1.15, p=0.008, respectively). No job sector had significantly higher odds for hypercholesterolemia compared with the unemployed/homemaker sector. Only the Accommodation & Food Service Activities sector had significantly higher odds for obesity (adj. POR 1.17, p≤0.001). Many job sectors were significantly associated with lower odds of having these three diseases when compared with the unemployed/homemaker sector. These differing associations between diverse job sectors and these diseases are important for public health intervention initiatives and prioritization.

Raising Public Awareness: The Role of the Household Sector in Mitigating Climate Change

PubMed Central

Lin, Shis-Ping

2015-01-01

In addition to greenhouse gas emissions from the industrial, transportation and commercial sectors, emissions from the household sector also contribute to global warming. By examining residents of Taiwan (N = 236), this study aims to reveal the factors that influence households’ intention to purchase energy-efficient appliances. The assessment in this study is based on the theory of planned behavior (TPB), and perceived benefit or cost (BOC) is introduced as an independent variable in the proposed efficiency action toward climate change (ECC) model. According to structural equation modeling, most of the indicators presented a good fit to the corresponding ECC model constructs. The analysis indicated that BOC is a good complementary variable to the TPB, as the ECC model explained 61.9% of the variation in intention to purchase energy-efficient appliances, which was higher than that explained by the TPB (58.4%). This result indicates that the ECC model is superior to the TPB. Thus, the strategy of promoting energy-efficient appliances in the household sector should emphasize global warming and include the concept of BOC. PMID:26492262

Raising Public Awareness: The Role of the Household Sector in Mitigating Climate Change.

PubMed

Lin, Shis-Ping

2015-10-20

In addition to greenhouse gas emissions from the industrial, transportation and commercial sectors, emissions from the household sector also contribute to global warming. By examining residents of Taiwan (N = 236), this study aims to reveal the factors that influence households' intention to purchase energy-efficient appliances. The assessment in this study is based on the theory of planned behavior (TPB), and perceived benefit or cost (BOC) is introduced as an independent variable in the proposed efficiency action toward climate change (ECC) model. According to structural equation modeling, most of the indicators presented a good fit to the corresponding ECC model constructs. The analysis indicated that BOC is a good complementary variable to the TPB, as the ECC model explained 61.9% of the variation in intention to purchase energy-efficient appliances, which was higher than that explained by the TPB (58.4%). This result indicates that the ECC model is superior to the TPB. Thus, the strategy of promoting energy-efficient appliances in the household sector should emphasize global warming and include the concept of BOC.

Analysis of technological innovation and environmental performance improvement in aviation sector.

PubMed

Lee, Joosung; Mo, Jeonghoon

2011-09-01

The past oil crises have caused dramatic improvements in fuel efficiency in all industrial sectors. The aviation sector-aircraft manufacturers and airlines-has also made significant efforts to improve the fuel efficiency through more advanced jet engines, high-lift wing designs, and lighter airframe materials. However, the innovations in energy-saving aircraft technologies do not coincide with the oil crisis periods. The largest improvement in aircraft fuel efficiency took place in the 1960s while the high oil prices in the 1970s and on did not induce manufacturers or airlines to achieve a faster rate of innovation. In this paper, we employ a historical analysis to examine the socio-economic reasons behind the relatively slow technological innovation in aircraft fuel efficiency over the last 40 years. Based on the industry and passenger behaviors studied and prospects for alternative fuel options, this paper offers insights for the aviation sector to shift toward more sustainable technological options in the medium term. Second-generation biofuels could be the feasible option with a meaningful reduction in aviation's lifecycle environmental impact if they can achieve sufficient economies of scale.

Investigating nurse practitioners in the private sector: a theoretically informed research protocol.

PubMed

Adams, Margaret; Gardner, Glenn; Yates, Patsy

2017-06-01

To report a study protocol and the theoretical framework normalisation process theory that informs this protocol for a case study investigation of private sector nurse practitioners. Most research evaluating nurse practitioner service is focused on public, mainly acute care environments where nurse practitioner service is well established with strong structures for governance and sustainability. Conversely, there is lack of clarity in governance for emerging models in the private sector. In a climate of healthcare reform, nurse practitioner service is extending beyond the familiar public health sector. Further research is required to inform knowledge of the practice, operational framework and governance of new nurse practitioner models. The proposed research will use a multiple exploratory case study design to examine private sector nurse practitioner service. Data collection includes interviews, surveys and audits. A sequential mixed method approach to analysis of each case will be conducted. Findings from within-case analysis will lead to a meta-synthesis across all four cases to gain a holistic understanding of the cases under study, private sector nurse practitioner service. Normalisation process theory will be used to guide the research process, specifically coding and analysis of data using theory constructs and the relevant components associated with those constructs. This article provides a blueprint for the research and describes a theoretical framework, normalisation process theory in terms of its flexibility as an analytical framework. Consistent with the goals of best research practice, this study protocol will inform the research community in the field of primary health care about emerging research in this field. Publishing a study protocol ensures researcher fidelity to the analysis plan and supports research collaboration across teams. © 2016 John Wiley & Sons Ltd.

[University-external sector linkage: a managerial strategy].

PubMed

Campos, Gilberto

2004-06-01

The University-External Sector vinculation is an increasing phenomenon in Latin America as in the rest of the world. The universities through its investigation processes actively participate in the creation and incorporation of science and technology to produce technological processes, to bring foreign technology into national reality, and also to create and transmit innovation for the productive sector. In those ways these institutions achieve bonds with the external sector which provide them with additional income and allows them to have certain relief for their tight teaching and investigation budgets. Several studies in university organizations have been made to identify the motivations and barriers for de adequate development of the interaction between the university and the external sector. The lack of vinculation between these institutions could be due in part to the lack of knowledge that the external sector has of the possibility to obtain services from the university, and also the lack of knowledge that the university has about the needs of potential users of their services. The goals achieved by public Venezuelan universities, in the last years, in their search of a vinculation with the external sector could grow and consolidate through an adequate strategic management plan that allows a mayor diffusion and promotion of the results of their investigations and services, to reach in a wider and more direct way, and to a greater number of potential clients.

'Reaching the hard to reach' - lessons learned from the VCS (voluntary and community Sector). A qualitative study

PubMed Central

2010-01-01

Background The notion 'hard to reach' is a contested and ambiguous term that is commonly used within the spheres of social care and health, especially in discourse around health and social inequalities. There is a need to address health inequalities and to engage in services the marginalized and socially excluded sectors of society. Methods This paper describes a pilot study involving interviews with representatives from eight Voluntary and Community Sector (VCS) organisations. The purpose of the study was to explore the notion of 'hard to reach' and perceptions of the barriers and facilitators to accessing services for 'hard to reach' groups from a voluntary and community sector perspective. Results The 'hard to reach' may include drug users, people living with HIV, people from sexual minority communities, asylum seekers, refugees, people from black and ethnic minority communities, and homeless people although defining the notion of the 'hard to reach' is not straight forward. It may be that certain groups resist engaging in treatment services and are deemed hard to reach by a particular service or from a societal stance. There are a number of potential barriers for people who may try and access services, including people having bad experiences in the past; location and opening times of services and how services are funded and managed. A number of areas of commonality are found in terms of how access to services for 'hard to reach' individuals and groups could be improved including: respectful treatment of service users, establishing trust with service users, offering service flexibility, partnership working with other organisations and harnessing service user involvement. Conclusions If health services are to engage with groups that are deemed 'hard to reach' and marginalised from mainstream health services, the experiences and practices for engagement from within the VCS may serve as useful lessons for service improvement for statutory health services. PMID:20377850

Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia.

PubMed

Byrne, Louise; Wilson, Michael; Burke, Karena J; Gaskin, Cadeyrn J; Happell, Brenda

2014-05-01

Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.

Public-Sector Managed Care for Children's Mental Health Services: Stakeholders' Perspectives. Symposium.

ERIC Educational Resources Information Center

Stangl, Dalene K.; Tweed, Dan L.; Farmer, Betsy; Langmeyer, David; Stelle, Lynn; Behar, Lenore B.; Gagliardi, Julia; Burns, Barbara J.

This paper presents contributions at a symposium about Carolina Alternatives (CA), a North Carolina program that blends capitated financing with public sector managed care for mental health and substance abuse services for children and youth eligible for Medicaid. The symposium focused on stakeholders' perspectives and on expenditure patterns of…

Insurance Sector Dynamics: Towards Transformation into Learning Organization

ERIC Educational Resources Information Center

Barkur, Gopalakrishna; Varambally, K. V. M.; Rodrigues, Lewlyn L. R.

2007-01-01

Purpose: The purpose of this research is to study the influence of five critical factors on service quality in the insurance sector. Having studied the influence of these critical factors, an attempt has been made to obtain a generic solution to enhance the quality of service by proposing a holistic framework of learning organization. As…

The Role of Further Government Intervention in Australian International Education

ERIC Educational Resources Information Center

Carrington, Roger; Meek, V. Lynn; Wood, Fiona Q.

2007-01-01

Trade in Australian education services has expanded rapidly over recent years. The sector is the third largest exporter of Australian services. In 2001-2002, exports of education were about $A 4.2 billion. Government assistance to the sector includes export market development, regulation of education standards, and funding education activities;…

SERVMO: A Measure for Service-Driven Market Orientation in Higher Education

ERIC Educational Resources Information Center

Voon, B. H.

2008-01-01

With the intensified pace of globalization and increasing customer expectations, the higher education sector, like other economy sectors, faces increasing competition in terms of serving customers better. Service has been recognized as an effective tool for a competitive advantage. Thus, there is always a need for a more effective way of improving…

Risk Factors for Cigarette, Alcohol, and Marijuana Use among Runaway Youth Utilizing Two Services Sectors

ERIC Educational Resources Information Center

Thompson, Sanna J.; Zittel-Palmara, Kimberley M.; Forehand, Gregory

2005-01-01

The high rates of substance use among American adolescents are challenging; however, runaway youth are at particularly high-risk for substance use. Runaway youth utilizing two service sectors, emergency crisis shelters and juvenile detention centers, were recruited to evaluate differences in risk factors associated with substance use. Findings…

School-Based Service Use by Youth with ADHD in Public-Sector Settings

ERIC Educational Resources Information Center

Leslie, Laurel K.; Lambros, Katina M.; Aarons, Gregory A.; Haine, Rachel A.; Hough, Richard L.

2008-01-01

This study investigates rates and predictors of school-based services (SBSs) for 390 youth meeting criteria for Attention Deficit Hyperactivity Disorder and served in the San Diego public sectors. Only 60% of youth had received an Attention Deficit Hyperactivity Disorder diagnosis; these youth were younger, male, Caucasian (versus Latino), and…

Utilising Six Sigma for Improving Pass Percentage of Students: A Technical Institute Case Study

ERIC Educational Resources Information Center

Kaushik, Prabhakar; Khanduja, Dinesh

2010-01-01

Service sector accounts for a substantial share in Indian economy and among the service industries, education sector is emerging as a major commercial activity in the nation. Globalization, growing competition among institutions, emergence of new technologies, changing socio-economic profiles of nations and knowledge driven economies have created…

Sector-Led Improvement in Children's Services: A Lever for Evidence-Informed Practice?

ERIC Educational Resources Information Center

Holmes, Dez; Brookes, Carole

2014-01-01

The drive for sector-led improvement within children's services has a more prominent place in improving outcomes for children and young people than ever before. Concurrently, the imperative to access and utilise evidence to inform practice has become increasingly important, enabling scarce resources to be allocated according to "what…

Home and community care sector accountability.

PubMed

Steele Gray, Carolyn; Berta, Whitney; Deber, Raisa B; Lum, Janet

2014-09-01

This paper focuses on accountability for the home and community care (HCC) sector in Ontario. The many different service delivery approaches, funding methods and types of organizations delivering HCC services make this sector highly heterogeneous. Findings from a document analysis and environmental scan suggest that organizations delivering HCC services face multiple accountability requirements from a wide array of stakeholders. Government stakeholders tend to rely on regulatory and expenditure instruments to hold organizations to account for service delivery. Semi-structured key informant interview respondents reported that the expenditure-based accountability tools being used carried a number of unintended consequences, both positive and negative. These include an increased organizational focus on quality, shifting care time away from clients (particularly problematic for small agencies), dissuading innovation, and reliance on performance indicators that do not adequately support the delivery of high-quality care. Copyright © 2014 Longwoods Publishing.

Home and Community Care Sector Accountability

PubMed Central

Gray, Carolyn Steele; Berta, Whitney; Deber, Raisa B.; Lum, Janet

2014-01-01

This paper focuses on accountability for the home and community care (HCC) sector in Ontario. The many different service delivery approaches, funding methods and types of organizations delivering HCC services make this sector highly heterogeneous. Findings from a document analysis and environmental scan suggest that organizations delivering HCC services face multiple accountability requirements from a wide array of stakeholders. Government stakeholders tend to rely on regulatory and expenditure instruments to hold organizations to account for service delivery. Semi-structured key informant interview respondents reported that the expenditure-based accountability tools being used carried a number of unintended consequences, both positive and negative. These include an increased organizational focus on quality, shifting care time away from clients (particularly problematic for small agencies), dissuading innovation, and reliance on performance indicators that do not adequately support the delivery of high-quality care. PMID:25305389

The costs and benefits of getting the ISO 9000 certification in the manufacturing sector in Saudi Arabia.

PubMed

Mezher, T; Ramadan, H

1998-01-01

Many Saudi companies, in their journey to improve quality, efficiency and competitiveness, are pursuing and obtaining the ISO 9000 certificate. Many studies have evaluated how to implement ISO 9000 in different sectors, but none have analyzed the effectiveness of ISO 9000 certification (costs and benefits) on improving the overall quality and on meeting expectations. This study addressed these issues by investigating manufacturing organizations in Saudi Arabia that have the ISO 9000 certification. A survey questionnaire was distributed to firms throughout the kingdom. Thirty-two firms participated in the study. Results indicate that increased consistency of operations, improved service, and product quality are among the top motivators for pursuing the ISO certificate. The benefits most often experienced were improved awareness of procedural problems, better management control, keeping existing customers, increased customer satisfaction, and improved customer service. Difficulties experienced during the certification process involved time and cost, but these were not considered to be major problems. A high volume of paperwork was the main problem experienced following initial certification. Respondents in general said that the ISO 9000 certification met their expectations and that their level of satisfaction regarding the impact of ISO 9000 was high. Most recommended that other organizations pursue the certificate.

The ISO 50001 Impact Estimator Tool (IET 50001 V1.1.4) - User Guide and Introduction to the ISO 50001 Impacts Methodology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Therkelsen, Peter L.; Rao, Prakash; Aghajanzadeh, Arian

ISO 50001-Energy management systems – Requirements with guidance for use, is an internationally developed standard that provides organizations with a flexible framework for implementing an energy management system (EnMS) with the goal of continual energy performance improvement. The ISO 50001 standard was first published in 2011 and has since seen growth in the number of certificates issued around the world, primarily in the industrial (agriculture, manufacturing, and mining) and service (commercial) sectors. Policy makers in many regions and countries are looking to or are already using ISO 50001 as a basis for energy efficiency, carbon reduction, and other energy performancemore » improvement schemes. The Impact Estimator Tool 50001 (IET 50001 Tool) is a computational model developed to assist researchers and policy makers determine the potential impact of ISO 50001 implementation in the industrial and service (commercial) sectors for a given region or country. The IET 50001 Tool is based upon a methodology initially developed by the Lawrence Berkeley National Laboratory that has been improved upon and vetted by a group of international researchers. By using a commonly accepted and transparent methodology, users of the IET 50001 Tool can easily and clearly communicate the potential impact of ISO 50001 for a region or country.« less

Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

PubMed

Desombre, T; Eccles, G

1998-01-01

This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

(Power sector efficiency analysis in Costa Rica). [Power Sector Efficiency Analysis in Costa Rica

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waddle, D.B.

I traveled to San Jose, Costa Rica, to review the state of the electric power utility with a team of specialists, including a transmission and distribution specialist, a hydroelectric engineering specialist, and a thermal power plant specialist. The purpose of the mission was to determine the costs and benefits of efficiency improvements to supply side technologies employed by the Instituto Costarricense de Electricidad, the national power company in Costa Rica, and the potential contribution of these efficiency measures to the future electric power needs of Costa Rica.

Risk of equine infectious disease transmission by non-race horse movements in Japan.

PubMed

Hayama, Yoko; Kobayashi, Sota; Nishida, Takeshi; Nishiguchi, Akiko; Tsutsui, Toshiyuki

2010-07-01

For determining surveillance programs or infectious disease countermeasures, risk evaluation approaches have been recently undertaken in the field of animal health. In the present study, to help establish efficient and effective surveillance and countermeasures for equine infectious diseases, we evaluated the potential risk of equine infectious disease transmission in non-race horses from the viewpoints of horse movements and health management practices by conducting a survey of non-race horse holdings. From the survey, the non-race horse population was classified into the following five sectors based on their purposes: the equestrian sector, private owner sector, exhibition sector, fattening sector and others. Our survey results showed that the equestrian and private owner sectors had the largest population sizes, and movements between and within these sectors occurred quite frequently, while there was little movement in the other sectors. Qualitative evaluation showed that the equestrian and private owner sectors had relatively high risks of equine infectious disease transmission through horse movements. Therefore, it would be effective to concentrate on these two sectors when implementing surveillance or preventative measures. Special priority should be given to the private owner sector because this sector has not implemented inspection and vaccination well compared with the equestrian sector, which possesses a high compliance rate for these practices. This qualitative risk evaluation focused on horse movements and health management practices could provide a basis for further risk evaluation to establish efficient and effective surveillance and countermeasures for equine infectious diseases.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh.

PubMed

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-03-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5-6 days/week, but close by 4-5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Public/Private Sector Interactions: The Implications for Networking. A Discussion Report Prepared by the Network Advisory Committee.

ERIC Educational Resources Information Center

Network Planning Paper, 1983

1983-01-01

At a 2-day meeting in October 1982, the Library of Congress Network Advisory Committee (NAC) members discussed the complex issues involved in public and private sector interactions and their relationship to networking activities. The report, "Public Sector/Private Sector Interaction in Providing Information Services," prepared by the…

Connecting the resource nexus to basic urban service provision – with a focus on water-energy interactions in New York City

DOE PAGES

Engström, Rebecka Ericsdotter; Howells, Mark; Destouni, Georgia; ...

2017-05-01

Urban water and energy systems are crucial for sustainably meeting basic service demands in cities. Therefore, this paper proposes and applies a technology-independent “reference resource-to-service system” framework for concurrent evaluation of urban water and energy system interventions and their ‘nexus’ or ‘interlinkages’. In a concrete application, data that approximate New York City conditions are used to evaluate a limited set of interventions in the residential sector, spanning from low-flow toilet shifts to extensive green roof installations. Results indicate that interventions motivated primarily by water management goals can considerably reduce energy use and contribute to mitigation of greenhouse gas emissions. Similarly,more » energy efficiency interventions can considerably reduce water use in addition to lowering emissions. However, interventions yielding the greatest reductions in energy use and emissions are not necessarily the most water conserving ones, and vice versa. Useful further research, expanding the present analysis should consider a broader set of resource interactions, towards a full climate, land, energy and water (CLEW) nexus approach. Overall, assessing the impacts, trade-offs and co-benefits from interventions in one urban resource system on others also holds promise as support for increased resource efficiency through integrated decision making.« less

The economics of soil C sequestration and agricultural emissions abatement

NASA Astrophysics Data System (ADS)

Alexander, P.; Paustian, K.; Smith, P.; Moran, D.

2015-04-01

Carbon is a critical component of soil vitality and is crucial to our ability to produce food. Carbon sequestered in soils also provides a further regulating ecosystem service, valued as the avoided damage from global climate change. We consider the demand and supply attributes that underpin and constrain the emergence of a market value for this vital global ecosystem service: markets being what economists regard as the most efficient institutions for allocating scarce resources to the supply and consumption of valuable goods. This paper considers how a potentially large global supply of soil carbon sequestration is reduced by economic and behavioural constraints that impinge on the emergence of markets, and alternative public policies that can efficiently transact demand for the service from private and public sector agents. In essence, this is a case of significant market failure. In the design of alternative policy options, we consider whether soil carbon mitigation is actually cost-effective relative to other measures in agriculture and elsewhere in the economy, and the nature of behavioural incentives that hinder policy options. We suggest that reducing the cost and uncertainties of mitigation through soil-based measures is crucial for improving uptake. Monitoring and auditing processes will also be required to eventually facilitate wide-scale adoption of these measures.

Connecting the resource nexus to basic urban service provision – with a focus on water-energy interactions in New York City

DOE Office of Scientific and Technical Information (OSTI.GOV)

Engström, Rebecka Ericsdotter; Howells, Mark; Destouni, Georgia

Urban water and energy systems are crucial for sustainably meeting basic service demands in cities. Therefore, this paper proposes and applies a technology-independent “reference resource-to-service system” framework for concurrent evaluation of urban water and energy system interventions and their ‘nexus’ or ‘interlinkages’. In a concrete application, data that approximate New York City conditions are used to evaluate a limited set of interventions in the residential sector, spanning from low-flow toilet shifts to extensive green roof installations. Results indicate that interventions motivated primarily by water management goals can considerably reduce energy use and contribute to mitigation of greenhouse gas emissions. Similarly,more » energy efficiency interventions can considerably reduce water use in addition to lowering emissions. However, interventions yielding the greatest reductions in energy use and emissions are not necessarily the most water conserving ones, and vice versa. Useful further research, expanding the present analysis should consider a broader set of resource interactions, towards a full climate, land, energy and water (CLEW) nexus approach. Overall, assessing the impacts, trade-offs and co-benefits from interventions in one urban resource system on others also holds promise as support for increased resource efficiency through integrated decision making.« less

Stakeholder-based evaluation categories for regional climate services - a case study at the German Baltic Sea coast

NASA Astrophysics Data System (ADS)

Meinke, Insa

2017-08-01

In this study, categories, dimensions, and criteria for evaluating regional climate services are derived by a participatory approach with potential service users at the German Baltic Sea coast. The development is carried out within nine face-to-face interviews conducted with decision makers, working in climate sensitive sectors at the German Baltic Sea coast. Three main groups of categories were localized which seem to matter most to the considered stakeholders and which seem to be crucial evaluation categories for regional climate services: (1) credibility, (2) relevance, and (3) appropriateness. For each of these evaluation categories several dimensions emerged, indicating certain perspectives of stakeholder demands. When summarizing these evaluation categories and their dimensions, 13 evaluation criteria for regional climate services can be derived (see Table 1). The results show that stakeholders do mainly address components other than those found in the literature (e.g. inputs, process, outputs, outcomes, and impacts). This might indicate that an evaluation, following solely literature-based (non-participative) components, is not sufficient to localize deficiencies or efficiencies within a regional climate service, since it might lead to results which are not relevant for potential users.

Analysing inter-relationships among water, governance, human development variables in developing countries: WatSan4Dev database coherency analysis

NASA Astrophysics Data System (ADS)

Dondeynaz, C.; Carmona Moreno, C.; Céspedes Lorente, J. J.

2012-01-01

The "Integrated Water Resources Management" principle was formally laid down at the International Conference on Water and Sustainable development in Dublin 1992. One of the main results of this conference is that improving Water and Sanitation Services (WSS), being a complex and interdisciplinary issue, passes through collaboration and coordination of different sectors (environment, health, economic activities, governance, and international cooperation). These sectors influence or are influenced by the access to WSS. The understanding of these interrelations appears as crucial for decision makers in the water sector. In this framework, the Joint Research Centre (JRC) of the European Commission (EC) has developed a new database (WatSan4Dev database) containing 45 indicators (called variables in this paper) from environmental, socio-economic, governance and financial aid flows data in developing countries. This paper describes the development of the WatSan4Dev dataset, the statistical processes needed to improve the data quality; and, finally, the analysis to verify the database coherence is presented. At the light of the first analysis, WatSan4Dev Dataset shows the coherency among the different variables that are confirmed by the direct field experience and/or the scientific literature in the domain. Preliminary analysis of the relationships indicates that the informal urbanisation development is an important factor influencing negatively the percentage of the population having access to WSS. Health, and in particular children health, benefits from the improvement of WSS. Efficient environmental governance is also an important factor for providing improved water supply services. The database would be at the base of posterior analyses to better understand the interrelationships between the different indicators associated in the water sector in developing countries. A data model using the different indicators will be realised on the next phase of this research work.

Examining the efficiency and interdependence of US credit and stock markets through MF-DFA and MF-DXA approaches

NASA Astrophysics Data System (ADS)

Shahzad, Syed Jawad Hussain; Nor, Safwan Mohd; Mensi, Walid; Kumar, Ronald Ravinesh

2017-04-01

This study examines the power law properties of 11 US credit and stock markets at the industry level. We use multifractal detrended fluctuation analysis (MF-DFA) and multifractal detrended cross-correlation analysis (MF-DXA) to first investigate the relative efficiency of credit and stock markets and then evaluate the mutual interdependence between CDS-equity market pairs. The scaling exponents of the MF-DFA approach suggest that CDS markets are relatively more inefficient than their equity counterparts. However, Banks and Financial credit markets are relatively more efficient. Basic Materials (both CDS and equity indices) is the most inefficient sector of the US economy. The cross-correlation exponents obtained through MF-DXA also suggest that the relationship of the CDS and equity sectors within and across markets is multifractal for all pairs. Within the CDS market, Basic Materials is the most dependent sector, whereas equity market sectors can be divided into two distinct groups based on interdependence. The pair-wise dependence between Basic Materials sector CDSs and the equity index is also the highest. The degree of cross-correlation shows that the sectoral pairs of CDS and equity markets belong to a persistent cross-correlated series within selected time intervals.

Private sector contribution to childhood immunization: Sri Lankan experience.

PubMed

Agampodi, S B; Amarasinghe, D A C L

2007-04-01

The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. To estimate the proportion of children immunized in the private sector; describe socio-demographic characteristics of private sector users and compare these with government sector users. A community-based crosssectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area.

Use of Private Sector Temporaries.

DTIC Science & Technology

1995-01-01

causing the reduction in personnel. My solution to this problem is to authorize and find the use of private sector temporaries to perform the workload...discuss cost factors, and describe the benefits Defense Finance and Accounting Service will receive by using private sector temporaries (AN)

Manufacturing’s Contribution to Pakistan’s Economic Expansion: Commodity - or Service-Led Growth

DTIC Science & Technology

1994-12-01

private sector from regulation and artificial price distortions. In addition, a complementary privatisation programme was launched with the aim of reducing the role of the public sector in manufacturing and services. As a side benefit, the programme was seen as alleviating the government’s financial and administrative burden and creating new opportunities for the private sector . While growth in large-scale manufacturing output has not accelerated in recent years (nor has its overall contribution to GDP growth increased), there is hope

Vouchers for primary healthcare services in an ageing world? The perspectives of elderly voucher recipients in Hong Kong.

PubMed

Lai, Angel Hor-Yan; Kuang, Zoey; Yam, Carrie Ho-Kwan; Ayub, Shereen; Yeoh, Eng-Kiong

2018-05-01

Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61-94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non-targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health-related issues with private practitioners. Findings were discussed with practice, policy and research implications. © 2017 John Wiley & Sons Ltd.

Improve processes on healthcare: current issues and future trends.

PubMed

Chen, Jason C H; Dolan, Matt; Lin, Binshan

2004-01-01

Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry.

Care co-ordination for older people in the third sector: scoping the evidence.

PubMed

Abendstern, Michele; Hughes, Jane; Jasper, Rowan; Sutcliffe, Caroline; Challis, David

2018-05-01

The third sector has played a significant role internationally in the delivery of adult social care services for many years. Its contribution to care co-ordination activities for older people, however, in England and elsewhere, is relatively unknown. A scoping review was therefore conducted to ascertain the character of the literature, the nature and extent of third sector care co-ordination activity, and to identify evidence gaps. It was undertaken between autumn 2013 and summer 2014 and updated with additional searches in 2016. Electronic and manual searches of international literature using distinct terms for different approaches to care co-ordination were undertaken. From a total of 835 papers, 26 met inclusion criteria. Data were organised in relation to care co-ordination approaches, types of third sector organisation and care recipients. Papers were predominantly from the UK and published this century. Key findings included that: a minority of literature focused specifically on older people and that those doing so described only one care co-ordination approach; third sector services tended to be associated with independence and person-centred practice; and working with the statutory sector, a prerequisite of care co-ordination, was challenging and required a range of features to be in place to support effective partnerships. Strengths and weaknesses of care co-ordination practice in the third sector according to key stakeholder groups were also highlighted. Areas for future research included the need for: a specific focus on older people's experiences; an investigation of workforce issues; detailed examination of third sector practices, outcomes and costs; interactions with the statutory sector; and an examination of quality assurance systems and their appropriateness to third sector practice. The main implication of the findings is a need to nurture variety within the third sector in order to provide older people and other adults with the range of service options desired. © 2017 John Wiley & Sons Ltd.

Analysis of power sector efficiency improvements for an integrated utility planning process in Costa Rica

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waddle, D.B.; MacDonald, J.M.

1990-01-01

In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 4 figs., 5 tabs.« less

Tax reform and energy in the Philippines economy: A general equilibrium computation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boyd, R.G.; Doroodian, K.; Udomvaech, P.

1994-12-31

This paper examines how energy tax cuts, offset with income tax increases, affect production, consumption, and total welfare in the Philippines economy. Our results show that energy tax cuts expand the energy and nonmetal mining sectors, but decrease output in the manufacturing, agricultural, and metal mining sectors. Consumption of all goods and services combined increases as the amount of energy tax reduction increases. Our welfare results, however, are mixed. While the welfare of the mid- and high-income levels increases, that of the lowest income level decreases. These results are robust with respect to changes in the elasticity of substitution inmore » energy production as well as the elasticity of substitution in consumer demand. From the standpoint of economic efficiency, a policy such as this would enhance growth and aggregate income. From an equity standpoint, however, this policy is highly regressive in spite of the fact that the richest households pay proportionately more to finance the energy tax reduction. 18 refs., 10 tabs.« less

Biotechnology as the engine for the Knowledge-Based Bio-Economy.

PubMed

Aguilar, Alfredo; Bochereau, Laurent; Matthiessen, Line

2010-01-01

The European Commission has defined the Knowledge-Based Bio-Economy (KBBE) as the process of transforming life science knowledge into new, sustainable, eco-efficient and competitive products. The term "Bio-Economy" encompasses all industries and economic sectors that produce, manage and otherwise exploit biological resources and related services. Over the last decades biotechnologies have led to innovations in many agricultural, industrial, medical sectors and societal activities. Biotechnology will continue to be a major contributor to the Bio-Economy, playing an essential role in support of economic growth, employment, energy supply and a new generation of bio-products, and to maintain the standard of living. The paper reviews some of the main biotechnology-related research activities at European level. Beyond the 7th Framework Program for Research and Technological Development (FP7), several initiatives have been launched to better integrate FP7 with European national research activities, promote public-private partnerships and create better market and regulatory environments for stimulating innovation.

The private management of public hospitals.

PubMed Central

Rundall, T G; Lambert, W K

1984-01-01

Since the public sector traditionally has provided the public goods viewed as unprofitable by the private sector, the growing trend to manage public hospitals under outside private contract raises some fundamental issues of concern. It is hypothesized here that the system maintenance and output goals of privately managed public hospitals become increasingly similar to those of investor-owned hospitals. The thesis is empirically tested using documented effects of private contract management on the operative goals of short-term, general hospitals owned by local governmental bodies. Traditionally managed public hospitals matched with the study hospitals on important characteristics serve as the control group. Costs do appear to be reduced under private contract management, but the service structure becomes somewhat altered. It is the task of public health policymakers to reconcile the cost-control and efficiency mechanisms brought about by private management with the community's right of access to comprehensive medical care. Carefully structured regionalization plans--a possible means of providing both--will require the stimulation of more government involvement during an era of cutbacks. PMID:6490379

Productivity Analysis of Public and Private Airports: A Causal Investigation

NASA Technical Reports Server (NTRS)

Vasigh, Bijan; Gorjidooz, Javad

2007-01-01

Around the world, airports are being viewed as enterprises, rather than public services, which are expected to be managed efficiently and provide passengers with courteous customer services. Governments are, increasingly, turning to the private sectors for their efficiency in managing the operation, financing, and development, as well as providing security for airports. Operational and financial performance evaluation has become increasingly important to airport operators due to recent trends in airport privatization. Assessing performance allows the airport operators to plan for human resources and capital investment as efficiently as possible. Productivity measurements may be used as comparisons and guidelines in strategic planning, in the internal analysis of operational efficiency and effectiveness, and in assessing the competitive position of an airport in transportation industry. The primary purpose of this paper is to investigate the operational and financial efficiencies of 22 major airports in the United States and Europe. These airports are divided into three groups based on private ownership (7 British Airport Authority airports), public ownership (8 major United States airports), and a mix of private and public ownership (7 major European Union airports. The detail ownership structures of these airports are presented in Appendix A. Total factor productivity (TFP) model was utilized to measure airport performance in terms of financial and operational efficiencies and to develop a benchmarking tool to identify the areas of strength and weakness. A regression model was then employed to measure the relationship between TFP and ownership structure. Finally a Granger causality test was performed to determine whether ownership structure is a Granger cause of TFP. The results of the analysis presented in this paper demonstrate that there is not a significant relationship between airport TFP and ownership structure. Airport productivity and efficiency is, however dependent upon the level of competition, choice of the market, and regulatory control.

Energy efficiency as a commodity: The emergence of a secondary market for efficiency savings in commercial buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kats, G.H.; Rosenfield, A.H.; McIntosh, T.A.

1997-06-01

The energy efficiency industry is constrained by lack of financing. For example, in the United States, commercial and public buildings need an investment of $100 billion for cost-effective retrofits with an average payback of about four years. But the current level of financing is stagnant at only about 34% of this level per year. The U.S. Department of Energy (DOE) has led the development of the North American Energy Measurement and Verification Protocol (NEMVP). This Protocol will increase the reliability and quality of estimated efficiency savings and improve realized savings. A critical element in the development of low cost financingmore » and a secondary market--whether for homes or credit card debt--is the adoption of protocols to provide uniformity and reliability of the product. This is also true of energy efficiency installations, which have been characterized by inconsistency in the installation methodologies and, frequently, unreliability of savings. This Protocol, published in April 1996, is a DOE-led effort involving American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc. ASHRAE, National Association of Energy Service Companies NAESCO, National Association of Regulatory Utility Commissioners NARUC, National Association of State Energy Officials NASEO, US Environmental Protection Agency EPA, Canada`s Canadian Association of Energy Service Companies CAESCO, and Mexico`s Comision Nacional Para El Ahorro De Energia CONAE and Fideicomiso De Apoyo Al Programa De Ahorro De Energia Del Sector Electrico FIDE. DOE has begun to build on this Protocol to develop new forms of lower-cost financing including, ultimately, development of a secondary market for energy efficiency. This could double financing for building energy efficiency within five years.« less

Outsourcing vaccine logistics to the private sector: The evidence and lessons learned from the Western Cape Province in South-Africa.

PubMed

Lydon, Patrick; Raubenheimer, Ticky; Arnot-Krüger, Michelle; Zaffran, Michel

2015-06-26

With few exceptions, immunization supply chains in developing countries continue to face chronic difficulties in providing uninterrupted availability of potent vaccines up to service delivery levels, and in the most efficient manner possible. As these countries struggle to keep pace with an ever growing number of vaccines, more and more Ministries of Health are considering options of engaging the private sector to manage vaccine storage, handling and distribution on their behalf. Despite this emerging trend, there is limited evidence on the benefits or challenges of this option to improve public supply chain performance for national immunization programmes. To bridge this knowledge gap, this study aims to shed light on the value proposition of outsourcing by documenting the specific experience of the Western Cape Province of South Africa. The methodology for this review rested on conducting two key supply chain assessments which allowed juxtaposing the performance of the government managed segments of the vaccine supply chain against those managed by the private sector. In particular, measures of effective vaccine management best practice and temperature control in the cold chain were analysed. In addition, the costs of engaging the private sector were analysed to get a better understanding of the economics underpinning outsourcing vaccine logistics. The results from this analysis confirmed some of the theoretical benefits of outsourcing to the private sector. Yet, if the experience in the Western Cape can be deemed a successful one, there are several policy and practice implications that developing countries should be mindful of when considering engaging the private sector. While outsourcing can help improve the performance of the vaccine supply chain, it has the potential to do the reverse if done incorrectly. The findings and lessons learnt from the Western Cape experience can serve as a step towards understanding the role of the private sector in immunization supply chain and logistics systems for developing countries. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Ins and Outs of Keeping US Service Jobs at Work

DTIC Science & Technology

2006-06-14

out of the US and into Mexico, Honduras, and eventually Asia. Gregory Mankiw , former Economic Advisor to the President, in 2004 said, “More things are...Background 12 1.2 History of Economic Evolution 16 1.3 Dealing with Change 21 1.4 Preparing the Framework 22 Chapter 2...16 1-4 Economic Development 17 1-5 Service Sector Growth in Dollars 18 1-6 Service Sector Growth in Percent of GDP 19 1-7

Privatisation in reproductive health services in Pakistan: three case studies.

PubMed

Ravindran, T K Sundari

2010-11-01

Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Energy data sourcebook for the US residential sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, T.P.; Koomey, J.G.; Sanchez, M.

Analysts assessing policies and programs to improve energy efficiency in the residential sector require disparate input data from a variety of sources. This sourcebook, which updates a previous report, compiles these input data into a single location. The data provided include information on end-use unit energy consumption (UEC) values of appliances and equipment efficiency; historical and current appliance and equipment market shares; appliances and equipment efficiency and sales trends; appliance and equipment efficiency standards; cost vs. efficiency data for appliances and equipment; product lifetime estimates; thermal shell characteristics of buildings; heating and cooling loads; shell measure cost data for newmore » and retrofit buildings; baseline housing stocks; forecasts of housing starts; and forecasts of energy prices and other economic drivers. This report is the essential sourcebook for policy analysts interested in residential sector energy use. The report can be downloaded from the Web at http://enduse.lbl. gov/Projects/RED.html. Future updates to the report, errata, and related links, will also be posted at this address.« less

Developing a long-term condition's information service in collaboration with third sector organisations.

PubMed

McShane, Lesley; Greenwell, Kate; Corbett, Sally; Walker, Richard

2014-06-01

People with long-term conditions need to be signposted to high quality information and advice to understand and manage their condition. Information seeking tools combined with third sector information could help address their information needs. To describe the development and implementation of an information service for people living with long-term conditions at one NHS acute trust in the Northeast of England. An information service was trialled using bespoke information models for three long-term conditions in collaboration with third sector organisations. These guided people to relevant, timely and reliable information. Both clinician and service user questionnaires were used to evaluate satisfaction with the service. Appropriately designed information models can be used interchangeably across all services. Between 75% and 91% of users agreed that they were satisfied with various aspects of the service. Generally, users received relevant, understandable and high quality information at the right time. Nearly all health professionals (94-100%) felt the service was accessible, provided high quality information and did not significantly impact on their consultation time. The developed information service was well received by service users and health professionals. Specifically, the use of information prescriptions and menus facilitated access to information for people with long-term conditions. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh.

PubMed

Hotchkiss, David R; Godha, Deepali; Do, Mai

2014-07-01

Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality-Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Forming Social Partnership Policy in Vocational Training of Service Sector Specialists in Germany and Austria

ERIC Educational Resources Information Center

Kredenets, Nadiya

2016-01-01

The article deals with the problem of forming social partnership policy in vocational training of service sector specialists in Germany and Austria. The foreign and domestic pedagogical experience in establishing an effective system of social partnership in vocational education has been analyzed. The author has considered main factors of social…

Geropsychology Post-Doctoral Training in Public Sector Service Delivery: The USF/Tampa VA Fellowship Model

ERIC Educational Resources Information Center

Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.

2005-01-01

There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care…

Upward Mobility Programs in the Service Sector for Disadvantaged and Dislocated Workers. Volume I: Final Report.

ERIC Educational Resources Information Center

Tao, Fumiyo; And Others

Upward mobility programs in the service sector for low-skilled, economically disadvantaged, and dislocated or displaced workers promote employment security, career development, and productivity. Two basic types of upward mobility programs are basic and job-specific skills training. Although 60-80 percent of all employer-sponsored formal training…

Textbooks, Taxes, and Objectivity in Economics Instruction.

ERIC Educational Resources Information Center

Fitzsimmons, Edward L.

1989-01-01

Presents an example that illustrates the connection between taxation of private goods or services and provision of public goods or services. Demonstrates that the burdens of taxation in the private sector can in theory be offset by gains in consumer surplus in the public sector, providing a more balanced view than can be found in many introductory…

The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

ERIC Educational Resources Information Center

Heinrich, Carolyn; Nisar, Hiren

2012-01-01

School districts required under No Child Left Behind to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in service provision. If the market does not work to drive out ineffective providers, students will be less likely to gain…

The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

ERIC Educational Resources Information Center

Heinrich, Carolyn J.; Nisar, Hiren

2013-01-01

School districts required under No Child Left Behind (NCLB) to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in services. If the market does not drive out ineffective providers, students may not gain through SES participation.…

The Service Sector and Rural America: Issues for Public Policy and Topics for Research,

DTIC Science & Technology

1980-01-01

service sector in fact achieves it. We have little data on whether the new jobs go to unemployed residents, or to already- employed residents, or to in...who gets the new jobs , current residents or in-migrants; those currently employed or the unemployed? One would ex- pect that characteristics of the

Measuring Stability and Security in Iraq

DTIC Science & Technology

2010-06-01

irrigation and agricultural infrastructure contribute to continued difficulties in this sector. Poor plant and animal genetics, insufficient fertilizer...education of public and private sector representatives, better management of water and soil resources, and improving animal and plant health. USDA...the National Agricultural Statistics Service, animal disease experts from the Animal and Plant Health Inspection Service, and experts from other

Upward Mobility Programs in the Service Sector for Disadvantaged and Dislocated Workers. Volume II: Technical Appendices.

ERIC Educational Resources Information Center

Tao, Fumiyo; And Others

This volume contains technical and supporting materials that supplement Volume I, which describes upward mobility programs for disadvantaged and dislocated workers in the service sector. Appendix A is a detailed description of the project methodology, including data collection methods and information on data compilation, processing, and analysis.…

[Health care plans: interfaces between the public and private system in the dental sector].

PubMed

Pietrobon, Louise; da Silva, Cíntia Magali; Batista, Luciana Rodrigues Vieira; Caetano, João Carlos

2008-01-01

The present work presents a brief history of health plans in Brazil examining the interface between the public and the private sector. The evolution and regulation of the supplementary care system is analyzed, the different care modalities are defined and the main differences between health plans and dental care insurance are pointed out. The coverage provided by the supplementary care system and its relationship with the public health system is shown on the basis of current data. On the other hand, the study focuses on the care services, health plans and the labor market in the sector correlating, also on the basis of current data, the challenges and new opportunities of the supplementary care market, mainly in the dental sector. Although the dental sector is living an extraordinary moment within the private health care system and given that ANS data are pointing to a growth of this sector of 210% over last the 7 years, the service coverage of the supplementary care sector mainly directed to medical and inpatient care does not meet the real demand for integrated health care.

20 CFR 641.640 - How do the private sector training activities authorized under section 502(e) differ from other...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How do the private sector training activities... COMMUNITY SERVICE EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.640 How do the private sector training activities authorized under section 502(e) differ from other...

Accelerated reforms in healthcare financing: the need to scale up private sector participation in Nigeria.

PubMed

Ejughemre, Ufuoma John

2014-01-01

The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government's commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage.

Determinants of eco-efficiency in the Chinese industrial sector.

PubMed

Fujii, Hidemichi; Managi, Shunsuke

2013-12-01

This study measures productive inefficiency within the context of multi-environmental pollution (eco-efficiency) in the Chinese industrial sector. The weighted Russell directional distance model is applied to measure eco-efficiency using production technology. The objective is to clarify how external factors affect eco-efficiency. The major findings are that both foreign direct investment and investment for pollution abatement improve eco-efficiency as measured by air pollutant substances. A levy system for wastewater discharge improves eco-efficiency as measured by wastewater pollutant substances. However, an air pollutant levy does not significantly affect eco-efficiency as measured by air pollutants. Copyright © 2013 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.

Anonymity-preserving Reputation Management System for health sector

PubMed Central

Hamid, Zara; Abdul, Wadood; Ghouzali, Sanaa; Khan, Abid; Malik, Saif Ur Rehman; Shaukat Khan, Mansoor; Nawaz, Sarfraz

2018-01-01

In health sector, trust is considered important because it indirectly influences the quality of health care through patient satisfaction, adherence and the continuity of its relationship with health care professionals and the promotion of accurate and timely diagnoses. One of the important requirements of TRSs in the health sector is rating secrecy, which mandates that the identification information about the service consumer should be kept secret to prevent any privacy violation. Anonymity and trust are two imperative objectives, and no significant explicit efforts have been made to achieve both of them at the same time. In this paper, we present a framework for solving the problem of reconciling trust with anonymity in the health sector. Our solution comprises Anonymous Reputation Management (ARM) protocol and Context-aware Trustworthiness Assessment (CTA) protocol. ARM protocol ensures that only those service consumers who received a service from a specific service provider provide a recommendation score anonymously with in the specified time limit. The CTA protocol computes the reputation of a user as a service provider and as a recommender. To determine the correctness of the proposed ARM protocol, formal modelling and verification are performed using High Level Petri Nets (HLPN) and Z3 Solver. Our simulation results verify the accuracy of the proposed context-aware trust assessment scheme. PMID:29649267

[Good governance of publicly-produced health services: ideas for moving forward].

PubMed

Freire, José Manuel; Repullo, Jose Ramon

2011-06-01

The good performance of publicly-produced health services is of vital importance, well beyond the health sector. Taking into account the great complexity of the health services in the public sector due both to their public and professional nature, we identify seven Gordian Knots as being responsible for the most frequent problems of publicly produced health services in Spain and Latin America. From the concept of good governance we take its character as a normative and ethical benchmark and its potential to renew and invigorate the government of the public sector. From comparative analysis of publicly-produced health services in the best performing countries, we extract eight characteristics which contribute significantly to good performance. A final reflection is on the relevance of the importance of offsetting the potential hostility to a reformist impulse of the status-quo with alliances that strengthen public trust and the social contract between health professionals and citizens based on the values of public health systems.

E-commerce application study and complementary services in the sector of laboratory diagnostics based on consumers' opinion.

PubMed

Kontis, Alexios-Patapios; Siassiakos, Konstantinos; Kaimakamis, Georgios; Lazakidou, Athina

2010-01-01

The field of the Laboratory Diagnostics (in vitro), a sector of the field of health services, constitutes an industrial market that includes activities of research, development, production and products distribution that are designated for laboratory use. These products are defined as techno-medical products including various categories of products such as simple medicines, advanced technological systems, etc. Despite the high performance, the enlargement and the increasing trends of the field, it is not recorded the expected progress in the methods and the ways of promotion, trading and supporting of these products in the market. The present paper aims at the investigation of the consumers' opinion and the specification of those services that are possible to be implemented in electronic services and commerce for a strongly competitive advantage for the enterprises of the sector. The analysis of the findings from the Consumer Purchase Decision Centres (CPDC) shows how important it is to implement web-based applications in the proposed services.

Estimating technical efficiency in the hospital sector with panel data: a comparison of parametric and non-parametric techniques.

PubMed

Siciliani, Luigi

2006-01-01

Policy makers are increasingly interested in developing performance indicators that measure hospital efficiency. These indicators may give the purchasers of health services an additional regulatory tool to contain health expenditure. Using panel data, this study compares different parametric (econometric) and non-parametric (linear programming) techniques for the measurement of a hospital's technical efficiency. This comparison was made using a sample of 17 Italian hospitals in the years 1996-9. Highest correlations are found in the efficiency scores between the non-parametric data envelopment analysis under the constant returns to scale assumption (DEA-CRS) and several parametric models. Correlation reduces markedly when using more flexible non-parametric specifications such as data envelopment analysis under the variable returns to scale assumption (DEA-VRS) and the free disposal hull (FDH) model. Correlation also generally reduces when moving from one output to two-output specifications. This analysis suggests that there is scope for developing performance indicators at hospital level using panel data, but it is important that extensive sensitivity analysis is carried out if purchasers wish to make use of these indicators in practice.

Operational efficiency and sustainability of vector control of malaria and dengue: descriptive case studies from the Philippines

PubMed Central

2012-01-01

Background Analysis is lacking on the management of vector control systems in disease-endemic countries with respect to the efficiency and sustainability of operations. Methods Three locations were selected, at the scale of province, municipality and barangay (i.e. village). Data on disease incidence, programme activities, and programme management were collected on-site through meetings and focus group discussions. Results Adaptation of disease control strategies to the epidemiological situation per barangay, through micro-stratification, brings gains in efficiency, but should be accompanied by further capacity building on local situational analysis for better selection and targeting of vector control interventions within the barangay. An integrated approach to vector control, aiming to improve the rational use of resources, was evident with a multi-disease strategy for detection and response, and by the use of combinations of vector control methods. Collaboration within the health sector was apparent from the involvement of barangay health workers, re-orientation of job descriptions and the creation of a disease surveillance unit. The engagement of barangay leaders and use of existing community structures helped mobilize local resources and voluntary services for vector control. In one location, local authorities and the community were involved in the planning, implementation and evaluation of malaria control, which triggered local programme ownership. Conclusions Strategies that contributed to an improved efficiency and sustainability of vector control operations were: micro-stratification, integration of vector control within the health sector, a multi-disease approach, involvement of local authorities, and empowerment of communities. Capacity building on situational analysis and vector surveillance should be addressed through national policy and guidelines. PMID:22873707

China's transportation energy consumption and CO2 emissions from a global perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yin, Xiang; Chen, Wenying; Eom, Jiyong

2015-07-01

ABSTRACT Rapidly growing energy demand from China's transportation sector in the last two decades have raised concerns over national energy security, local air pollution, and carbon dioxide (CO2) emissions, and there is broad consensus that China's transportation sector will continue to grow in the coming decades. This paper explores the future development of China's transportation sector in terms of service demands, final energy consumption, and CO2 emissions, and their interactions with global climate policy. This study develops a detailed China transportation energy model that is nested in an integrated assessment model—Global Change Assessment Model (GCAM)—to evaluate the long-term energy consumptionmore » and CO2 emissions of China's transportation sector from a global perspective. The analysis suggests that, without major policy intervention, future transportation energy consumption and CO2 emissions will continue to rapidly increase and the transportation sector will remain heavily reliant on fossil fuels. Although carbon price policies may significantly reduce the sector's energy consumption and CO2 emissions, the associated changes in service demands and modal split will be modest, particularly in the passenger transport sector. The analysis also suggests that it is more difficult to decarbonize the transportation sector than other sectors of the economy, primarily owing to its heavy reliance on petroleum products.« less

[Analysis of the effectiveness of the public health system with special reference to the health of children].

PubMed

Köhler, L; Brogren, P O

1990-01-01

A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.

Patterns and Predictors of Dropout from Mental Health Treatment in an Asian Population.

PubMed

Sagayadevan, Vathsala; Subramaniam, Mythily; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann

2015-07-01

Studies examining mental health treatment dropout have primarily focused on Western populations and less so on Asian samples. The current study explored the prevalence and correlates of mental health treatment dropout across the various healthcare sectors in Singapore. Data was utilised from the Singapore Mental Health Study (SMHS), a cross-sectional epidemiological survey conducted among an adult population (n = 6616) aged 18 years and above. Statistical analyses were done on a subsample of respondents (n = 55) who had sought treatment from the various treatment providers (i.e. mental health, medical, social services and religious healers) in the past 12 months. The World Mental Health (WMH) Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was used to determine diagnoses of mental disorders, chronic medical disorders and service utilisation. Of those who had received treatment, 37.6% had ended treatment prematurely, 23.2% had completed treatment and 39.2% were still in treatment. The religious and spiritual sector (83.1%) had the highest dropout, followed by the general medical sector (34.6%), mental health services sector (33.9%) and the social services sector (30%). Marital status emerged as the only sociodemographic factor that significantly predicted treatment dropout-with those who were married being significantly less likely to drop out than those who were single. The overall dropout rate across the various healthcare sectors was comparable to past studies. While the small sample size limits the generalisability of findings, the current study provides useful insight into treatment dropout in an Asian population.

Potential role of dermatologists and dermatological services in developing and sustaining the leprosy control referral system in resource constrained settings.

PubMed

Kawuma, Herman Joseph S

2007-03-01

General Health Services that pay due attention to the management of skin conditions are opportune for suspecting and diagnosing early leprosy. In many developing countries, patients with dermatological conditions can only access specialist services in the larger cities and university hospitals; unaffordable costs make the services even less accessible if they can only be provided in the private sector. The high profile of dermatologists in the health services, gives them the opportunity to facilitate the development and implementation of a referral system that includes leprosy. This potential benefit for leprosy control must be initiated by current National Leprosy Programme Managers through establishing formal relationships with the dermatologists and involving them and other partners in the re-designing of leprosy control strategies to keep them in tandem with changing epidemiological patterns, national policies and on -going health sector reforms. The same health service managers should avail of the opportunities from the dermatologists (both in public and private sectors) about the current knowledge on the management and control of leprosy.

Smart Sectors

EPA Pesticide Factsheets

EPA is taking a sector based approach to environmental protection to improve environmental performance through better-informed rulemakings, reduced burden, and more efficient, effective, and consensus-based solutions to environmental problems.

Public-private sector partnership in household waste management as perceived by residents in south-west Nigeria.

PubMed

Ezebilo, Eugene E; Animasaun, Emmanuel D

2012-08-01

In most developing countries public-private sector partnership is becoming increasingly applied in household waste management service delivery especially in urban areas to reduce cost and improve effectiveness. This paper reports a study of householders' perceptions of public-private sector partnership in provision of household waste management services in Ilorin, south-west Nigeria. A multistage random sampling technique was used to select 224 households for the study. The data generated from the survey were analysed using a binary logit model. The results show that most of the respondents were of the opinion that the public-private partnership has not been able to improve household waste management services. Time taken to visit solid waste collection point, income and marital status negatively influenced their perceptions, while activities of sanitary inspectors, occupation and gender had positive influence. The public-private partnership will be more effective and sustainable if the public sector could pay more attention to performance monitoring and accountability.

Psychosocial safety climate: a multilevel theory of work stress in the health and community service sector.

PubMed

Dollard, M F; McTernan, W

2011-12-01

Work stress is widely thought to be a significant problem in the health and community services sector. We reviewed evidence from a range of different data sources that confirms this belief. High levels of psychosocial risk factors, psychological health problems and workers compensation claims for stress are found in the sector. We propose a multilevel theoretical model of work stress to account for the results. Psychosocial safety climate (PSC) refers to a climate for psychological health and safety. It reflects the balance of concern by management about psychological health v. productivity. By extending the health erosion and motivational paths of the Job Demands-Resources model we propose that PSC within work organisations predicts work conditions and in turn psychological health and engagement. Over and above this, however, we expect that the external environment of the sector particularly government policies, driven by economic rationalist ideology, is increasing work pressure and exhaustion. These conditions are likely to lead to a reduced quality of service, errors and mistakes.

Privatized managed care and forensic mental health services.

PubMed

Packer, I K

1998-01-01

Managed care for mental health services, which began in the private, commercial sector, has spread over the past few years to the public mental health sector as well. Recently, states have begun considering whether to include the forensic population within their privatized managed care systems. This article explores some of the complexities and special challenges unique to forensic services and notes some of the problems that might be incurred if the forensic population were included in a managed care system.

Climate services in the tourism sector - examples and market research

NASA Astrophysics Data System (ADS)

Damm, Andrea; Köberl, Judith; Prettenthaler, Franz; Kortschak, Dominik; Hofer, Marianne; Winkler, Claudia

2017-04-01

Tourism is one of the most weather-sensitive sectors. Hence, dealing with weather and climate risks is an important part of operational risk management. WEDDA® (WEather Driven Demand Analysis), developed by Joanneum Research, represents a comprehensive and flexible toolbox for managing weather and climate risks. Modelling the demand for products or services of a particular economic sector or company and its weather and climate sensitivity usually forms the starting and central point of WEDDA®. Coupling the calibrated demand models to either long-term climate scenarios or short-term weather forecasts enables the use of WEDDA® for the following areas of application: (i) implementing short-term forecasting systems for the prediction of the considered indicator; (ii) quantifying the weather risk of a particular economic sector or company using parameters from finance (e.g. Value-at-Risk); (iii) assessing the potential impacts of changing climatic conditions on a particular economic sector or company. WEDDA® for short-term forecasts on the demand for products or services is currently used by various tourism businesses, such as open-air swimming pools, ski areas, and restaurants. It supports tourism and recreation facilities to better cope with (increasing) weather variability by optimizing the disposability of staff, resources and merchandise according to expected demand. Since coping with increasing weather variability forms one of the challenges with respect to climate change, WEDDA® may become an important component within a whole pool of weather and climate services designed to support tourism and recreation facilities to adapt to climate change. Climate change impact assessments at European scale, as conducted in the EU-FP7 project IMPACT2C, provide basic information of climate change impacts on tourism demand not only for individual tourism businesses, but also for regional and national tourism planners and policy makers interested in benchmarks for the vulnerability of their tourism destination. In this project we analysed the impacts of +2 °C global warming on winter tourism demand in ski tourism related regions in Europe. In order to achieve the climate targets, tailored climate information services - for individual businesses as well as at the regional and national level - play an important role. The current market, however, is still in the early stages. In the ongoing H2020 projects EU-MACS (www.eu-macs.eu) and MARCO (www.marco-h2020.eu) (Nov 2016 - Oct 2018) Joanneum Research explores the climate services market in the tourism sector. The current use of climate services is reviewed in detail and in an interactive process key market barriers and enablers will be identified in close collaboration with stakeholders from the tourism industry. The analysis and co-development of new climate services concepts for the tourism sector aims to reduce the gaps between climate services supply and demand.

User-tailored seasonal forecasts for agriculture - creating socio-economic benefit through climate services in the Andes

NASA Astrophysics Data System (ADS)

De Ventura, Sara; Avalos, Grinia; Rossa, Andrea; Flubacher, Moritz; Gubler, Stefanie; Sedlmeier, Katrin; Dapozzo, Marlene; Garcia, Teresa; Quevedo, Karim; Liniger, Mark; Spirig, Christoph; Rosas, Gabriela; Schwierz, Cornelia

2017-04-01

The project Climandes is a twinning project between the Peruvian National Meteorological and Hydrological Service (SENAMHI) and the Federal Office of Meteorology and Climatology of Switzerland (MeteoSwiss) aiming at improving climate services for the Andean Region. It was launched in 2012 as a pilot project of the Global Framework for Climate Services (GFCS) of WMO. In 2016 a second phase of the project has started. Until now, Peru as all the Andean countries has had only a limited access to climate services, and the few instruments already in place have mostly not been developed in concordance with the user needs. Due to this mismatch, the opportunity to achieve veritable socio-economic benefits (SEB) has been overlooked so far. An additional difficulty is the lack of trained and experienced climatology and meteorology professionals able to develop and provide high quality climate services. Furthermore, the importance of climate information and its far-reaching benefits has not yet been fully acknowledged and embraced by the political decision-makers. The overall goals of the Climandes project are the following:. • Provision of user-tailored climate services for the Andean Region to improve socio- economic benefits for the agricultural sector and for society at large. • Improvement of the capacities of the meteorological service of Peru to generate user-tailored climate services in the agricultural sector. These goals are elaborated within three mutually dependent modules: The first one comprises user-tailored climate products for the agricultural sector in the Peruvian Andes. This includes drought and precipitation monitoring as well as the development of a prototype seasonal prediction system for the region including indices tailored to the agricultural sector. The second module focuses on capacity building, enabling climatology-related professionals and students to develop high-quality climate services for Peru and the Andean Region. Training courses as well as E-learning tools covering the knowledge needed for the elaboration and use of climate services (e.g. monitoring, seasonal prediction of precipitation) are developed and implemented. The third module aims at raising the awareness of political stakeholders of the SEB of SENAMHI's sector-specific climate services underpinned by a case study to quantify the SEB of drought and precipitation information platform for selected crops. This contribution will give an overview of the project and highlights some of the results of the first year of Climandes 2.

Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

PubMed

Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

2012-01-01

The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to those reported in the rural health literature but rarely in the context of allied health and disability services. Relatively recent innovations such as therapy assistants, information technology, and trans-disciplinary approaches, were raised as important service delivery considerations within the region. These and other innovations were expected to extend the coverage provided by therapists. Non-government organisations played a significant role in service delivery and support in the region. Participants recognised the need for therapists working for different organisations, in rural areas, to collaborate both in terms of peer support and service delivery to clients.

The impact of the economic downturn on environmental health services and professionals in North Carolina.

PubMed

Weston-Cox, Paula

2012-06-01

The objective of the authors' study was to examine the impact of the economic recession on the environmental health profession between budget year (BY) 2006-2007 and BY 2010-2011 in the following areas: (1) environmental health department fees for services; (2) changes in staffing levels, benefits, or pay; (3) changes in staff responsibilities; and (4) the impact to the private environmental sector compared to public environmental health professionals. Data were summarized from the following surveys: North Carolina Environmental Health Supervisors Association Fee and Economic Surveys; University of North Carolina Chapel Hill School of Government Current Salary Index; and a created online survey of private-sector environmental professionals. Total fees in the public sector for services have risen for most environmental health departments, but not enough to offset budget reductions. All of the counties that participated in the survey either have reduced staff, pay, or benefits due to budget cuts, and some counties utilized staff in other areas through cross-training. The private environmental sector also reduced staff in response to a reduced workload. Public sector employers may have difficulties retaining existing employees and recruiting new employees over the long-term in the current economic climate.

[Evaluation of customer satisfaction with the hospital catering system in the city of Palermo (Italy)].

PubMed

Firenze, Alberto; Morici, Mariagrazia; Calamus, Giuseppe; Gelsomino, Viviana; Aprea, Luigi; Di Benedetto, Antonino; Muangala, Muana A Luila; Centineo, Giovanni; Romano, Nino

2009-01-01

The aim of the study was to evaluate patients' customer satisfaction with the hospital catering services of two public hospitals and one private sector hospital in the city of Palermo (Italy). A multiple choice questionnaire was administered by face-to-face interview to 207 of 227 hospitalized patients. Positive responses regarding the perceived quality of food were given especially by patients of the private sector hospital, 80% of which reported being satisfied with the catering service. A higher percentage of patients in the private sector hospital were satisfied with the food distribution modalities with respect to the two public hospitals. Only 3% of patients in the private sector hospital required their families to bring food from home, with respect to 7.9% and 30% respectively in the two public hospitals. Private sector patients also reported appreciating the wide availability of food and the help given by health care workers (79% vs a mean of 55% in the two public hospitals). No differences were found amongst hospitals with regards to the hygienic characteristics of meals. The results of this study indicate the need to make changes in the management of the catering service of one of the involved public hospitals especially.

Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

PubMed

Ntuli, Samuel T; Maboya, Edwin

2017-09-27

The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

The fiscal crisis in the health sector: Patterns of cutback management across Europe.

PubMed

Ongaro, Edoardo; Ferré, Francesca; Fattore, Giovanni

2015-07-01

The article investigates trends in health sector cutback management strategies occurred during the ongoing financial and fiscal crisis across Europe. A European-wide survey to top public healthcare managers was conducted in ten different countries to understand their perception about public sector policy reactions to the financial and economic crisis; answers from 760 respondents from the healthcare sector (30.7% response rate) were analyzed. A multinomial logistic regression was used to assess the characteristics of respondents, countries' institutional healthcare models and the trend in public health resources availability during the crisis associated to the decision to introduce unselective cuts, targeted cuts or efficiency savings measures. Differentiated responses to the fiscal crisis that buffeted public finances were reported both across and within countries. Organizational position of respondents is significant in explaining the perceived cutback management approach introduced, where decentralized positions detect a higher use of linear cuts compared to their colleagues working in central level organizations. Compared to Bismark-like systems Beveridge-like ones favour the introduction of targeted cuts. Postponing the implementation of new programmes and containing expenses through instruments like pay freezes are some of the most popular responses adopted, while outright staff layoffs or reduction of frontline services have been more selectively employed. To cope with the effects of the fiscal crisis healthcare systems are undergoing important changes, possibly also affecting the scope of universal coverage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The management and design of economic development projects: A case study of World Bank electricity projects in Egypt

DOE Office of Scientific and Technical Information (OSTI.GOV)

El Sabaa, S.M.

1992-01-01

This study is concerned with the efficiency of World Bank projects in Egypt. The study seeks improvements in the methods of evaluating public sector projects in Egypt. To approaches are employed: (1) project identification to optimally allocate Egypt's and World Bank's resources; (2) project appraisal to assess the economic viability and efficiency of investments. The electricity sector is compared with the agriculture sector as a means of employing project identification for priority ordering of investment for development in Egypt. The key criteria for evaluation are the impacts of developments of each sector upon Egypt's national objectives and needs. These includemore » employment opportunities, growth, alleviation of poverty, cross comparison of per capita consumption in each sector, economic rate of return, national security, balance of payments and foreign debt. The allocation of scarce investments would have been more efficient in agriculture than in electricity in meeting Egypt's national objectives and needs. World Bank lending programs in Egypt reveal a priority ordering of electricity over agriculture and rural development. World Bank development projects in Egypt have not been optimally identified, and its programs have not followed an efficient allocation of World Bank's and Egypt's resources. The key parameters in evaluating economic viability and efficiency of development projects are: (1) the discount rate (the opportunity cost of public funds); (2) the exchange rate; and (3) the cost of major inputs, as approximated by shadow prices of labor, water, electricity, and transportation for development projects. Alternative approaches to estimating the opportunity cost of public funds are made. The parameters in evaluating the efficiency of projects have not been accurately estimated in the appraisal stage of the World Bank projects in Egypt, resulting in false or misleading information concerning the economic viability and efficiency of the projects.« less

Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

PubMed

Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth

2018-01-01

Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78-1.03). These three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB.

Evaluating the impact of a maternal health voucher programme on service use before and after the introduction of free maternity services in Kenya: a quasi-experimental study.

PubMed

Dennis, Mardieh L; Abuya, Timothy; Campbell, Oona Maeve Renee; Benova, Lenka; Baschieri, Angela; Quartagno, Matteo; Bellows, Benjamin

2018-01-01

From 2006 to 2016, the Government of Kenya implemented a reproductive health voucher programme in select counties, providing poor women subsidised access to public and private sector care. In June 2013, the government introduced a policy calling for free maternity services to be provided in all public facilities. The concurrent implementation of these interventions presents an opportunity to provide new insights into how users adapt to a changing health financing and service provision landscape. We used data from three cross-sectional surveys to assess changes over time in use of 4+ antenatal care visits, facility delivery, postnatal care and maternal healthcare across the continuum among a sample of predominantly poor women in six counties. We conducted a difference-in-differences analysis to estimate the impact of the voucher programme on these outcomes, and whether programme impact changed after free maternity services were introduced. Between the preintervention/roll-out phase and full implementation, the voucher programme was associated with a 5.5% greater absolute increase in use of facility delivery and substantial increases in use of the private sector for all services. After free maternity services were introduced, the voucher programme was associated with a 5.7% higher absolute increase in use of the recommended package of maternal health services; however, disparities in access to facility births between voucher and comparison counties declined. Increased use of private sector services by women in voucher counties accounts for their greater access to care across the continuum. Our findings show that the voucher programme is associated with a modest increase in women's use of the full continuum of maternal health services at the recommended timings after free maternity services were introduced. The greater use of private sector services in voucher counties also suggests that there is need to expand women's access to acceptable and affordable providers.

Ownership status and home health care performance.

PubMed

Grabowski, David C; Huskamp, Haiden A; Stevenson, David G; Keating, Nancy L

2009-01-01

Few studies have analyzed for-profit and nonprofit differences in the home health care sector. Using data from the National Home and Hospice Care Survey, we found that patients in nonprofit agencies were more likely to be discharged within 30 days under Medicare cost-based payment compared to patients in for-profit agencies. However, this difference in length of enrollment did not translate into meaningful differences in discharge outcomes between nonprofit and for-profit patients, suggesting that-under a cost-based payment system-nonprofits may behave more efficiently relative to for-profits. These results highlight the importance of organizational and payment factors in the delivery of home health care services.

Preventing the cure from being worse than the disease: special issues in hospital outsourcing.

PubMed

Beardwood, John; Alleyne, Andrew

2004-01-01

Like private sector organizations, hospitals are increasingly outsourcing services from food/cafeteria and security and facilities maintenance to the consulting and training of personnel and information technology (IT) functions. Also like private sector organizations, while hospitals seek the cure that will improve services at less cost, without careful management, the cure can be worse than the disease.

Information Technology Sector Baseline Risk Assessment

DTIC Science & Technology

2009-08-01

alternative root be economically advantageous , an actor’s ability to exploit market forces and create an alternative root would be significantly improved...conduct their operations. Therefore, a loss or disruption to Internet services would not be advantageous for the desired outcomes of these syndicates.26... eCommerce Service loss or disruption [C] Traffic Redirection [C] = Undesired consequence Information Technology Sector Baseline Risk Assessment

Challenge 21. Building Tomorrow's Public Service. Report of the Multilevel Public Sector Leadership Symposium (Lake Lanier Islands, Georgia, March 22-23, 1990).

ERIC Educational Resources Information Center

Office of Personnel Management, Washington, DC.

This document summarizes the discussions held at a conference of public sector executives and human resource managers designed to address the problems of attracting and keeping good workers in public service. Presentations made by the governor of Georgia, federal officials, educators, and regional representatives in three plenary sessions…

Does the Public Sector Outperform the Nonprofit and For-Profit Sectors? Evidence from a National Panel Study on Nursing Home Quality and Access

ERIC Educational Resources Information Center

Amirkhanyan, Anna A.; Kim, Hyun Joon; Lambright, Kristina T.

2008-01-01

Are public and private organizations fundamentally different? This question has been among the most enduring inquiries in public administration. Our study explores the impact of organizational ownership on two complementary aspects of performance: service quality and access to services for impoverished clients. Derived from public management…

How to Enhance the Impact of Training on Service Quality? Evidence from Malaysian Public Sector Context

ERIC Educational Resources Information Center

Zumrah, Abdul Rahim

2015-01-01

Purpose: The purpose of this study is to highlight the importance role of transfer of training as a mediator in the relationship between training and service quality. Design/methodology/approach: The data of this study were collected from three sources: the employees of public sector organizations in Malaysia who participated in a Basic Financial…

Examining the Relationship between Perceived Organizational Support, Transfer of Training and Service Quality in the Malaysian Public Sector

ERIC Educational Resources Information Center

Zumrah, Abdul Rahim

2015-01-01

Purpose: This study aims to investigate the relationships among perceived organizational support (POS), transfer of training outcomes to the workplace and service quality in the context of public sector organizations in Malaysia. Design/methodology/approach: The data for this study have been collected from three sources, the employees of public…

Training Needs Assessment in the Botswana Public Service: A Case Study of Five State Sector Ministries

ERIC Educational Resources Information Center

Balisi, Shadreck

2014-01-01

Using qualitative methods, this study analysed the process of training needs assessment in the Botswana public service, with special focus on five state sector ministries. It is evident from the research findings that there is little and an unsystematic approach to the needs assessment prior to training. The research further revealed that the…

Cooperative Home Care Associates: A Case Study of a Sectoral Employment Development Approach. Sectoral Employment Development Learning Project Case Studies Series.

ERIC Educational Resources Information Center

Inserra, Anne; Conway, Maureen; Rodat, John

Cooperative Home Care Associates (CHCA) is a worker-owned cooperative and employer-based training program that provides home health aide services in New York City's South Bronx. Since 1985, CHCA has developed from an outsider advocating for change in the home health sector to an insider within the sector. CHCA exhibits the following…

The roles of energy and material efficiency in meeting steel industry CO2 targets.

PubMed

Milford, Rachel L; Pauliuk, Stefan; Allwood, Julian M; Müller, Daniel B

2013-04-02

Identifying strategies for reducing greenhouse gas emissions from steel production requires a comprehensive model of the sector but previous work has either failed to consider the whole supply chain or considered only a subset of possible abatement options. In this work, a global mass flow analysis is combined with process emissions intensities to allow forecasts of future steel sector emissions under all abatement options. Scenario analysis shows that global capacity for primary steel production is already near to a peak and that if sectoral emissions are to be reduced by 50% by 2050, the last required blast furnace will be built by 2020. Emissions reduction targets cannot be met by energy and emissions efficiency alone, but deploying material efficiency provides sufficient extra abatement potential.

Public-non-governmental organisation partnerships for health: an exploratory study with case studies from recent Ghanaian experience.

PubMed

Hushie, Martin

2016-09-13

The last few decades have seen a dramatic increase in public-non-governmental organisation (NGO) partnerships in the health sector of many low- and middle- income countries (LMICs) as a means of improving the public's health. However, little research has focused to date on the nature, facilitators and barriers of these partnerships. In-depth qualitative interviews were conducted with 17 participants from five different NGOs and their collaboration with state partners in the Ghanaian health sector at the national and local levels in four regions of the country (Northern, Upper East, Greater Accra, and Eastern) to explore the drivers and nature of these partnerships and their advantages and disadvantages in the effort to improve the public's health. Major findings reveal that: 1) each collaboration between civil society organisations (CSOs) and the state in the health sector demands different partnerships; 2) partnership types can range from equal, formal contractual, decentralized to advocacy ones; 3) commitment by the state and NGOs to work in collaboration lead to improved service delivery, reduced health inequities and disparities; 4) added value of NGOs lies in their knowledge, expertise, community legitimacy, ability to attract donor funding and implementation capacity to address health needs in geographical areas or communities where the government does not reach and for services, which it does not provide and 5) success factors and challenges to be considered, moving forward to promote such partnerships in other LMICs. Recommendations are offered for NGOs, governments, donors, and future research including studying the organisational effectiveness and sustainability of these partnerships to deliver effective and efficient health outcomes to recommend universal best practices in health care.

Using Patient Pathway Analysis to Design Patient-centered Referral Networks for Diagnosis and Treatment of Tuberculosis: The Case of the Philippines.

PubMed

Garfin, Celine; Mantala, Mariquita; Yadav, Rajendra; Hanson, Christy L; Osberg, Mike; Hymoff, Aaron; Makayova, Julia

2017-11-06

Tuberculosis (TB) is the 8th leading cause of death in the Philippines. A recent prevalence survey found that there were nearly 70% more cases of tuberculosis than previously estimated. Given these new data, the National TB Program (NTP), operating through a decentralized health system, identified about 58% of the estimated new drug-sensitive (DS) TB patients in 2016. However, the NTP only identified and commenced treatment for around 17% of estimated new drug-resistant patients. In order to reach the remaining 42% of drug-sensitive patients and 83% of drug-resistant patients, it is necessary to develop a better understanding of where patients seek care. National and regional patient pathway analyses (PPAs) were undertaken using existing national survey and NTP data. The PPA assessed the alignment between patient care seeking and the availability of TB diagnostic and treatment services. Systemic referral networks from the community-level Barangay Health Stations (BHSs) to diagnostic facilities have enabled more efficient detection of drug-sensitive tuberculosis in the public sector. Approximately 36% of patients initiated care in the private sector, where there is limited coverage of appropriate diagnostic technologies. Important differences in the alignment between care seeking patterns and diagnostic and treatment availability were found between regions. The PPA identified opportunities for strengthening access to care for all forms of tuberculosis and for accelerating the time to diagnosis by aligning services to where patients initiate care. Geographic variations in care seeking may guide prioritization of some regions for intensified engagement with the private sector. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Payments and quality of care in private for-profit and public hospitals in Greece.

PubMed

Kondilis, Elias; Gavana, Magda; Giannakopoulos, Stathis; Smyrnakis, Emmanouil; Dombros, Nikolaos; Benos, Alexis

2011-09-23

Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.

India's pulp and paper industry: Productivity and energy efficiency

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schumacher, Katja

1999-07-01

Historical estimates of productivity growth in India's pulp and paper sector vary from indicating an improvement to a decline in the sector's productivity. The variance may be traced to the time period of study, source of data for analysis, and type of indices and econometric specifications used for reporting productivity growth. The authors derive both statistical and econometric estimates of productivity growth for this sector. Their results show that productivity declined over the observed period from 1973-74 to 1993-94 by 1.1% p.a. Using a translog specification the econometric analysis reveals that technical progress in India's pulp and paper sector hasmore » been biased towards the use of energy and material, while it has been capital and labor saving. The decline in productivity was caused largely by the protection afforded by high tariffs on imported paper products and other policies, which allowed inefficient, small plants to enter the market and flourish. Will these trends continue into the future, particularly where energy use is concerned? The authors examine the current changes in structure and energy efficiency undergoing in the sector. Their analysis shows that with liberalization of the sector, and tighter environmental controls, the industry is moving towards higher efficiency and productivity. However, the analysis also shows that because these improvements are being hampered by significant financial and other barriers the industry might have a long way to go.« less

Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jacobsen, R., E-mail: ray.jacobsen@ugent.be; Buysse, J., E-mail: j.buysse@ugent.be; Gellynck, X., E-mail: xavier.gellynck@ugent.be

2013-01-15

Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticedmore » in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.« less

77 FR 59899 - U.S. Multi-Sector Trade Mission to South India and Sri Lanka

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... development of the residential and mixed use, tourism, and healthcare sectors, and encourage applications from... following text: Architecture Services Sub-Sectors [cir] Tourism [cir] Hospital and Healthcare [cir... broad need for all building types, especially for residential development, tourism and health facilities...

[Harassment in the public sector].

PubMed

Puech, Paloma; Pitcho, Benjamin

2013-01-01

The French Labour Code, which provides full protection against moral and sexual harassment, is not applicable to public sector workers. The public hospital is however not exempt from such behaviour, which could go unpunished. Public sector workers are therefore protected by the French General Civil Service Regulations and the penal code.

Organization of the Saudi health system.

PubMed

Al-Yousuf, M; Akerele, T M; Al-Mazrou, Y Y

2002-01-01

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health.

Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

PubMed

Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

2015-06-01

The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Spanish strategy on bioeconomy: Towards a knowledge based sustainable innovation.

PubMed

Lainez, Manuel; González, José Manuel; Aguilar, Alfredo; Vela, Carmen

2018-01-25

Spain launched its own strategy on bioeconomy in January 2016 aiming at boosting a bioeconomy based on the sustainable and efficient production and use of biological resources. It highlights global societal challenges related with agricultural and biotechnological sciences in Spain and the great dynamism of the private sectors involved, particularly the agri-food, biotech and biomass sectors. The targeted sectors are food, agriculture and forestry, conditioned by water availability. It also includes the production of those industrial bioproducts and bioenergy obtained from the use and valorisation of wastes and residues and other non-conventional sources of biomass, in a circular economy. The strategy also puts a focus on rural and coastal development through several uses and services linked to ecosystems. The capacity to generate know-how in this area and the promotion of public and private collaboration are important pillars in order to enhance existing value chains and to create new ones. The strategy is led by R&I and Agriculture, Food and Environment policy managers and largely supported at regional level too. The strategic objective is the maintenance of the bioeconomy as an essential part of Spanish economy to contribute to the economic growth by creating new jobs and fostering investments. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Economic Constraints – the Growing Challenge for Western Breast Cancer Centers

PubMed Central

Seidel, Rene P.; Lux, Michael P.; Hoellthaler, Josef; Beckmann, Matthias W.; Voigt, Wieland

2013-01-01

Summary Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed ‘trans-sectoral’ care approach which could allow to shift unprofitable procedures to the outpatient sector – in the sense of a win-win situation for both sectors and without loss of care quality – seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed. PMID:24715842

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

PubMed Central

2013-01-01

Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The public sector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address public sector constraints such as understaffing and supply shortages. Conclusions Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the public sector into the voucher program. PMID:24139603

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda.

PubMed

Okal, Jerry; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Abuya, Timothy; Bange, Teresah; Warren, Charlotte; Askew, Ian; Bellows, Ben

2013-10-18

Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The public sector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address public sector constraints such as understaffing and supply shortages. Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the public sector into the voucher program.

Water for wood products versus nature, food or feed

NASA Astrophysics Data System (ADS)

Schyns, Joep; Booij, Martijn; Hoekstra, Arjen

2017-04-01

Forests play a central interlinked role in the 2030 Agenda on Sustainable Development. The Agenda aims at an increased share of renewable energy in the global energy mix (target 7.2) and restoration and sustainable management of forests (targets 6.6, 15.1 & 15.2). Forests also play a key role in the hydrological cycle accounting for the largest water flux from land to atmosphere. However, we do not know which part of this is used for the production of wood products such as lumber, pulp and paper, firewood or biofuel. SDG target 6.4 calls for increased water-use efficiency across all sectors and requires understanding the competing demands for water and the potential conflicts between wood production and other purposes like food (SDG 2). To reach the SDGs we need to understand the interlinkages between the SDGs and know how much water is used in the forestry sector. We provide the first estimate of global water use in the forestry sector, using the water footprint (WF) as indicator and distinguishing between consumption of green water (precipitation) and blue water (groundwater through capillary rise). We estimate forest evaporation at a high spatial resolution level and attribute total water consumption to the various forest products, including ecosystem services. Global water consumption for wood production increased by 34% over 50 years to 290x109 m3/y in 2001-2010. Wood has a higher economic water productivity (EWP, US/m3) than common food or feed crops like wheat, maize and sugar beet, and bio-ethanol from wood has a small WF per unit of energy compared to first-generation bio-ethanol from these three crops. Counterintuitively, extensive wood production has a smaller WF and hence a higher EWP than intensive wood production. The reason is that extensively exploited forests host relatively more value next to wood production in the form of other ecosystem services. Recycling of wood products could effectively reduce the WF of the forestry sector, thereby leaving more water available for the generation of other ecosystem services. Our findings contribute to a more complete picture of the human appropriation of water and the understanding of the interlinkages between the SDGs, thus feeding the debate on water for wood products versus nature, food or feed.

Thailand mental health country profile.

PubMed

Siriwanarangsan, Porntep; Liknapichitkul, Dusit; Khandelwal, Sudhir K

2004-01-01

Thailand, a constitutional monarchy, has undergone a rapid shift in its demography and economy in last two decades. This has put a great burden on the health services, including mental health care of the country. The current emphasis of the Ministry of Public Health is to change its role from health care provider to policymaker and regulator of standards, and to provide technical support to health facilities under its jurisdiction as well as in the private sector. The Department of Mental Health, established in 1994, has laid down a mental health policy that aims to promote mental health care within the community with the help of people's participation in health programmes. Focus has been placed on developing suitable and efficient technology by seeking cooperation both within and outside the Ministry of Public Health. Consequently, the Department of Mental Health has been receiving increasing budgetary allocations. Since there is a paucity of trained manpower, the emphasis is being laid on the utilization of general health care for mental health care. Some of the specific interventions are community services, prison services, psychiatric rehabilitation, and use of media in mental health operations. There have been active efforts towards international cooperation for developing technologies for specific programmes. Private and non-governmental organizations are supported and encouraged to provide mental health care to the marginalized sections of society. Efforts have also been made by the Department of Mental Health to inspect and raise the efficiency of its operations to result in quality service.

What China can learn from international policy experiences to improve industrial energy efficiency and reduce CO 2 emissions?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Xu; Shen, Bo; Price, Lynn

China’s industrial sector dominates the country’s total energy consumption and energy efficiency in the industry sector is crucial to help China reach its energy and CO 2 emissions reduction goals. There are many energy efficiency policies in China, but the motivation and willingness of enterprises to improve energy efficiency has weakened. This report first identifies barriers that enterprises face to be self-motivated to implement energy efficiency measures. Then, this report reviews international policies and programs to improve energy efficiency and evaluates how these policies helped to address the identified barriers. Lastly, this report draws conclusions and provides recommendations to Chinamore » in developing policies and programs to motivate enterprises to improve energy efficiency.« less

The Impact of Military Training on Veterans’ Earnings in the Private Sector: Is there Complimentarity Between Military and Private Training for Veterans

DTIC Science & Technology

1994-03-01

thesis analyzed the complimentarity between military and post-military private sector training and the effect of military training on private sector wages...of data. The results of the thesis indicate that military training increases post-military private sector earnings of Veterans by 0.18 percent per...between military and post-service private sector training. When type of occupation is included in the models, the wage effect of military training fell to

Data warehouse for detection of occupational diseases in OHS data.

PubMed

Godderis, L; Mylle, G; Coene, M; Verbeek, C; Viaene, B; Bulterys, S; Schouteden, M

2015-11-01

Occupational health and safety (OHS) services collect a wide range of data during health surveillance. To build a 'data warehouse' to make OHS data available for research and to investigate sector-specific health problems. Medical data were extracted, transformed and loaded into the data warehouse. After validation, data on lifestyle, categorized medication use, ICD-9-CM encoded sickness absences and health complaints, collected between 2010 and 2014, were analysed with logistic regression to compare proportions between employment sectors, taking into account age, gender, body mass index (BMI) and year of examination. The data set comprised 585000 employees. Average age and employment seniority were 39 ± 12 and 8 ± 9 years, respectively. BMI was 26 ± 5 kg/m(2). Health complaints, medication use and sickness absence significantly increased with BMI and age. The proportion of employees with health problems was highest in health care (64%), government (61%) and manufacturing (60%) and lowest in the service sector. In all sectors, 10% of workers reported locomotor health problems, apart from the service sector (8%) with similar results for medication consumption. Neuropsychological drugs were more frequently used by health care workers (8%). The transport sector contained the highest proportion of cardiological medication users (12%). Finally, 30-59% of employees reported at least one sickness absence episode. Sickness absence due to locomotor issues was highest in manufacturing (11%) and health care (10%), followed by government (9%) and construction (9%). Significant differences in indices of workers' health were observed between sectors. This information is now being used in the implementation of a sector-oriented health surveillance programme. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Use of family planning and child health services in the private sector: an equity analysis of 12 DHS surveys.

PubMed

Chakraborty, Nirali M; Sprockett, Andrea

2018-04-24

A key component of universal health coverage is the ability to access quality healthcare without financial hardship. Poorer individuals are less likely to receive care than wealthier individuals, leading to important differences in health outcomes, and a needed focus on equity. To improve access to healthcare while minimizing financial hardships or inequitable service delivery we need to understand where individuals of different wealth seek care. To ensure progress toward SDG 3, we need to specifically understand where individuals seek reproductive, maternal, and child health services. We analyzed Demographic and Health Survey data from Bangladesh, Cambodia, DRC, Dominican Republic, Ghana, Haiti, Kenya, Liberia, Mali, Nigeria, Senegal and Zambia. We conducted weighted descriptive analyses on current users of modern FP and the youngest household child under age 5 to understand and compare country-specific care seeking patterns in use of public or private facilities based on urban/rural residence and wealth quintile. Modern contraceptive prevalence rate ranged from 8.1% to 52.6% across countries, generally rising with increasing wealth within countries. For relatively wealthy women in all countries except Ghana, Liberia, Mali, Senegal and Zambia, the private sector was the dominant source. Source of FP and type of method sought across facilities types differed widely across countries. Across all countries women were more likely to use the public sector for permanent and long-acting reversible contraceptive methods. Wealthier women demonstrated greater use of the private sector for FP services than poorer women. Overall prevalence rates for diarrhea and fever/ARI were similar, and generally not associated with wealth. The majority of sick children in Haiti did not seek treatment for either diarrhea or fever/ARI, while over 40% of children with cough or fever did not seek treatment in DRC, Haiti, Mali, and Senegal. Of all children who sought care for diarrhea, more than half visited the public sector and just over 30% visited the private sector; differences are more pronounced in the lower wealth quintiles. Use of the private sector varies widely by reason for visit, country and wealth status. Given these differences, country-specific examination of the role of the private sector furthers our understanding of its utility in expanding access to services across wealth quintiles and providing equitable care.

New public management in Iran's health complex: a management framework for primary health care system.

PubMed

Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

2018-05-01

New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

The economic rationale of public and private sector roles in the provision of animal health services.

PubMed

Ahuja, V

2004-04-01

In the changing market environment of livestock products, the delivery of animal health services is emerging as an important priority area for enhancing the competitiveness of poor livestock producers. At the same time, governments are continuing to face serious budgetary difficulties and are finding it difficult to expand the reach of these services or improve service quality. In this context of a changing environment and dwindling public resources, this paper revisits the economic framework that has thus far guided thinking about public and private sector roles in the provision of animal health services and examines the ongoing debate on livestock service delivery for the poor. The paper highlights the importance of strong institutions and appropriate legislation for regulating behaviour and enforcing contracts and re-emphasises the idea, which is supported by economic theory, that there is a need for task sharing between the public and private sectors. The paper further emphasizes the need for: a) integrating the debate on livestock service delivery with the larger debate on political economy and institutional development, and b) ensuring service access in poor marginal areas by working through membership organisations, self-help groups and civil society organisations, and by promoting the use of para-professionals and community-based animal health delivery systems.

Providing HIV-related services in China for men who have sex with men.

PubMed

Cheng, Weibin; Cai, Yanshan; Tang, Weiming; Zhong, Fei; Meng, Gang; Gu, Jing; Hao, Chun; Han, Zhigang; Li, Jingyan; Das, Aritra; Zhao, Jinkou; Xu, Huifang; Tucker, Joseph D; Wang, Ming

2016-03-01

In China, human immunodeficiency virus (HIV) care provided by community-based organizations and the public sector are not well integrated. A community-based organization and experts from the Guangzhou Center for Disease Control and Prevention developed internet-based services for men who have sex with men, in Guangzhou, China. The internet services were linked to clinical services offering HIV testing and care. The expanding HIV epidemic among men who have sex with men is a public health problem in China. HIV control and prevention measures are implemented primarily through the public system. Only a limited number of community organizations are involved in providing HIV services. The programme integrated community and public sector HIV services including health education, online HIV risk assessment, on-site HIV counselling and testing, partner notification, psychosocial care and support, counting of CD4+ T-lymphocytes and treatment guidance. The internet can facilitate HIV prevention among a subset of men who have sex with men by enhancing awareness, service uptake, retention in care and adherence to treatment. Collaboration between the public sector and the community group promoted acceptance by the target population. Task sharing by community groups can increase access of this high-risk group to available HIV-related services.

Characteristics of private abortion services in Mexico City after legalization.

PubMed

Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia

2010-11-01

In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Automotive Sectors (NAICS 336, 4231, 8111)

EPA Pesticide Factsheets

Find regulatory, compliance, and enforcement information for environmental laws and regulations for the automotive sectors, which includes transportation equipment manufacturing, and establishments involved in repair and maintenance services for vehicles

Dry Cleaning Sector (NAICS 8123)

EPA Pesticide Factsheets

The dry cleaning sector includes establishments engaged in providing laundry services and industrial launderers. Find environmental regulatory information for perchloroethylene (PERC) cleaners as well as hazardous waste regulations for dry cleaners.