Decentralisation and health services delivery in Tanzania: Analysis of decision space in planning, allocation, and use of financial resources.

PubMed

Kigume, Ramadhani; Maluka, Stephen; Kamuzora, Peter

2018-04-01

While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space. In the areas of priority setting and planning, district health authorities had moderate decision space. However, in the financial resource allocation and expenditure of funds from the central government, the districts had narrow decision-making space. The districts, nevertheless, had wider decision-making space in mobilising and using locally generated financial resources. However, the ability of the districts to allocate and use locally generated resources was constrained by bureaucratic procedures of the central government. The study concludes that decentralisation by devolution which is being promoted in the policy documents in Tanzania is yet to be realised at the district and local levels. The study recommends that the central government should provide more space to the decentralised district health systems to incorporate locally defined priorities in the district health plans. Copyright © 2018 John Wiley & Sons, Ltd.

Decision-making in crisis: Applying a healthcare triage methodology to business continuity management.

PubMed

Moore, Bethany; Bone, Eric A

2017-01-01

The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.

What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?

PubMed Central

Lane, Haylee; Sturgess, Tamica; Philip, Kathleen; Markham, Donna; Martin, Jennifer; Walsh, Jill; Hubbard, Wendy; Haines, Terry

2018-01-01

Background: Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Methods: Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Results: Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Conclusion: Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers face. PMID:29764105

The California Law Enforcement Community’s Intelligence-Led Policing Capacity

DTIC Science & Technology

2010-12-01

intelligence product used for sound decision making , strategic targeting, and more efficient resource allocation, whereas lack of clarity and the...providing law enforcement executives with actionable intelligence products for sound decision making , strategic targeting, and efficient resource

Gender Discrimination in the Allocation of Migrant Household Resources.

PubMed

Antman, Francisca M

2015-07-01

This paper considers the relationship between international migration and gender discrimination through the lens of decision-making power over intrahousehold resource allocation. The endogeneity of migration is addressed with a difference-in-differences style identification strategy and a model with household fixed effects. The results suggest that while a migrant household head is away, a greater share of resources is spent on girls relative to boys and his spouse commands greater decision-making power. Once the head returns home, however, a greater share of resources goes to boys and there is suggestive evidence of greater authority for the head of household.

Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions.

PubMed

Husain, Sara; Kadir, Masood; Fatmi, Zafar

2007-01-23

Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make financial allocations based on real, rather than perceived needs. With a large part of HIV program funding dedicated to public-private partnerships, it becomes imperative to develop public sector capacity to administer contracts, coordinate and monitor activities of the non-governmental sector.

Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions

PubMed Central

Husain, Sara; Kadir, Masood; Fatmi, Zafar

2007-01-01

Background Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. Methods A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. Results HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Conclusion Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make financial allocations based on real, rather than perceived needs. With a large part of HIV program funding dedicated to public-private partnerships, it becomes imperative to develop public sector capacity to administer contracts, coordinate and monitor activities of the non-governmental sector. PMID:17244371

TESTING MULTI-CRITERIA DECISION ANALYSIS FOR MORE TRANSPARENT RESOURCE-ALLOCATION DECISION MAKING IN COLOMBIA.

PubMed

Castro Jaramillo, Hector Eduardo; Goetghebeur, Mireille; Moreno-Mattar, Ornella

2016-01-01

In 2012, Colombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute (IETS), the disbandment of the Regulatory Commission for Health and the reassignment of reimbursement decision-making powers to the Ministry of Health and Social Protection (MoHSP). These dynamic changes provided the opportunity to test Multi-Criteria Decision Analysis (MCDA) for systematic and more transparent resource-allocation decision-making. During 2012 and 2013, the MCDA framework Evidence and Value: Impact on Decision Making (EVIDEM) was tested in Colombia. This consisted of a preparatory stage in which the investigators conducted literature searches and produced HTA reports for four interventions of interest, followed by a panel session with decision makers. This method was contrasted with a current approach used in Colombia for updating the publicly financed benefits package (POS), where narrative health technology assessment (HTA) reports are presented alongside comprehensive budget impact analyses (BIAs). Disease severity, size of population, and efficacy ranked at the top among fifteen preselected relevant criteria. MCDA estimates of technologies of interest ranged between 71 to 90 percent of maximum value. The ranking of technologies was sensitive to the methods used. Participants considered that a two-step approach including an MCDA template, complemented by a detailed BIA would be the best approach to assist decision-making in this context. Participants agreed that systematic priority setting should take place in Colombia. This work may serve as the basis to the MoHSP on its interest of setting up a systematic and more transparent process for resource-allocation decision-making.

Gender Discrimination in the Allocation of Migrant Household Resources*

PubMed Central

Antman, Francisca M.

2016-01-01

This paper considers the relationship between international migration and gender discrimination through the lens of decision-making power over intrahousehold resource allocation. The endogeneity of migration is addressed with a difference-in-differences style identification strategy and a model with household fixed effects. The results suggest that while a migrant household head is away, a greater share of resources is spent on girls relative to boys and his spouse commands greater decision-making power. Once the head returns home, however, a greater share of resources goes to boys and there is suggestive evidence of greater authority for the head of household. PMID:27546986

Satisficing in Split-Second Decision Making Is Characterized by Strategic Cue Discounting

ERIC Educational Resources Information Center

Oh, Hanna; Beck, Jeffrey M.; Zhu, Pingping; Sommer, Marc A.; Ferrari, Silvia; Egner, Tobias

2016-01-01

Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through "satisficing," fast but "good-enough" heuristic decision making that prioritizes some sources of…

Ethical triage and scarce resource allocation during public health emergencies: tenets and procedures.

PubMed

Kuschner, Ware G; Pollard, John B; Ezeji-Okoye, Stephen C

2007-01-01

Public health emergencies may result in mass casualties and a surge in demand for hospital-based care. Healthcare standards may need to be altered to respond to an imbalance between demands for care and resources. Clinical decisions that involve triage and scarce resource allocation may present unique ethical challenges. To address these challenges, the authors detailed tenets and procedures to guide triage and scarce resource allocation during public health emergencies. The authors propose health care organizations deploy a Triage and Scarce Resource Allocation Team to over-see and guide ethically challenging clinical decision-making during a crisis period. The authors' goal is to help healthcare organizations and clinicians balance public health responsibilities and their duty to individual patients during emergencies in as equitable and humane a manner as possible.

Resource allocation in public health practice: a national survey of local public health officials.

PubMed

Baum, Nancy M; DesRoches, Catherine; Campbell, Eric G; Goold, Susan Dorr

2011-01-01

The purpose of this study was to gain an empirical understanding of the types of allocation decisions local health officials (LHOs) make and the factors that influence those allocation decisions. We conducted a national survey of LHOs in the United States in 2008 to 2009. The sample was stratified by the size of the population served by the department. We merged our data with data from the 2008 National Association of County and City Health Officials Profile survey. Descriptive statistics were generated using weighted data. Our final sample size was 608 respondents, with an average of 10 years experience. The LHOs reported little shifting of resources among population groups but greater capacity to redirect staffing time. Less than half of LHOs reported using economic analyses or conducting needs assessments when setting priorities. Having sole provider status in a community strongly influenced LHOs' allocation decisions. In addition, the effectiveness of activities, previous budget allocations, and input from boards of health were influential factors in allocation decisions. Public expectations were moderately to very influential, but direct public input had a low impact on allocation decisions. Survey findings provide a clearer understanding of how LHOs fulfill their obligations as stewards of public health resources and ensure effective activities and access to needed services. It may be useful to assess the value of more structured allocation methods (eg, decision frameworks) in the allocation process. Expanding opportunities for public engagement in priority setting may also be valuable for difficult allocation decisions.

The Cost Structure of Higher Education: Implications for Governmental Policy in Steady State.

ERIC Educational Resources Information Center

Lyell, Edward H.

The historical pattern of resource allocation in American higher education as exemplified by public colleges in Colorado was examined. The reliance upon average cost information in making resource allocation decisions was critiqued for the special problems that arise from student enrollment decline or steady state. A model of resource allocation…

Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

PubMed

Goeree, Ron; Diaby, Vakaramoko

2013-12-01

In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Understanding Resource Allocation in High Schools.

ERIC Educational Resources Information Center

Hartman, William T.

Despite commonly held views concerning educators' rational decision-making behavior, there are competing interpretations of school personnels' objective, actions, and decision-making processes. Alternative explanations emphasize bureaucratic routine, administrative convenience, educator self-interest, and political motivations, rather than…

Sustainability in health care by allocating resources effectively (SHARE) 4: exploring opportunities and methods for consumer engagement in resource allocation in a local healthcare setting.

PubMed

Harris, Claire; Ko, Henry; Waller, Cara; Sloss, Pamela; Williams, Pamela

2017-05-05

This is the fourth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Healthcare decision-makers have sought to improve the effectiveness and efficiency of services through removal or restriction of practices that are unsafe or of little benefit, often referred to as 'disinvestment'. A systematic, integrated, evidence-based program for disinvestment was being established within a large Australian health service network. Consumer engagement was acknowledged as integral to this process. This paper reports the process of developing a model to integrate consumer views and preferences into an organisation-wide approach to resource allocation. A literature search was conducted and interviews and workshops were undertaken with health service consumers and staff. Findings were drafted into a model for consumer engagement in resource allocation which was workshopped and refined. Although consumer engagement is increasingly becoming a requirement of publicly-funded health services and documented in standards and policies, participation in organisational decision-making is not widespread. Several consistent messages for consumer engagement in this context emerged from the literature and consumer responses. Opportunities, settings and activities for consumer engagement through communication, consultation and participation were identified within the resource allocation process. Sources of information regarding consumer values and perspectives in publications and locally-collected data, and methods to use them in health service decision-making, were identified. A model bringing these elements together was developed. The proposed model presents potential opportunities and activities for consumer engagement in the context of resource allocation.

Societal values in the allocation of healthcare resources: is it all about the health gain?

PubMed

Stafinski, Tania; Menon, Devidas; Marshall, Deborah; Caulfield, Timothy

2011-01-01

Over the past decade, public distrust in unavoidable value-laden decisions on the allocation of resources to new health technologies has grown. In response, healthcare organizations have made considerable efforts to improve their acceptability by increasing transparency in decision-making processes. However, the social value judgments (distributive preferences of the public) embedded in them have yet to be defined. While the need to explicate such judgments has become widely recognized, the most appropriate approach to accomplishing this remains unclear. The aims of this review were to identify factors around which distributive preferences of the public have been sought, create a list of social values proposed or used in current resource allocation decision-making processes for new health technologies, and review approaches to eliciting such values from the general public. Social values proposed or used in making resource allocation decisions for new health technologies were identified through three approaches: (i) a comprehensive review of published, peer-reviewed, empirical studies of public preferences for the distribution of healthcare; (ii) an analysis of non-technical factors or social value statements considered by technology funding decision-making processes in Canada and abroad; and (iii) a review of appeals to funding decisions on grounds in part related to social value judgments. A total of 34 empirical studies, 10 technology funding decision-making processes, and 12 appeals to decisions were identified and reviewed. The key factors/patient characteristics addressed through policy statements and around which distributive preferences of the public have been sought included severity of illness, immediate need, age (and its relationship to lifetime health), health gain (amount and final outcome/health state), personal responsibility for illness, caregiving responsibilities, and number of patients who could benefit (rarity). Empirical studies typically examined the importance of these factors in isolation. Therefore, the extent to which preferences around one factor may be modified in the presence of others is still unclear. Research that seeks to clarify interactions among factors by asking the public to weigh several of them at once is needed to ensure the relevance of elicited preferences to real-world technology funding decisions.

Linking Performance Measures to Resource Allocation: Exploring Unmapped Terrain.

ERIC Educational Resources Information Center

Ewell, Peter T.

1999-01-01

Examination of how (and whether) particular types of institutional performance measures can be beneficially used in making resource allocation decisions finds that only easily verifiable "hard" statistics should be used in classic performance funding approaches, although surveys and the use of good practices by institutions may…

Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

PubMed

Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

2012-01-01

Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

Opinions of Swedish citizens, health-care politicians, administrators and doctors on rationing and health-care financing.

PubMed

Rosén, Per; Karlberg, Ingvar

2002-06-01

To compare the views of citizens and health-care decision-makers on health-care financing, the limits of public health-care, and resource allocation. A postal survey based on a randomized sample of adults taken by the national registration and stratified samples of health-care politicians, administrators, and doctors in five Swedish counties. A total number of 1194 citizens (response rate 60%) and 427 decision-makers (response rate 69%). The general public have high expectations of public health-care, expectations that do not fit with the decision-makers' views on what should be offered. To overcome the discrepancy between demand and resources, physicians prefer increased patient fees and complementary private insurance schemes to a higher degree than do the other respondents. Physicians take a more favourable view of letting politicians on a national level exert a greater influence on resource allocation within public health-care. A majority of physicians want politicians to assume a greater responsibility for the exclusion of certain therapies or diagnoses. Most politicians, on the other hand, prefer physicians to make more rigorous decisions as to which medical indications should entitle a person to public health-care. The gap between public expectations and health-care resources makes it more important to be clear about who should be accountable for resource-allocation decisions in public health-care. Significant differences between physicians' and politicians' opinions on financing and responsibility for prioritization make the question of accountability even more important.

Forecasting resource-allocation decisions under climate uncertainty: fire suppression with assessment of net benefits of research

Treesearch

Jeffrey P. Prestemon; Geoffrey H. Donovan

2008-01-01

Making input decisions under climate uncertainty often involves two-stage methods that use expensive and opaque transfer functions. This article describes an alternative, single-stage approach to such decisions using forecasting methods. The example shown is for preseason fire suppression resource contracting decisions faced by the United States Forest Service. Two-...

Improving Shipboard Decision Making in the CBR-D (Chemical/Biological Radiological Defense) Environment: Concepts of Use for and Functional Description of a Decision Aid/Training System (DECAID)

DTIC Science & Technology

1988-08-19

take place over the period of several days. Decisions regarding MOPP level or resource allocation made on day I may have no immediate impact, but a...present -- conditions, and manage a resource library to assist the DCA in making decisions under conditions of uncertainty. Several areas of utilization are...students work through a scenario, the device couid then display the consequences of those decisions or provide optimal decision recommendations

Resource allocation and funding challenges for regional local health departments in Nebraska.

PubMed

Chen, Li-Wu; Jacobson, Janelle; Roberts, Sara; Palm, David

2012-01-01

This study examined the mechanism of resource allocation among member counties and the funding challenges of regional health departments (RHDs) in Nebraska. DESIGN AND STUDY SETTING: In 2009, we conducted a qualitative case study of 2 Nebraska RHDs to gain insight into their experiences of making resource allocation decisions and confronting funding challenges. The 2 RHD sites were selected for this case study on the basis of their heterogeneity in terms of population distribution in member counties. Sixteen semistructured in-person interviews were conducted with RHD directors, staff, and board of health members. Interview data were coded and analyzed using NVivo qualitative analysis software (QSR International [Americas] Inc., Cambridge, MA). Our findings suggested that the directors of RHDs play an integral role in making resource allocation decisions on the basis of community needs, not on a formula or on individual county population size. Interviewees also reported that the size of the vulnerable population served by the RHD had a significant impact on the level of resources for RHD's programs. The RHD's decisions about resource allocation were also dependent on the amount and type of resources received from the state. Interviewees identified inadequacy and instability of funding as the 2 main funding challenges for their RHD. These challenges negatively impacted workforce capacity and the long-term sustainability of some programs. Regional health departments may not benefit from better leveraging resources and building a stronger structural capacity unless the issues of funding inadequacy and instability are addressed. Strategies that can be used by RHDs to address these funding challenges include seeking grants to support programs, leveraging existing resources, and building community partnerships to share resources. Future research is needed to identify RHDs' optimal workforce capacity, required funding level, and potential funding mechanisms.

Utilization of health technologies-Do not look where there is a light; shine your light where there is a need to look! Relating national health goals with resource allocation decision-making; illustration through examining the Israeli healthcare system.

PubMed

Shavit, Oren

2009-10-01

Innovative health technologies are often the focus of attention. However, in the allocation of public resources for improving health, the focus should be on the health needs of the population. It is the need that should be analyzed first, and decision makers should then evaluate the full range of interventions available, whether new or old, to meet this need. This is in contrast to analyzing the technology first and then characterizing the need it meets, which is the current practice in reimbursement decision-making in several countries. The identified health need should define national health goals, and these goals should be proactively assimilated into the reimbursement decision-making process. Differential reimbursement rates could reflect the relative contribution of the technology to the unmet health need.

Protecting resources for primary health care under fiscal federalism: options for resource allocation.

PubMed

Okorafor, Okore A; Thomas, Stephen

2007-11-01

The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved.

What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?

PubMed

Lane, Haylee; Sturgess, Tamica; Philip, Kathleen; Markham, Donna; Martin, Jennifer; Walsh, Jill; Hubbard, Wendy; Haines, Terry

2017-09-12

Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers face. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Equity in healthcare resource allocation decision making: A systematic review.

PubMed

Lane, Haylee; Sarkies, Mitchell; Martin, Jennifer; Haines, Terry

2017-02-01

To identify elements of endorsed definitions of equity in healthcare and classify domains of these definitions so that policy makers, managers, clinicians, and politicians can form an operational definition of equity that reflects the values and preferences of the society they serve. Systematic review where verbatim text describing explicit and implicit definitions of equity were extracted and subjected to a thematic analysis. The full holdings of the AMED, CINAHL plus, OVID Medline, Scopus, PsychInfo and ProQuest (ProQuest Health & Medical Complete, ProQuest Nursing and Allied Health Source, ProQuest Social Science Journals) were individually searched in April 2015. Studies were included if they provided an original, explicit or implicit definition of equity in regards to healthcare resource allocation decision making. Papers that only cited earlier definitions of equity and provided no new information or extensions to this definition were excluded. The search strategy yielded 74 papers appropriate for this review; 60 of these provided an explicit definition of equity, with a further 14 papers discussing implicit elements of equity that the authors endorsed in regards to healthcare resource allocation decision making. FIVE KEY THEMES EMERGED: i) Equalisation across the health service supply/access/outcome chain, ii) Need or potential to benefit, iii) Groupings of equalisation, iv) Caveats to equalisation, and v) Close enough is good enough. There is great inconsistency in definitions of equity endorsed by different authors. Operational definitions of equity need to be more explicit in addressing these five thematic areas before they can be directly applied to healthcare resource allocation decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

PubMed

Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

2018-02-23

In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training outcomes may not provide sufficient information for policy-makers to make decisions on future training programmes. Based on our findings, we have developed an evidence-based framework, which incorporates but expands beyond the Kirkpatrick model, to provide conceptual and practical guidance that aids in the design of training programme evaluations better suited to meet the information needs of policy-makers and to inform policy decisions.

Optimal allocation model of construction land based on two-level system optimization theory

NASA Astrophysics Data System (ADS)

Liu, Min; Liu, Yanfang; Xia, Yuping; Lei, Qihong

2007-06-01

The allocation of construction land is an important task in land-use planning. Whether implementation of planning decisions is a success or not, usually depends on a reasonable and scientific distribution method. Considering the constitution of land-use planning system and planning process in China, multiple levels and multiple objective decision problems is its essence. Also, planning quantity decomposition is a two-level system optimization problem and an optimal resource allocation decision problem between a decision-maker in the topper and a number of parallel decision-makers in the lower. According the characteristics of the decision-making process of two-level decision-making system, this paper develops an optimal allocation model of construction land based on two-level linear planning. In order to verify the rationality and the validity of our model, Baoan district of Shenzhen City has been taken as a test case. Under the assistance of the allocation model, construction land is allocated to ten townships of Baoan district. The result obtained from our model is compared to that of traditional method, and results show that our model is reasonable and usable. In the end, the paper points out the shortcomings of the model and further research directions.

Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

PubMed

Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

2016-09-01

To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

Decision making in the Navy Budget Office.

DTIC Science & Technology

1986-06-01

The primary objective of this thesis is to familiarize the reader with the budget decision making pocesses and considerations which influence the ...formulation of the Department of the navy’s (DON) budget from perspective of the Office of Budget and Reports (OBR), the impact of resource allocation...budgetary) decisions upon the overall framwork within which DON budgetary decisions are made, the organizational

Health care priority setting: principles, practice and challenges

PubMed Central

Mitton, Craig; Donaldson, Cam

2004-01-01

Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA). Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated. PMID:15104792

The Rational Approach to Budget Cuts: One University's Experience. ASHE 1987 Annual Meeting Paper.

ERIC Educational Resources Information Center

Hardy, Cynthia

The experiences of the University of Montreal in using a rational-analytic framework to allocate resources at a time of budget costs are discussed. The following characteristics for rational decision-making are identified and applied to the University of Montreal: whether goals were known, whether alternative methods of resource allocation were…

Allocation of Public Resources for Psychological Therapy between Types of Mental Health Condition: Towards Structural Balance

ERIC Educational Resources Information Center

Tustin, Don

2009-01-01

This paper addresses issues of allocating public resources efficiently between mental health conditions that are associated with different levels of disability, and presents an adaptation of an established framework to help decision-making in this area. The adapted framework refers to psychological interventions that are universal, indicated,…

Decision space for health workforce management in decentralized settings: a case study in Uganda.

PubMed

Alonso-Garbayo, Alvaro; Raven, Joanna; Theobald, Sally; Ssengooba, Freddie; Nattimba, Milly; Martineau, Tim

2017-11-01

The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that managers have in six areas of HRM (e.g. policy, planning, remuneration and incentives, performance management, education and information) the study compares the roles allocated by Uganda's policy and regulatory frameworks with the actual room for decision-making that district health managers perceive that they have. Results show that in some areas District Health Management Team (DHMT) members make decisions beyond their conferred authority while in others they do not use all the space allocated by policy. DHMT members operate close to the boundaries defined by public policy in planning, remuneration and incentives, policy and performance management. However, they make decisions beyond their conferred authority in the area of information and do not use all the space allocated by policy in the area of education. DHMTs' decision-making capacity to manage their workforce is influenced by their own perceived authority and sometimes it is constrained by decisions made at higher levels. We can conclude that decentralization, to improve workforce performance, needs to devolve power further down from district authorities onto district health managers. DHMTs need not only more power and authority to make decisions about their workforce but also more control over resources to be able to implement these decisions. © The Author 2017. 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.

Fair Resource Allocation to Health Research: Priority Topics for Bioethics Scholarship.

PubMed

Pratt, Bridget; Hyder, Adnan A

2017-07-01

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. © 2017 John Wiley & Sons Ltd.

What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.

PubMed

Page, Katie; Barnett, Adrain G; Graves, Nicholas

2017-02-14

Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is the better value for making resource decisions, and we describe our valuation method and estimations for costing this important resource. We performed a contingent valuation using 37 Australian Chief Executive Officers' (CEOs) willingness to pay (WTP) to release bed days in their hospitals, both generally and using specific cases. We provide a succinct thematic analysis from qualitative interviews post survey completion, which provide insight into the decision making process. On average CEOs are willing to pay a marginal rate of $216 for a ward bed day and $436 for an Intensive Care Unit (ICU) bed day, with estimates of uncertainty being greater for ICU beds. These estimates are significantly lower (four times for ward beds and seven times for ICU beds) than the traditional accounting costs often used. Key themes to emerge from the interviews include the importance of national funding and targets, and their associated incentive structures, as well as the aversion to discuss bed days as an economic resource. This study highlights the importance for valuing bed days as an economic resource to inform cost effectiveness models and thus improve hospital decision making and resource allocation. Significantly under or over valuing the resource is very likely to result in sub-optimal decision making. We discuss the importance of recognising the opportunity costs of this resource and highlight areas for future research.

Priority setting and the ethics of resource allocation within VA healthcare facilities: results of a survey.

PubMed

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa M; Altemose, Jane A; Fox, Ellen

2008-01-01

Setting priorities and the subsequent allocation of resources is a major ethical issue facing healthcare facilities, including the Veterans Health Administration (VHA), the largest integrated healthcare delivery network in the United States. Yet despite the importance of priority setting and its impact on those who receive and those who provide care, we know relatively little about how clinicians and managers view allocation processes within their facilities. The purpose of this secondary analysis of survey data was to characterize staff members' perceptions regarding the fairness of healthcare ethics practices related to resource allocation in Veterans Administration (VA) facilities. The specific aim of the study was to compare the responses of clinicians, clinician managers, and non-clinician managers with respect to these survey items. We utilized a paper and web-based survey and a cross-sectional design of VHA clinicians and managers. Our sample consisted of a purposive stratified sample of 109 managers and a stratified random sample of 269 clinicians employed 20 or more hours per week in one of four VA medical centers. The four medical centers were participating as field sites selected to test the logistics of administering and reporting results of the Integrated Ethics Staff Survey, an assessment tool aimed at characterizing a broad range of ethical practices within a healthcare organization. In general, clinicians were more critical than clinician managers or non-clinician managers of the institutions' allocation processes and of the impact of resource decisions on patient care. Clinicians commonly reported that they did not (a) understand their facility's decision-making processes, (b) receive explanations from management regarding the reasons behind important allocation decisions, or (b) perceive that they were influential in allocation decisions. In addition, clinicians and managers both perceived that education related to the ethics of resource allocation was insufficient and that their facilities could increase their effectiveness in identifying and resolving ethical problems related to resource allocation. How well a healthcare facility ensures fairness in the way it allocates its resources across programs and services depends on multiple factors, including awareness by decision makers that setting priorities and allocating resources is a moral enterprise (moral awareness), the availability of a consistent process that includes important stakeholder groups (procedural justice), and concurrence by stakeholders that decisions represent outcomes that fairly balance competing interests and have a positive net effect on the quality of care (distributive justice). In this study, clinicians and managers alike identified the need for improvement in healthcare ethics practices related to resource allocation.

Exploring Data-Driven Decision-Making in the Field: How Faculty Use Data and Other Forms of Information to Guide Instructional Decision-Making. WCER Working Paper No. 2014-3

ERIC Educational Resources Information Center

Hora, Matthew T.; Bouwma-Gearhart, Jana; Park, Hyoung Joon

2014-01-01

A defining characteristic of current U.S. educational policy is the use of data to inform decisions about resource allocation, teacher hiring, and curriculum and instruction. Perhaps the biggest challenge to data-driven decision making (DDDM) is that data use alone does not automatically result in improved teaching and learning. Research indicates…

Making Decisions about Workforce Development in Registered Training Organisations

ERIC Educational Resources Information Center

Hawke, Geof

2008-01-01

The purpose of this research activity is to understand further how large and small registered training organisations (RTOs) make decisions about the allocation of resources for developing their workforces. Six registered training organisations--four technical and further education (TAFE) institutes and two private providers--were selected for…

An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department.

PubMed

Yousefi, M; Ferreira, R P M

2017-03-30

This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section. In this simulation, unlike previous studies, all staff agents took part in the decision-making process to re-allocate the resources in the emergency department. The simulation modeled the behavior of patients, receptionists, triage nurses, emergency room nurses and doctors. Patients were able to decide whether to stay in the system or leave the department at any stage of treatment. In order to evaluate the performance of this approach, 6 different scenarios were introduced. In each scenario, various key performance indicators were investigated before and after applying the group decision-making. The outputs of each simulation were number of deaths, number of patients who leave the emergency department without being attended, length of stay, waiting time and total number of discharged patients from the emergency department. Applying the self-organizing approach in the simulation showed an average of 12.7 and 14.4% decrease in total waiting time and number of patients who left without being seen, respectively. The results showed an average increase of 11.5% in total number of discharged patients from emergency department.

An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department

PubMed Central

Yousefi, M.; Ferreira, R.P.M.

2017-01-01

This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section. In this simulation, unlike previous studies, all staff agents took part in the decision-making process to re-allocate the resources in the emergency department. The simulation modeled the behavior of patients, receptionists, triage nurses, emergency room nurses and doctors. Patients were able to decide whether to stay in the system or leave the department at any stage of treatment. In order to evaluate the performance of this approach, 6 different scenarios were introduced. In each scenario, various key performance indicators were investigated before and after applying the group decision-making. The outputs of each simulation were number of deaths, number of patients who leave the emergency department without being attended, length of stay, waiting time and total number of discharged patients from the emergency department. Applying the self-organizing approach in the simulation showed an average of 12.7 and 14.4% decrease in total waiting time and number of patients who left without being seen, respectively. The results showed an average increase of 11.5% in total number of discharged patients from emergency department. PMID:28380196

A Cost-Effectiveness Evaluation Approach to Improving Resource Allocations for School Systems. Administering for Change Program. A Professional Paper.

ERIC Educational Resources Information Center

Temkin, Sanford

This dissertation begins with a description of some methods employed in making public-sector resource-allocation decisions, with conclusions on the appropriateness of each method for evaluating the ongoing programs of a school system. The second section has been rewritten and published as "A Comprehensive Theory of Cost-Effectiveness" (EA 002…

Nonprofit Decision Making and Resource Allocation: The Importance of Membership Preferences, Community Needs, and Interorganizational Ties.

ERIC Educational Resources Information Center

Markham, William T.; Johnson, Margaret A.; Bonjean, Charles M.

1999-01-01

Results of a study of community service organizations (n=12) and their communities indicate that distribution of volunteer funds and time was unrelated to community needs as measured by objective indicators. The most important determinants of resource allocation are members' perceptions of the severity of problems and their willingness to work in…

Pressure Point On Campus: Academic Program Planning and Resource Allocation in Conflict with the Bargaining Table.

ERIC Educational Resources Information Center

Kieft, Raymond

Considered are the nature and extent of some of the basic conflicts that arise when two, future-oriented, decision-making processes--institutional program planning/resource allocation and collective bargaining--are both present on the same campus. The identified conflicts come from the experiences of a university that was one of the first in the…

Cross-cultural differences in distributive justice: a comparison of Turkey and the U.S.

PubMed

Murphy-Berman, Virginia A; Berman, John J; Cukur, Cem Safak

2012-01-01

When allocators make decisions about distributing resources, they face a dilemma if the expectations for consequences that will flow from particular choices are incongruent with each other. For example, a certain allocation choice might be expected to make an allocator appear warm and likable but unfair. Previous research has found that culture can shape these perceptions and, thus, their congruence or incongruence. The present study further investigated these ideas. Differences between Turkish and U.S. students' perceptions of allocators who distributed resources on the basis of merit vs. need were investigated. Results revealed an allocation dilemma among the U.S. but not among the Turkish students. Specifically, the U.S. students perceived greater incongruence among allocation consequences for both merit and need choices than did the students from Turkey for whom perceptions of allocator's fairness were more aligned with perceptions of allocator's warmth.

Working against Ourselves: Decision Making in a Small Rural School District

ERIC Educational Resources Information Center

Patterson, Jean A.; Koenigs, Andrew; Mohn, Gordon; Rasmussen, Cheryl

2006-01-01

Purpose: The purpose of this paper is to examine decision making and resource allocation in a small, rural district in a Midwestern state of the USA during a time of economic retrenchment. Design/methodology/approach: Qualitative case study methods were used, including focus groups and personal interviews with current and former district…

[Strategic decisions in public psychiatric institutions: a proposed method for resource analysis and allocation].

PubMed

Micheletti, Pierre; Chierici, Piero; Durang, Xavier; Salvador, Nathalie; Lopez, Nathalie

2011-01-01

Because of its sector-based organization and extra-hospital care, public psychiatry has a unique position in healthcare. This paper describes the tools and procedures used to analyze and allocate the resources of the "Centre Hospitalier Alpes-Isère", a hospital serving a catchment population of 530,000 adults. A consensus-based approach was used to validate the selected indicators and included the participation of a geographer. Five levels of resource allocation were identified and classified using a decision tree. At each level, the relevant authorities and criteria were identified as key components of the decision-making process. This paper describes the first three levels of care provision. Focusing on adult care, a comparative assessment of the resources allocated to general psychiatric care and specialist care was conducted, in addition to a comparative assessment of the resources allocated to each of the hospital's four local centers. Geographical accessibility to extramural facilities was also assessed. A study of the characteristics of each general psychiatry clinic revealed significant disparities. The paper highlights several issues: the poor knowledge of psychiatric epidemiological data relating to the population within the catchment area, the difficulty of assessing non-consolidated data or indicators from multiple sources, and the limited and partial nature of geographical data for characterizing and evaluating health care in the hospital's peripheral clinics. Several studies are currently underway to assess the operational effectiveness of the tools and procedures used to analyze and allocate resources.

Allocating resources during a crisis: you can't always get what you want.

PubMed

Hick, John L; DeVries, Aaron S; Fink-Kocken, Paula; Braun, Jane E; Marchetti, Judy

2012-04-01

During a disaster or disease outbreak, health care providers may have to make difficult decisions about how to allocate scarce resources. A committee convened by the Minnesota Department of Health has recently focused on this issue as part of statewide disaster preparedness planning. This article presents the group's recommendation that health care facilities need to plan for shortages and introduces resources and strategies that can be used in planning. It also discusses ethical considerations that must be taken into account when shortages occur and decisions must be made about how to distribute equipment, supplies, or medications in short supply.

The ethics of end-of-life decisions in the elderly: deliberations from the ECOPE study.

PubMed

Reiter-Theil, Stella

2003-06-01

Is age a factor underlying clinical decision-making? Should age be a criterion in the allocation of health care resources? Is it correct to criticize this approach as 'ageism'? What role does 'paternalism' play? These questions are the focus of this chapter which takes an interdisciplinary perspective of clinical ethics in order to provide an ethical evaluation of the situation of the elderly in health care. First, the text of the chapter is based on the descriptive level referring to (a) clinical ethics consultation, (b) the ECOPE study on 'Ethical Conditions of Passive Euthanasia' focusing on decision-making, and studies about age as a factor in clinical decisions, such as the American SUPPORT study. Second, at the normative level, ethical deliberations are discussed for and against age as a criterion for allocating health care resources. Finally, it is suggested that the differences in evidence to be found about the role of age as a factor in clinical decision-making may be due to the different national health policies as well as to the insufficient awareness of ethical principles violated by covert 'ageist' attitudes.

Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression

PubMed Central

Petrovic, Nada; Alderson, David L.; Carlson, Jean M.

2012-01-01

Challenges associated with the allocation of limited resources to mitigate the impact of natural disasters inspire fundamentally new theoretical questions for dynamic decision making in coupled human and natural systems. Wildfires are one of several types of disaster phenomena, including oil spills and disease epidemics, where (1) the disaster evolves on the same timescale as the response effort, and (2) delays in response can lead to increased disaster severity and thus greater demand for resources. We introduce a minimal stochastic process to represent wildfire progression that nonetheless accurately captures the heavy tailed statistical distribution of fire sizes observed in nature. We then couple this model for fire spread to a series of response models that isolate fundamental tradeoffs both in the strength and timing of response and also in division of limited resources across multiple competing suppression efforts. Using this framework, we compute optimal strategies for decision making scenarios that arise in fire response policy. PMID:22514605

How Do College Campuses Make Decisions about Allocating Resources for Student Mental Health? Findings from Key Participant Interviews

ERIC Educational Resources Information Center

Hunt, Justin B.; Watkins, Daphne; Eisenberg, Daniel

2012-01-01

Given the significant burden of mental illness among young adults, colleges offer a promising venue for prevention and treatment, which can help set late adolescents and young adults on a path to success and wellbeing. Despite the potential benefits, there have been no published studies of how campuses decide about allocating resources for mental…

Alchemy to reason: Effective use of Cumulative Effects Assessment in resource management

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

Hegmann, George, E-mail: george.hegmann@stantec.com; Yarranton, G.A., E-mail: yarran@shaw.ca

2011-09-15

Cumulative Effects Assessment (CEA) is a tool that can be useful in making decisions about natural resource management and allocation. The decisions to be made include those (i) necessary to construct planning and regulatory frameworks to control development activity so that societal goals will be achieved and (ii) whether or not to approve individual development projects, with or without conditions. The evolution of CEA into a more successful tool cannot occur independently of the evolution of decision making processes. Currently progress is painfully slow on both fronts. This paper explores some opportunities to accelerate improvements in decision making in naturalmore » resource management and in the utility of CEA as a tool to assist in making such decisions. The focus of the paper is on how to define the public interest by determining what is acceptable.« less

Stochastic Optimization For Water Resources Allocation

NASA Astrophysics Data System (ADS)

Yamout, G.; Hatfield, K.

2003-12-01

For more than 40 years, water resources allocation problems have been addressed using deterministic mathematical optimization. When data uncertainties exist, these methods could lead to solutions that are sub-optimal or even infeasible. While optimization models have been proposed for water resources decision-making under uncertainty, no attempts have been made to address the uncertainties in water allocation problems in an integrated approach. This paper presents an Integrated Dynamic, Multi-stage, Feedback-controlled, Linear, Stochastic, and Distributed parameter optimization approach to solve a problem of water resources allocation. It attempts to capture (1) the conflict caused by competing objectives, (2) environmental degradation produced by resource consumption, and finally (3) the uncertainty and risk generated by the inherently random nature of state and decision parameters involved in such a problem. A theoretical system is defined throughout its different elements. These elements consisting mainly of water resource components and end-users are described in terms of quantity, quality, and present and future associated risks and uncertainties. Models are identified, modified, and interfaced together to constitute an integrated water allocation optimization framework. This effort is a novel approach to confront the water allocation optimization problem while accounting for uncertainties associated with all its elements; thus resulting in a solution that correctly reflects the physical problem in hand.

Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression

DTIC Science & Technology

2012-04-13

S, Martı́nez-Falero E, Pérez-González JM (2002) Optimiza- tion of the resources management in fighting wildfires . Environmental Management 30: 352...Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression Nada Petrovic1*, David L. Alderson2, Jean M. Carlson3 1Center for...inspire fundamentally new theoretical questions for dynamic decision making in coupled human and natural systems. Wildfires are one of several types of

Mixed strategy to allocate resources with air pollution treatment in China: based on the analytic network process and large-group decision-making method.

PubMed

Chen, Xi; Zhao, Liu; Özdemir, Mujgan Sagir; Liang, Haiming

2018-04-05

The resource allocation of air pollution treatment in China is a complex problem, since many alternatives are available and many criteria influence mutually. A number of stakeholders participate in this issue holding different opinions because of the benefits they value. So a method is needed, based on the analytic network process (ANP) and large-group decision-making (LGDM), to rank the alternatives considering interdependent criteria and stakeholders' opinions. In this method, the criteria related to air pollution treatment are examined by experts. Then, the network structure of the problem is constructed based on the relationships between the criteria. Further, every participant in each group provide comparison matrices by judging the importance between criteria according to dominance, regarding a certain criteria (or goal), and the geometric average comparison matrix of each group is obtained. The decision weight of each group is derived by combining the subjective weight and the objective weight, in which the subjective weight is provided by organizers, while the objective weight is determined by considering the consensus levels of groups. The final comparison matrices are obtained by the geometric average of comparison matrices and the decision weights. Next, the resource allocation is made according to the priorities of the alternatives using the super decision software. Finally, an example is given to illustrate the use of the proposed method.

Bayesian Decision Theory Guiding Educational Decision-Making: Theories, Models and Application

ERIC Educational Resources Information Center

Pan, Yilin

2016-01-01

Given the importance of education and the growing public demand for improving education quality under tight budget constraints, there has been an emerging movement to call for research-informed decisions in educational resource allocation. Despite the abundance of rigorous studies on the effectiveness, cost, and implementation of educational…

Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina

2017-06-21

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

Stochastic multi-objective auto-optimization for resource allocation decision-making in fixed-input health systems.

PubMed

Bastian, Nathaniel D; Ekin, Tahir; Kang, Hyojung; Griffin, Paul M; Fulton, Lawrence V; Grannan, Benjamin C

2017-06-01

The management of hospitals within fixed-input health systems such as the U.S. Military Health System (MHS) can be challenging due to the large number of hospitals, as well as the uncertainty in input resources and achievable outputs. This paper introduces a stochastic multi-objective auto-optimization model (SMAOM) for resource allocation decision-making in fixed-input health systems. The model can automatically identify where to re-allocate system input resources at the hospital level in order to optimize overall system performance, while considering uncertainty in the model parameters. The model is applied to 128 hospitals in the three services (Air Force, Army, and Navy) in the MHS using hospital-level data from 2009 - 2013. The results are compared to the traditional input-oriented variable returns-to-scale Data Envelopment Analysis (DEA) model. The application of SMAOM to the MHS increases the expected system-wide technical efficiency by 18 % over the DEA model while also accounting for uncertainty of health system inputs and outputs. The developed method is useful for decision-makers in the Defense Health Agency (DHA), who have a strategic level objective of integrating clinical and business processes through better sharing of resources across the MHS and through system-wide standardization across the services. It is also less sensitive to data outliers or sampling errors than traditional DEA methods.

The Emperor's New Clothes: The h-Index as a Guide to Resource Allocation in Higher Education

ERIC Educational Resources Information Center

Barnes, Cameron

2014-01-01

This article calls into question the use of the h-index as an aid to decision-making in the higher education sector. The h-index is increasingly employed by institutions, funding bodies and even governments as a guide to the allocation of resources. This practice is contrary to the evidence that the h-index is intrinsically meaningless, a point…

Allocating scarce medical resources to the overweight.

PubMed

Furnham, Adrian; Loganathan, Niroosha; McClelland, Alastair

2010-01-01

A programmatic research effort investigated how lay people weigh information on hypothetical patients when making decisions regarding the allocation of scarce medical resources. This study is partly replicative and partly innovative, and looks particularly at whether overweight patients would be discriminated against in allocating resources. This study aims to determine the importance given to specific patient characteristics when lay participants are asked to allocate scarce medical resources. In all, 156 British adults (82 males, 73 females), aged 19 to 84 years, took part. There were few students. Participants completed a questionnaire requiring them to rank 16 hypothetical patients for access to a kidney dialysis machine.The demographic information presented regarding each hypothetical patient differed on four dimensions: gender, weight, mental health, and religiousness. There were significant main effects for gender, weight, and mental health; females, patients of normal weight, and the mentally well were ranked the highest priority for access to a kidney dialysis machine. Participants discriminated most regarding the weight of hypothetical patients. Different patient characteristics, unrelated to medical prognoses, particularly being overweight, may have an impact on decisions regarding the use of scarce medical resources.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Ramsey, Wayne; King, Richard; Green, Sally

2018-05-30

This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes.

Economic Evaluation Enhances Public Health Decision Making

PubMed Central

Rabarison, Kristina M.; Bish, Connie L.; Massoudi, Mehran S.; Giles, Wayne H.

2015-01-01

Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking “how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?” is important when making decisions about resource allocation and scaling of interventions. PMID:26157792

A review of alternative approaches to healthcare resource allocation.

PubMed

Petrou, S; Wolstenholme, J

2000-07-01

The resources available for healthcare are limited compared with demand, if not need, and all healthcare systems, regardless of their financing and organisation, employ mechanisms to ration or prioritise finite healthcare resources. This paper reviews alternative approaches that can be used to allocate healthcare resources. It discusses the problems encountered when allocating healthcare resources according to free market principles. It then proceeds to discuss the advantages and disadvantages of alternative resource allocation approaches that can be applied to public health systems. These include: (i) approaches based on the concept of meeting the needs of the population to maximising its capacity to benefit from interventions; (ii) economic approaches that identify the most efficient allocation of resources with the view of maximising health benefits or other measures of social welfare; (iii) approaches that seek to ration healthcare by age; and (iv) approaches that resolve resource allocation disputes through debate and bargaining. At present, there appears to be no consensus about the relative importance of the potentially conflicting principles that can be used to guide resource allocation decisions. It is concluded that whatever shape tomorrow's health service takes, the requirement to make equitable and efficient use of finite healthcare resources will remain.

Decision-making under surprise and uncertainty: Arsenic contamination of water supplies

NASA Astrophysics Data System (ADS)

Randhir, Timothy O.; Mozumder, Pallab; Halim, Nafisa

2018-05-01

With ignorance and potential surprise dominating decision making in water resources, a framework for dealing with such uncertainty is a critical need in hydrology. We operationalize the 'potential surprise' criterion proposed by Shackle, Vickers, and Katzner (SVK) to derive decision rules to manage water resources under uncertainty and ignorance. We apply this framework to managing water supply systems in Bangladesh that face severe, naturally occurring arsenic contamination. The uncertainty involved with arsenic in water supplies makes the application of conventional analysis of decision-making ineffective. Given the uncertainty and surprise involved in such cases, we find that optimal decisions tend to favor actions that avoid irreversible outcomes instead of conventional cost-effective actions. We observe that a diversification of the water supply system also emerges as a robust strategy to avert unintended outcomes of water contamination. Shallow wells had a slight higher optimal level (36%) compare to deep wells and surface treatment which had allocation levels of roughly 32% under each. The approach can be applied in a variety of other cases that involve decision making under uncertainty and surprise, a frequent situation in natural resources management.

Method for optimizing resource allocation in a government organization. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Afarin, James

1994-01-01

The managers in Federal agencies are challenged to control the extensive activities in government and still provide high-quality products and services to the American taxpayers. Considering today's complex social and economic environment and the $3.8 billion daily cost of operating the Federal Government, it is evident that there is a need to develop decision-making tools for accurate resource allocation and total quality management. The goal of this thesis is to provide a methodical process that will aid managers in Federal Government to make budgetary decisions based on the cost of services, the agency's objectives, and the customers' perception of the agency's product. A general resource allocation procedure was developed in this study that can be applied to any government organization. A government organization, hereafter the 'organization,' is assumed to be a multidivision enterprise. This procedure was applied to a small organization for the proof of the concept. This organization is the Technical Services Directorate (TSD) at the NASA Lewis Research Center in Cleveland, Ohio. As part of the procedure, a nonlinear programming model was developed to account for the resources of the organization, the outputs produced by the organization, the decision-maker's views, and the customers' satisfaction with the organization. The information on the resources of the organization was acquired from current budget levels of the organization and the human resources assigned to the divisions. The outputs of the organization were defined and measured by identifying metrics that assess the outputs, the most challenging task in this study. The decision-maker's views are represented in the model as weights assigned to the various outputs and were quantified by using the analytic hierarchy process. The customer's opinions regarding the outputs of the organization were collected through questionnaires that were designed for each division individually. Following the philosophy of total quality management, information on customers' satisfaction is presented in the model as the quality of output. The model is a nonlinear one whose objective is to maximize customers' satisfaction such that the total cost of operation does not exceed the organization's budget. This model represents a structured approach or policy mechanism, at the agency level, to make capital investment decisions based on the priorities of the agency and the quality of outputs. This procedure applied to TSD resulted in a resources allocation scheme that was reasonable and acceptable to the decision-makers and, as expected, dependent on the assumptions and accuracy of the data used in the model.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions.

PubMed

Dakin, Helen; Gray, Alastair

2018-05-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of "mutually exclusive." This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were "mutually exclusive" makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions

PubMed Central

Dakin, Helen; Gray, Alastair

2018-01-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of “mutually exclusive.” This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were “mutually exclusive” makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making. PMID:29683792

D-Side: A Facility and Workforce Planning Group Multi-criteria Decision Support System for Johnson Space Center

NASA Technical Reports Server (NTRS)

Tavana, Madjid

2005-01-01

"To understand and protect our home planet, to explore the universe and search for life, and to inspire the next generation of explorers" is NASA's mission. The Systems Management Office at Johnson Space Center (JSC) is searching for methods to effectively manage the Center's resources to meet NASA's mission. D-Side is a group multi-criteria decision support system (GMDSS) developed to support facility decisions at JSC. D-Side uses a series of sequential and structured processes to plot facilities in a three-dimensional (3-D) graph on the basis of each facility alignment with NASA's mission and goals, the extent to which other facilities are dependent on the facility, and the dollar value of capital investments that have been postponed at the facility relative to the facility replacement value. A similarity factor rank orders facilities based on their Euclidean distance from Ideal and Nadir points. These similarity factors are then used to allocate capital improvement resources across facilities. We also present a parallel model that can be used to support decisions concerning allocation of human resources investments across workforce units. Finally, we present results from a pilot study where 12 experienced facility managers from NASA used D-Side and the organization's current approach to rank order and allocate funds for capital improvement across 20 facilities. Users evaluated D-Side favorably in terms of ease of use, the quality of the decision-making process, decision quality, and overall value-added. Their evaluations of D-Side were significantly more favorable than their evaluations of the current approach. Keywords: NASA, Multi-Criteria Decision Making, Decision Support System, AHP, Euclidean Distance, 3-D Modeling, Facility Planning, Workforce Planning.

Multiple Criteria Decision-Making Techniques in Higher Education

ERIC Educational Resources Information Center

Ho, William; Dey, Prasanta K.; Higson, Helen E.

2006-01-01

Purpose: The purpose of this paper is to review the literature which focuses on four major higher education decision problems. These are: resource allocation; performance measurement; budgeting; and scheduling. Design/methodology/approach: Related articles appearing in the international journals from 1996 to 2005 are gathered and analyzed so that…

Offspring Size and Reproductive Allocation in Harvester Ants.

PubMed

Wiernasz, Diane C; Cole, Blaine J

2018-01-01

A fundamental decision that an organism must make is how to allocate resources to offspring, with respect to both size and number. The two major theoretical approaches to this problem, optimal offspring size and optimistic brood size models, make different predictions that may be reconciled by including how offspring fitness is related to size. We extended the reasoning of Trivers and Willard (1973) to derive a general model of how parents should allocate additional resources with respect to the number of males and females produced, and among individuals of each sex, based on the fitness payoffs of each. We then predicted how harvester ant colonies should invest additional resources and tested three hypotheses derived from our model, using data from 3 years of food supplementation bracketed by 6 years without food addition. All major results were predicted by our model: food supplementation increased the number of reproductives produced. Male, but not female, size increased with food addition; the greatest increases in male size occurred in colonies that made small females. We discuss how use of a fitness landscape improves quantitative predictions about allocation decisions. When parents can invest differentially in offspring of different types, the best strategy will depend on parental state as well as the effect of investment on offspring fitness.

Business School Computer Usage, Fourth Annual UCLA Survey.

ERIC Educational Resources Information Center

Frand, Jason L.; And Others

The changing nature of the business school computing environment is monitored in a report whose purpose is to provide deans and other policy-makers with information to use in making allocation decisions and program plans. This survey focuses on resource allocations of 249 accredited U.S. business schools and 15 Canadian schools. A total of 128…

Tactical decision making for selective expansion of operating room resources incorporating financial criteria and uncertainty in subspecialties' future workloads.

PubMed

Dexter, Franklin; Ledolter, Johannes; Wachtel, Ruth E

2005-05-01

We considered the allocation of operating room (OR) time at facilities where the strategic decision had been made to increase the number of ORs. Allocation occurs in two stages: a long-term tactical stage followed by short-term operational stage. Tactical decisions, approximately 1 yr in advance, determine what specialized equipment and expertise will be needed. Tactical decisions are based on estimates of future OR workload for each subspecialty or surgeon. We show that groups of surgeons can be excluded from consideration at this tactical stage (e.g., surgeons who need intensive care beds or those with below average contribution margins per OR hour). Lower and upper limits are estimated for the future demand of OR time by the remaining surgeons. Thus, initial OR allocations can be accomplished with only partial information on future OR workload. Once the new ORs open, operational decision-making based on OR efficiency is used to fill the OR time and adjust staffing. Surgeons who were not allocated additional time at the tactical stage are provided increased OR time through operational adjustments based on their actual workload. In a case study from a tertiary hospital, future demand estimates were needed for only 15% of surgeons, illustrating the practicality of these methods for use in tactical OR allocation decisions.

Key factors that influence government policies and decision making about healthcare priorities: Lessons for the field of eating disorders.

PubMed

Whiteford, Harvey; Weissman, Ruth Striegel

2017-03-01

Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies. Beyond setting priorities for resource allocation, governments also become involved where there is a need for regulation to maintain quality in the delivery of healthcare. By providing field-specific examples for each factor, we illustrate how advocates in the eating disorder field may use evidence to inform government policy about resource allocation and regulation in support of individuals with an eating disorder. © 2017 Wiley Periodicals, Inc.

Predicting Fire Season Severity in the Pacific Northwest

Treesearch

Paul Werth

2006-01-01

Projections of fire season severity that integrate historical weather and fire information can be used by fire managers when making decisions about allocating and prioritizing firefighting resources. They enable fire managers to anticipate fire activity and pre-position resources to maximize public and firefighter safety, reduce environmental impacts, and lower...

Factors influencing resource allocation decisions and equity in the health system of Ghana.

PubMed

Asante, A D; Zwi, A B

2009-05-01

Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and diverse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

PubMed Central

Teerawattananon, Yot; Russell, Steve

2008-01-01

Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions. PMID:18817579

A centre-free approach for resource allocation with lower bounds

NASA Astrophysics Data System (ADS)

Obando, Germán; Quijano, Nicanor; Rakoto-Ravalontsalama, Naly

2017-09-01

Since complexity and scale of systems are continuously increasing, there is a growing interest in developing distributed algorithms that are capable to address information constraints, specially for solving optimisation and decision-making problems. In this paper, we propose a novel method to solve distributed resource allocation problems that include lower bound constraints. The optimisation process is carried out by a set of agents that use a communication network to coordinate their decisions. Convergence and optimality of the method are guaranteed under some mild assumptions related to the convexity of the problem and the connectivity of the underlying graph. Finally, we compare our approach with other techniques reported in the literature, and we present some engineering applications.

Out of Alignment? Limitations of the Global Burden of Disease in Assessing the Allocation of Global Health Aid

PubMed Central

Voigt, Kristin; King, Nicholas B

2017-01-01

Abstract The Global Burden of Disease (GBD) project quantifies the impact of different health conditions by combining information about morbidity and premature mortality within a single metric, the Disability Adjusted Life Year. One important goal for the GBD project has been to inform decisions about global health priorities. A number of recent studies have used GBD data to argue that global health funding fails to align with the GBD. We argue that these studies’ shared assumption that global health resources should ‘align’ with the burden of disease is unfounded and has troubling implications. First, since the allocation of resources involves difficult trade-offs between different, potentially competing goals, any ‘misalignment’ of allocation and disease burdens need not necessarily indicate that the allocation of funds fails to meet recipient countries’ needs or interests. Second, using alignment as a baseline implicitly makes controversial assumptions about how harms of different magnitudes affecting different numbers of individuals should be aggregated. We discuss two alternative ways in which GBD data could help inform decisions about resource allocation, neither of which gives more than a limited role to GBD data. PMID:29731809

How resource allocation decisions are made in the health care market.

PubMed

Vogel, W B

2000-10-01

This paper describes how economists view resource allocation decisions in health care markets. The basic economic decisions that must be made in any economic system and the resource allocation decisions in a perfectly competitive market are described. An idealized market can achieve an efficient allocation of resources and is contrasted with a more realistic description of the numerous ways in which health care markets depart from the perfectly competitive ideal. The implications of these departures for health care policy are discussed, along with key controversies concerning reliance upon markets for resource allocation in health care. In particular, the failure of competitive markets to achieve what many consider an equitable distribution of health care is emphasized. The paper concludes with some practical observations on how pharmacists can use the increasing emphasis on economic efficiency to the advantage of their profession.

Health care costs attributable to the treatment of rheumatoid arthritis.

PubMed

Sørensen, J

2004-01-01

A 'programme budget' for the resources used in the treatment and care of patients with rheumatoid arthritis (RA) was developed with a view of helping decision-makers assess the appropriateness of the current use of resources and to discuss future resource allocation. The programme budget was developed using data from several national administrative registers. Patients with RA were identified by hospital diagnostic codes. The incremental cost of treating RA was defined as the difference in resource use for patients with and without RA. Incremental mortality due to RA was defined in similar way. Cost data were estimated for 5-year age groups. Patients with RA used on average 3.2 times as many health care resources as people without RA. The average 1997 incremental costs of primary and hospital care were EUR 253 and EUR 2.660 per patient respectively, corresponding to a national incremental cost of EUR 30 million (2000 price level). RA resulted in an annual loss of 1,549 life years. The programme budget approach is a useful tool in resource allocation decision-making, but discussions of alternative resource allocations must be based on robust studies of effectiveness and cost-effectiveness in the treatment of patients with RA.

Funding Based on Needs? A Study on the Use of Needs Assessment Data by a Major Humanitarian Health Assistance Donor in its Decisions to Allocate Funds

PubMed Central

Olin, Emma; von Schreeb, Johan

2014-01-01

Background: International humanitarian assistance is essential for disaster-affected populations, particularly in resource scarce settings. To target such assistance, needs assessments are required. According to internationally endorsed principles, donor governments should provide funding for humanitarian assistance based on need. Aim: The aim of this study is to explore a major donor’s use of needs assessment data in decision-making for allocations of funds for health-related humanitarian assistance contributions. Setting: This is a case study of the Swedish International Development Cooperation Agency (Sida), a major and respected international donor of humanitarian assistance. Methods: To explore Sida’s use of needs assessment data in practice for needs-based allocations, we reviewed all decision documents and assessment memoranda for humanitarian assistance contributions for 2012 using content analysis; this was followed by interviews with key personnel at Sida. Results: Our document analysis found that needs assessment data was not systematically included in Sida’s assessment memoranda and decision documents. In the interviews, we observed various descriptions of the concept of needs assessments, the importance of contextual influences as well as previous collaborations with implementing humanitarian assistance organizations. Our findings indicate that policies guiding funding decisions on humanitarian assistance need to be matched with available needs assessment data and that terminologies and concepts have to be clearly defined. Conclusion: Based on the document analysis and the interviews, it is unclear how well Sida used needs assessment data for decisions to allocate funds. However, although our observations show that needs assessments are seldom used in decision making, Sida’s use of needs assessments has improved compared to a previous study. To improve project funds allocations based on needs assessment data, it will be critical to develop distinct frameworks for allocation distributions based on needs assessment and clear definitions, measurements and interpretations of needs. Key words: Needs assessment, humanitarian assistance, disasters, donor decision-making PMID:24894417

Proposing integrated Shannon's entropy-inverse data envelopment analysis methods for resource allocation problem under a fuzzy environment

NASA Astrophysics Data System (ADS)

Çakır, Süleyman

2017-10-01

In this study, a two-phase methodology for resource allocation problems under a fuzzy environment is proposed. In the first phase, the imprecise Shannon's entropy method and the acceptability index are suggested, for the first time in the literature, to select input and output variables to be used in the data envelopment analysis (DEA) application. In the second step, an interval inverse DEA model is executed for resource allocation in a short run. In an effort to exemplify the practicality of the proposed fuzzy model, a real case application has been conducted involving 16 cement firms listed in Borsa Istanbul. The results of the case application indicated that the proposed hybrid model is a viable procedure to handle input-output selection and resource allocation problems under fuzzy conditions. The presented methodology can also lend itself to different applications such as multi-criteria decision-making problems.

Tactical resource allocation and elective patient admission planning in care processes.

PubMed

Hulshof, Peter J H; Boucherie, Richard J; Hans, Erwin W; Hurink, Johann L

2013-06-01

Tactical planning of resources in hospitals concerns elective patient admission planning and the intermediate term allocation of resource capacities. Its main objectives are to achieve equitable access for patients, to meet production targets/to serve the strategically agreed number of patients, and to use resources efficiently. This paper proposes a method to develop a tactical resource allocation and elective patient admission plan. These tactical plans allocate available resources to various care processes and determine the selection of patients to be served that are at a particular stage of their care process. Our method is developed in a Mixed Integer Linear Programming (MILP) framework and copes with multiple resources, multiple time periods and multiple patient groups with various uncertain treatment paths through the hospital, thereby integrating decision making for a chain of hospital resources. Computational results indicate that our method leads to a more equitable distribution of resources and provides control of patient access times, the number of patients served and the fraction of allocated resource capacity. Our approach is generic, as the base MILP and the solution approach allow for including various extensions to both the objective criteria and the constraints. Consequently, the proposed method is applicable in various settings of tactical hospital management.

Buying and Using Tomorrow's Computers in Today's Tertiary Institutions.

ERIC Educational Resources Information Center

Sungalia, Helen

1980-01-01

Higher-education administrators are alerted to the advent of the microprocessor and the capabilities of desk computers. The potential use of the microcomputer in administrative decision making, efficiency, and resource allocation are reviewed briefly. (MSE)

Data Systems Linking Resources to Actions and Outcomes: One of the Nation's Most Pressing Education Challenges

ERIC Educational Resources Information Center

Guthrie, James W.

2007-01-01

The inadequacy of present-day public school financial and performance reporting restricts policymakers. With existing spending and activity information now generally available, public officials can determine only overall education resource levels and make allocative decisions only among gross input categories such as relative amounts of labor and…

The Power of 2: Partnership Paves the Way for Teacher Leadership Academy

ERIC Educational Resources Information Center

Harmon, Jeanne; Herren, Kip; Luke, Rod; Emry, Terese

2012-01-01

A clear vision is the essential foundation for making decisions about precious resources for implementing professional learning: (1) people; (2) time; and (3) money. The Auburn School District in Washington state learned firsthand how a clear vision drives resource allocation to support strategic actions and how effective partnerships can be the…

Clinic Workflow Simulations using Secondary EHR Data

PubMed Central

Hribar, Michelle R.; Biermann, David; Read-Brown, Sarah; Reznick, Leah; Lombardi, Lorinna; Parikh, Mansi; Chamberlain, Winston; Yackel, Thomas R.; Chiang, Michael F.

2016-01-01

Clinicians today face increased patient loads, decreased reimbursements and potential negative productivity impacts of using electronic health records (EHR), but have little guidance on how to improve clinic efficiency. Discrete event simulation models are powerful tools for evaluating clinical workflow and improving efficiency, particularly when they are built from secondary EHR timing data. The purpose of this study is to demonstrate that these simulation models can be used for resource allocation decision making as well as for evaluating novel scheduling strategies in outpatient ophthalmology clinics. Key findings from this study are that: 1) secondary use of EHR timestamp data in simulation models represents clinic workflow, 2) simulations provide insight into the best allocation of resources in a clinic, 3) simulations provide critical information for schedule creation and decision making by clinic managers, and 4) simulation models built from EHR data are potentially generalizable. PMID:28269861

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

Introducing priority setting and resource allocation in home and community care programs.

PubMed

Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

2008-01-01

To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

Physicians as gatekeepers: illness certification as a rationing device.

PubMed

Stone, D A

1979-01-01

Illness or disability is often used as an eligibility criterion by public programs that distribute money, services, privileges, and exemptions. Physicians then play a central role in the allocation process. But physicians are caught between a large pool of applicants who want some benefit, on the one hand, and an organization with limited resources to distribute, on the other hand. Three conflicts are engendered in this gatekeeping role: the tension between trusting and mistrusting information provided by the patient, the tension between erring on the false positive side and the false negative side in diagnostic decision-making, and the tension between doing everything possible for each patient and allocating limited resources among several needy clients. Several non-medical factors influence the ultimate outcome of this allocation process, which, in theory, rests on clinical decision-making: the specificity and restrictiveness of the formal definitions of illness and disability used by a program; the structure of the determination process; the overall policy of the organization on distribution of benefits; and the ability of the organization to use administrative review, direct incentives, and written standards to control the certifying behavior of physicians.

Children's understanding of equity in the context of inequality.

PubMed

Rizzo, Michael T; Killen, Melanie

2016-11-01

In the context of a pre-existing resource inequality, the concerns for strict equality (allocating the same number of resources to all recipients) conflict with the concerns for equity (allocating resources to rectify the inequality). This study demonstrated age-related changes in children's (3-8 years old, N = 133) ability to simultaneously weigh the concerns for equality and equity through the analysis of children's judgements, allocations, and reasoning in the context of a pre-existing inequality. Three- to 4-year-olds took equity into account in their judgements of allocations, but allocated resources equally in a behavioural task. In contrast, 5- to 6-year-olds rectified the inequality in their allocations, but judged both equitable and equal allocations to be fair. It was not until 7-8 years old that children focused on rectifying the inequality in their allocations and judgements, as well as judged equal allocations less positively than equitable allocations, thereby demonstrating a more complete understanding of the necessity of rectifying inequalities. The novel findings revealed age-related changes from 3 to 8 years old regarding how the concerns for equity and equality develop, and how children's judgements, allocations, and reasoning are coordinated when making allocation decisions. © 2016 The British Psychological Society.

Optimality versus stability in water resource allocation.

PubMed

Read, Laura; Madani, Kaveh; Inanloo, Bahareh

2014-01-15

Water allocation is a growing concern in a developing world where limited resources like fresh water are in greater demand by more parties. Negotiations over allocations often involve multiple groups with disparate social, economic, and political status and needs, who are seeking a management solution for a wide range of demands. Optimization techniques for identifying the Pareto-optimal (social planner solution) to multi-criteria multi-participant problems are commonly implemented, although often reaching agreement for this solution is difficult. In negotiations with multiple-decision makers, parties who base decisions on individual rationality may find the social planner solution to be unfair, thus creating a need to evaluate the willingness to cooperate and practicality of a cooperative allocation solution, i.e., the solution's stability. This paper suggests seeking solutions for multi-participant resource allocation problems through an economics-based power index allocation method. This method can inform on allocation schemes that quantify a party's willingness to participate in a negotiation rather than opt for no agreement. Through comparison of the suggested method with a range of distance-based multi-criteria decision making rules, namely, least squares, MAXIMIN, MINIMAX, and compromise programming, this paper shows that optimality and stability can produce different allocation solutions. The mismatch between the socially-optimal alternative and the most stable alternative can potentially result in parties leaving the negotiation as they may be too dissatisfied with their resource share. This finding has important policy implications as it justifies why stakeholders may not accept the socially optimal solution in practice, and underlies the necessity of considering stability where it may be more appropriate to give up an unstable Pareto-optimal solution for an inferior stable one. Authors suggest assessing the stability of an allocation solution as an additional component to an analysis that seeks to distribute water in a negotiated process. Copyright © 2013 Elsevier Ltd. All rights reserved.

Managing healthcare budgets in times of austerity: the role of program budgeting and marginal analysis.

PubMed

Mitton, Craig; Dionne, Francois; Donaldson, Cam

2014-04-01

Given limited resources, priority setting or choice making will remain a reality at all levels of publicly funded healthcare across countries for many years to come. The pressures may well be even more acute as the impact of the economic crisis of 2008 continues to play out but, even as economies begin to turn around, resources within healthcare will be limited, thus some form of rationing will be required. Over the last few decades, research on healthcare priority setting has focused on methods of implementation as well as on the development of approaches related to fairness and legitimacy and on more technical aspects of decision making including the use of multi-criteria decision analysis. Recently, research has led to better understanding of evaluating priority setting activity including defining 'success' and articulating key elements for high performance. This body of research, however, often goes untapped by those charged with making challenging decisions and as such, in line with prevailing public sector incentives, decisions are often reliant on historical allocation patterns and/or political negotiation. These archaic and ineffective approaches not only lead to poor decisions in terms of value for money but further do not reflect basic ethical conditions that can lead to fairness in the decision-making process. The purpose of this paper is to outline a comprehensive approach to priority setting and resource allocation that has been used in different contexts across countries. This will provide decision makers with a single point of access for a basic understanding of relevant tools when faced with having to make difficult decisions about what healthcare services to fund and what not to fund. The paper also addresses several key issues related to priority setting including how health technology assessments can be used, how performance can be improved at a practical level, and what ongoing resource management practice should look like. In terms of future research, one of the most important areas of priority setting that needs further attention is how best to engage public members.

Attitudes of rehabilitation medicine doctors toward medical ethics in Malaysia.

PubMed

Mazlina, M; Julia, P E

2011-06-01

Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care. We surveyed 74 rehabilitation physicians and residents in Malaysia using a self-administered descriptive questionnaire. The questions covered medical ethics issues on allocation of resources, patient confidentiality, discharge planning, goal-setting, reimbursement documentation, decision-making capacity and withdrawal of life support. The overall response rate was 69 percent. More than 80 percent of respondents would disclose confidential information to their team members if it would affect the rehabilitation process. More than two-thirds of respondents would not allocate scarce rehabilitation resources if the functional outcome is marginally positive. Issues involving patients' autonomy in decision-making, both in life-threatening and non-life-threatening situations, showed mix responses. The least common response was on the issue of discharge planning, where 51 percent of respondents would send a patient back to a nursing home with suboptimal care if there were no other alternatives. The attitude of Malaysian rehabilitation doctors toward ethical issues is reflective of the level of maturity of rehabilitation medicine in Malaysia. Issues on allocation of resources, discharge planning and decision-making capacity are significantly influenced by limited rehabilitation facilities in parts of the country. The lack of influence from external factors, such as a developed health insurance system, contributes to the difference in attitude between rehabilitation doctors in Malaysia and those in developed countries.

Improving Hospital-Wide Early Resource Allocation through Machine Learning.

PubMed

Gartner, Daniel; Padman, Rema

2015-01-01

The objective of this paper is to evaluate the extent to which early determination of diagnosis-related groups (DRGs) can be used for better allocation of scarce hospital resources. When elective patients seek admission, the true DRG, currently determined only at discharge, is unknown. We approach the problem of early DRG determination in three stages: (1) test how much a Naïve Bayes classifier can improve classification accuracy as compared to a hospital's current approach; (2) develop a statistical program that makes admission and scheduling decisions based on the patients' clincial pathways and scarce hospital resources; and (3) feed the DRG as classified by the Naïve Bayes classifier and the hospitals' baseline approach into the model (which we evaluate in simulation). Our results reveal that the DRG grouper performs poorly in classifying the DRG correctly before admission while the Naïve Bayes approach substantially improves the classification task. The results from the connection of the classification method with the mathematical program also reveal that resource allocation decisions can be more effective and efficient with the hybrid approach.

Community College Presidents' Perspectives of Dichotomous Events: The Consequences of the Great Recession & Coincidental Increased Enrollment

ERIC Educational Resources Information Center

Carlson, Corey W.

2013-01-01

The community college, like all of higher education, has been significantly impacted by the Great Recession and coincidental increased enrollment. The purpose of this qualitative study was to examine the decision making processes of community college presidents as related to resource allocation and the impact of these decisions on the…

Managing resources in NHS dentistry: the views of decision-makers in primary care organisations.

PubMed

Holmes, R D; Donaldson, C; Exley, C; Steele, J G

2008-09-27

To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations. This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method. The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners. To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

Deliberation favours social efficiency by making people disregard their relative shares: evidence from USA and India

PubMed Central

Corgnet, Brice; Espín, Antonio M.; Hernán-González, Roberto

2017-01-01

Groups make decisions on both the production and the distribution of resources. These decisions typically involve a tension between increasing the total level of group resources (i.e. social efficiency) and distributing these resources among group members (i.e. individuals' relative shares). This is the case because the redistribution process may destroy part of the resources, thus resulting in socially inefficient allocations. Here we apply a dual-process approach to understand the cognitive underpinnings of this fundamental tension. We conducted a set of experiments to examine the extent to which different allocation decisions respond to intuition or deliberation. In a newly developed approach, we assess intuition and deliberation at both the trait level (using the Cognitive Reflection Test, henceforth CRT) and the state level (through the experimental manipulation of response times). To test for robustness, experiments were conducted in two countries: the USA and India. Despite absolute-level differences across countries, in both locations we show that: (i) time pressure and low CRT scores are associated with individuals' concerns for their relative shares and (ii) time delay and high CRT scores are associated with individuals' concerns for social efficiency. These findings demonstrate that deliberation favours social efficiency by overriding individuals' intuitive tendency to focus on relative shares. PMID:28386421

Modeling the value for money of changing clinical practice change: a stochastic application in diabetes care.

PubMed

Hoomans, Ties; Abrams, Keith R; Ament, Andre J H A; Evers, Silvia M A A; Severens, Johan L

2009-10-01

Decision making about resource allocation for guideline implementation to change clinical practice is inevitably undertaken in a context of uncertainty surrounding the cost-effectiveness of both clinical guidelines and implementation strategies. Adopting a total net benefit approach, a model was recently developed to overcome problems with the use of combined ratio statistics when analyzing decision uncertainty. To demonstrate the stochastic application of the model for informing decision making about the adoption of an audit and feedback strategy for implementing a guideline recommending intensive blood glucose control in type 2 diabetes in primary care in the Netherlands. An integrated Bayesian approach to decision modeling and evidence synthesis is adopted, using Markov Chain Monte Carlo simulation in WinBUGs. Data on model parameters is gathered from various sources, with effectiveness of implementation being estimated using pooled, random-effects meta-analysis. Decision uncertainty is illustrated using cost-effectiveness acceptability curves and frontier. Decisions about whether to adopt intensified glycemic control and whether to adopt audit and feedback alter for the maximum values that decision makers are willing to pay for health gain. Through simultaneously incorporating uncertain economic evidence on both guidance and implementation strategy, the cost-effectiveness acceptability curves and cost-effectiveness acceptability frontier show an increase in decision uncertainty concerning guideline implementation. The stochastic application in diabetes care demonstrates that the model provides a simple and useful tool for quantifying and exploring the (combined) uncertainty associated with decision making about adopting guidelines and implementation strategies and, therefore, for informing decisions about efficient resource allocation to change clinical practice.

Ethical considerations in resource allocation in a cochlear implant program.

PubMed

Westerberg, Brian D; Pijl, Sipke; McDonald, Michael

2008-04-01

To review processes of resource allocation and the ethical considerations relevant to the fair allocation of a limited number of cochlear implants to increasing numbers of potential recipients. Review of relevant considerations. Tertiary referral hospital. Editorial discussion of the ethical issues of resource allocation. Heterogeneity of audiometric thresholds, self-reported disability of hearing loss, age of the potential cochlear implant recipient, cost-effectiveness, access to resources, compliance with follow-up, social support available to the recipient, social consequences of hearing impairment, and other recipient-related factors. In a publicly funded health care system, there will always be a need for decision-making processes for allocation of finite fiscal resources. All candidates for cochlear implantation deserve fair consideration. However, they are a heterogeneous group in terms of needs and expected outcomes consisting of traditional and marginal candidates, with a wide range of benefit from acoustic amplification. We argue that implant programs should thoughtfully prioritize treatment on the basis of need and potential benefit. We reject queuing on the basis of "first-come, first-served" or on the basis of perceived social worth.

The once and future application of cost-effectiveness analysis.

PubMed

Berger, M L

1999-09-01

Cost-effectiveness analysis (CEA) is used by payers to make coverage decisions, by providers to make formulary decisions, and by large purchasers/employers and policymakers to choose health care performance measures. However, it continues to be poorly utilized in the marketplace because of overriding financial imperatives to control costs and a low apparent willingness to pay for quality. There is no obvious relationship between the cost-effectiveness of life-saving interventions and their application. Health care decision makers consider financial impact, safety, and effectiveness before cost-effectiveness. WHY IS CEA NOT MORE WIDELY APPLIED? Most health care providers have a short-term parochial financial perspective, whereas CEA takes a long-term view that captures all costs, benefits, and hazards, regardless of to whom they accrue. In addition, a history of poor standardization of methods, unrealistic expectations that CEA could answer fundamental ethical and political issues, and society's failure to accept the need for allocating scarce resources more judiciously, have contributed to relatively little use of the method by decision makers. HOW WILL CEA FIND GREATER UTILITY IN THE FUTURE? As decision makers take a longer-term view and understand that CEA can provide a quantitative perspective on important resource allocation decisions, including the distributional consequences of alternative choices, CEA is likely to find greater use. However, it must be embedded within a framework that promotes confidence in the social justice of health care decision making through ongoing dialogue about how the value of health and health care are defined.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 10: operationalising disinvestment in a conceptual framework for resource allocation.

PubMed

Harris, Claire; Green, Sally; Elshaug, Adam G

2017-09-08

This is the tenth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. After more than a decade of research, there is little published evidence of active and successful disinvestment. The paucity of frameworks, methods and tools is reported to be a factor in the lack of success. However there are clear and consistent messages in the literature that can be used to inform development of a framework for operationalising disinvestment. This paper, along with the conceptual review of disinvestment in Paper 9 of this series, aims to integrate the findings of the SHARE Program with the existing disinvestment literature to address the lack of information regarding systematic organisation-wide approaches to disinvestment at the local health service level. A framework for disinvestment in a local healthcare setting is proposed. Definitions for essential terms and key concepts underpinning the framework have been made explicit to address the lack of consistent terminology. Given the negative connotations of the word 'disinvestment' and the problems inherent in considering disinvestment in isolation, the basis for the proposed framework is 'resource allocation' to address the spectrum of decision-making from investment to disinvestment. The focus is positive: optimising healthcare, improving health outcomes, using resources effectively. The framework is based on three components: a program for decision-making, projects to implement decisions and evaluate outcomes, and research to understand and improve the program and project activities. The program consists of principles for decision-making and settings that provide opportunities to introduce systematic prompts and triggers to initiate disinvestment. The projects follow the steps in the disinvestment process. Potential methods and tools are presented, however the framework does not stipulate project design or conduct; allowing application of any theories, methods or tools at each step. Barriers are discussed and examples illustrating constituent elements are provided. The framework can be employed at network, institutional, departmental, ward or committee level. It is proposed as an organisation-wide application, embedded within existing systems and processes, which can be responsive to needs and priorities at the level of implementation. It can be used in policy, management or clinical contexts.

Realigning Resources for District Success: Duval County Public Schools Final Report

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

Realigning Resources for District Success: Duval County Public Schools Final Report. Executive Summary

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

Risk-based decision making for staggered bioterrorist attacks : resource allocation and risk reduction in "reload" scenarios.

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

Lemaster, Michelle Nicole; Gay, David M.; Ehlen, Mark Andrew

2009-10-01

Staggered bioterrorist attacks with aerosolized pathogens on population centers present a formidable challenge to resource allocation and response planning. The response and planning will commence immediately after the detection of the first attack and with no or little information of the second attack. In this report, we outline a method by which resource allocation may be performed. It involves probabilistic reconstruction of the bioterrorist attack from partial observations of the outbreak, followed by an optimization-under-uncertainty approach to perform resource allocations. We consider both single-site and time-staggered multi-site attacks (i.e., a reload scenario) under conditions when resources (personnel and equipment whichmore » are difficult to gather and transport) are insufficient. Both communicable (plague) and non-communicable diseases (anthrax) are addressed, and we also consider cases when the data, the time-series of people reporting with symptoms, are confounded with a reporting delay. We demonstrate how our approach develops allocations profiles that have the potential to reduce the probability of an extremely adverse outcome in exchange for a more certain, but less adverse outcome. We explore the effect of placing limits on daily allocations. Further, since our method is data-driven, the resource allocation progressively improves as more data becomes available.« less

Health technology assessment in Saudi Arabia.

PubMed

Al-Aqeel, Sinaa

2018-05-16

The Saudi government, similar to any other government, is committed to making public spending more efficient, using resources more effectively, and limiting waste. Health technology assessment (HTA) is a tool that informs policy and decision makers regarding the formulation of safe and effective policies that are patient-focused and help to achieve efficiency when allocating limited health-care resources. Areas covered: After a brief description of HTA in the international context, this review provides a brief introduction to Saudi Arabia's health-care system, followed by a delineation of the decision maker(s) and influencers and the decision-making process for pricing and reimbursement. The article then discusses the current status of HTA in Saudi Arabia and proposes four strategic objectives that can form the first step in the development of a formal HTA process. Expert commentary: In Saudi Arabia, facilitators for incorporating HTA into the decision-making process exist. Future local research is needed to guide the implementation of full HTA.

Allocation Anatomy: How District Policies That Deploy Resources Can Support (or Undermine) District Reform Strategies

ERIC Educational Resources Information Center

Roza, Marguerite

2008-01-01

The goal of this paper is to explore the effects of micro-budgeting decisions and show how they might support or hamper district reform strategies. The study draws on public and private sector resource allocation literature to identify key elements of resource allocation decisions. These elements are used to highlight different allocation…

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

Wu, Hao; Garzoglio, Gabriele; Ren, Shangping

FermiCloud is a private cloud developed in Fermi National Accelerator Laboratory to provide elastic and on-demand resources for different scientific research experiments. The design goal of the FermiCloud is to automatically allocate resources for different scientific applications so that the QoS required by these applications is met and the operational cost of the FermiCloud is minimized. Our earlier research shows that VM launching overhead has large variations. If such variations are not taken into consideration when making resource allocation decisions, it may lead to poor performance and resource waste. In this paper, we show how we may use an VMmore » launching overhead reference model to minimize VM launching overhead. In particular, we first present a training algorithm that automatically tunes a given refer- ence model to accurately reflect FermiCloud environment. Based on the tuned reference model for virtual machine launching overhead, we develop an overhead-aware-best-fit resource allocation algorithm that decides where and when to allocate resources so that the average virtual machine launching overhead is minimized. The experimental results indicate that the developed overhead-aware-best-fit resource allocation algorithm can significantly improved the VM launching time when large number of VMs are simultaneously launched.« less

Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

PubMed

Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

2009-01-01

In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

Allocating conservation resources between areas where persistence of a species is uncertain.

PubMed

McDonald-Madden, Eve; Chadès, Iadine; McCarthy, Michael A; Linkie, Matthew; Possingham, Hugh P

2011-04-01

Research on the allocation of resources to manage threatened species typically assumes that the state of the system is completely observable; for example whether a species is present or not. The majority of this research has converged on modeling problems as Markov decision processes (MDP), which give an optimal strategy driven by the current state of the system being managed. However, the presence of threatened species in an area can be uncertain. Typically, resource allocation among multiple conservation areas has been based on the biggest expected benefit (return on investment) but fails to incorporate the risk of imperfect detection. We provide the first decision-making framework for confronting the trade-off between information and return on investment, and we illustrate the approach for populations of the Sumatran tiger (Panthera tigris sumatrae) in Kerinci Seblat National Park. The problem is posed as a partially observable Markov decision process (POMDP), which extends MDP to incorporate incomplete detection and allows decisions based on our confidence in particular states. POMDP has previously been used for making optimal management decisions for a single population of a threatened species. We extend this work by investigating two populations, enabling us to explore the importance of variation in expected return on investment between populations on how we should act. We compare the performance of optimal strategies derived assuming complete (MDP) and incomplete (POMDP) observability. We find that uncertainty about the presence of a species affects how we should act. Further, we show that assuming full knowledge of a species presence will deliver poorer strategic outcomes than if uncertainty about a species status is explicitly considered. MDP solutions perform up to 90% worse than the POMDP for highly cryptic species, and they only converge in performance when we are certain of observing the species during management: an unlikely scenario for many threatened species. This study illustrates an approach to allocating limited resources to threatened species where the conservation status of the species in different areas is uncertain. The results highlight the importance of including partial observability in future models of optimal species management when the species of concern is cryptic in nature.

Budgeting Approaches in Community Colleges

ERIC Educational Resources Information Center

Palmer, James C.

2014-01-01

Several budgeting approaches have been initiated as alternatives to the traditional, incremental process. These include formula budgeting; zero-base budgeting; planning, programming, and budgeting systems; and responsibility center budgeting. Each is premised on assumptions about how organizations might best make resource allocation decisions.…

Are Universities Rational Organizations?

ERIC Educational Resources Information Center

Dufty, N. F.

1980-01-01

Administrators in higher education frequently assume a type of rationality based on bureaucratic or political models of organizations, or some combination of the two. This assumption is questioned, and suggestions are made for models of decision making, resource allocation, and policy formation and implementation. (MSE)

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

Does earmarked donor funding make it more or less likely that developing countries will allocate their resources towards programmes that yield the greatest health benefits?

PubMed

Waddington, Catriona

2004-09-01

It should not be assumed that earmarked donor funding automatically increases the allocation of developing-country resources towards programmes that yield the greatest health benefits. Sometimes it does, sometimes it does not--how the funding is designed can influence this. This is true particularly in the longer term, once the earmarked funding has ended. Even in the short term, total funding does not necessarily increase because of fungibility (i.e. recipient governments adjust their spending to offset donor funding preferences). The author explores six problems with earmarked funding: the multiplicity of earmarked funds confuses the situation for decision-makers; earmarking works against the spirit of the sectorwide approach; from the national perspective, it makes sense not to double-fund activities; local ownership of an activity is often compromised; earmarking can lead governments to accept interventions which they cannot afford in the longer term; and earmarking can distort local resource allocation.

An Empirical Study of the Application of Decision Making Model Using Judgement in the Allocation of Resources to Competing Educational Programs. Final Report.

ERIC Educational Resources Information Center

Tuscher, Leroy J.

The purpose of the study was to provide "baseline" data for determining the feasibility of further investigation into the use of quantitive judgmental data in evaluating school programs for determining program budget allocations. The specific objectives were to: 1) Apply a Cost-Utility Model to a "real world" situation in a public secondary…

Rationing of resources: ethical issues in disasters and epidemic situations.

PubMed

Lin, Janet Y; Anderson-Shaw, Lisa

2009-01-01

In an epidemic situation or large-scale disaster, medical and human resources may be stretched to the point of exhaustion. Appropriate planning must incorporate plans of action that minimize public health morbidity and mortality while maximizing the appropriate use of medical and human healthcare resources. While the current novel H1N1 influenza has spread throughout the world, the severity of this strain of influenza appears to be relatively less virulent and lethal compared to the 1918 influenza pandemic. However, the presence of this new influenza strain has reignited interest in pandemic planning. Amongst other necessary resources needed to combat pandemic influenza, a major medical resource concern is the limited number of mechanical ventilators that would be available to be used to treat ill patients. Recent reported cases of avian influenza suggest that mechanical ventilation will be required for the successful recovery of many individuals ill with this strain of virus. However, should the need for ventilators exceed the number of available machines, how will care providers make the difficult ethical decisions as to who should be placed or who should remain on these machines as more influenza patients arrive in need of care? This paper presents a decision-making model for clinicians that is based upon the bioethical principles of beneficence and justice. The model begins with the basic assumptions of triage and progresses into a useful algorithm based upon utilitarian principles. The model is intended to be used as a guide for clinicians in making decisions about the allocation of scarce resources in a just manner and to serve as an impetus for institutions to create or adapt plans to address resource allocation issues should the need arise.

The business of radiology: cost accounting.

PubMed

Camponovo, Ernest J

2004-08-01

Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

Managing resources in NHS dentistry: using health economics to inform commissioning decisions.

PubMed

Holmes, Richard D; Steele, Jimmy; Exley, Catherine E; Donaldson, Cam

2011-05-31

The aim of this study is to develop, apply and evaluate an economics-based framework to assist commissioners in their management of finite resources for local dental services. In April 2006, Primary Care Trusts in England were charged with managing finite dental budgets for the first time, yet several independent reports have since criticised the variability in commissioning skills within these organisations. The study will explore the views of stakeholders (dentists, patients and commissioners) regarding priority setting and the criteria used for decision-making and resource allocation. Two inter-related case studies will explore the dental commissioning and resource allocation processes through the application of a pragmatic economics-based framework known as Programme Budgeting and Marginal Analysis. The study will adopt an action research approach. Qualitative methods including semi-structured interviews, focus groups, field notes and document analysis will record the views of participants and their involvement in the research process. The first case study will be based within a Primary Care Trust where mixed methods will record the views of dentists, patients and dental commissioners on issues, priorities and processes associated with managing local dental services. A Programme Budgeting and Marginal Analysis framework will be applied to determine the potential value of economic principles to the decision-making process. A further case study will be conducted in a secondary care dental teaching hospital using the same approach. Qualitative data will be analysed using thematic analysis and managed using a framework approach. The recent announcement by government regarding the proposed abolition of Primary Care Trusts may pose challenges for the research team regarding their engagement with the research study. However, whichever commissioning organisations are responsible for resource allocation for dental services in the future; resource scarcity is highly likely to remain an issue. Wider understanding of the complexities of priority setting and resource allocation at local levels are important considerations in the development of dental commissioning processes, national oral health policy and the future new dental contract which is expected to be implemented in April 2014.

The ethics of attaching research conditions to access to new health technologies.

PubMed

Holland, Stephen; Hope, Tony

2012-06-01

Decisions on which new health technologies to provide are controversial because of the scarcity of healthcare resources, the competing demands of payers, providers and patients and the uncertainty of the evidence base. Given this, additional information about new health technologies is often considered valuable. One response is to make access to a new health technology conditional on further research. Access can be restricted to patients who participate in a research study, such as a randomised controlled trial; alternatively, a new treatment can be made generally available, but only on condition that further evidence is collected (eg, on long-term outcomes and adverse events, in patient registries). The National Institute for Health and Clinical Excellence (NICE), which provides guidance on which new health technologies to make available under the UK's NHS, for example, has made some research conditional recommendations, and the current interest in such options suggests that they are likely to become more prevalent in the future. This paper identifies and discusses the main ethical issues created by this distinctive range of recommendations. We argue that decisions to put research conditions on access to new technologies are compatible with widely accepted values, principles and practices relevant to resource allocation. However, there are important features of these distinctive judgements that must be taken into account by resource allocation decision-making bodies and research ethics committees, and that require new sorts of empirical data.

Role of pharmacoeconomic analysis in R&D decision making: when, where, how?

PubMed

Miller, Paul

2005-01-01

Pharmacoeconomics is vitally important to drug manufacturers in terms of communicating to external decision-makers (payers, prescribers, patients) the value of their products, achieving regulatory and reimbursement approval and contributing to commercial success. Since development of new drugs is long, costly and risky, and decisions must be made how to allocate considerable research and development (R&D) resources, pharmacoeconomics also has an essential role informing internal decision-making (within a company) during drug development. The use of pharmacoeconomics in early development phases is likely to enhance the efficiency of R&D resource use and also provide a solid foundation for communicating product value to external decision-makers further downstream, increasing the likelihood of regulatory (reimbursement) approval and commercial success. This paper puts the case for use of pharmacoeconomic analyses earlier in the development process and outlines five techniques (clinical trial simulation [CTS], option pricing [OP], investment appraisal [IA], threshold analysis [TA] and value of information [VOI] analysis) that can provide useful input into the design of clinical development programmes, portfolio management and optimal pricing strategy. CTS can estimate efficacy and tolerability profiles before clinical data are available. OP can show the value of different clinical programme designs, sequencing of studies and stop decisions. IA can compare expected net present value (NPV) of different product profiles or study designs. TA can be used to understand development drug profile requirements given partial data. VOI can assist risk management by quantifying uncertainty and assessing the economic viability of gathering further information on the development drug. No amount of pharmacoeconomic data can make a bad drug good; what it can do is enhance the drug developers understanding of the characteristics of that drug. Decision-making, in light of this information, is likely to be better than that without it, whether it leads to faster termination of uneconomic projects or the allocation of more appropriate resources to attractive projects.

Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective

PubMed Central

2016-01-01

When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247

A review of cost measures for the economic impact of domestic violence.

PubMed

Chan, Ko Ling; Cho, Esther Yin-Nei

2010-07-01

Although economic analyses of domestic violence typically guide decisions concerning resource allocation, allowing policy makers to make better informed decisions on how to prioritize and allocate scarce resources, the methods adopted to calculate domestic violence costs have varied widely from study to study. In particular, only a few studies have reviewed the cost measures of the economic impact of domestic violence. This article reviews and compares these measures by covering approaches to categorizing costs, the cost components, and ways to estimate them and recommends an integrated framework that brings the various approaches together. Some issues still need to be addressed when further developing measures such as including omitted but significant measures and expanding the time horizons of others. The implications for future study of domestic violence costs are discussed.

US neurologists: attitudes on rationing.

PubMed

Holloway, R G; Ringel, S P; Bernat, J L; Keran, C M; Lawyer, B L

2000-11-28

To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is currently being underused in resource allocation decisions. The authors surveyed a random sample of neurologists practicing in the United States (response rate, 44.4%) with three hypothetical scenarios. Two scenarios were designed to address general attitudes on allocating finite resources with emphasis on formulary decisions for costly drugs. The third scenario was designed to assess whether neurologists would optimize the allocation of a fixed budget as recommended by cost-effectiveness analysis. Three-quarters of respondents thought that neurologists make daily decisions that effectively ration healthcare resources, and 60% felt a professional responsibility to consider the financial impact of individualized treatment decisions on other patients. Only 25% of respondents thought that there should be no restrictions placed on any of the five newer antiepileptic agents. In a 1995 survey, 75% of similarly sampled neurologists agreed that no restrictions should be placed on the availability of FDA-approved medications. Nearly half (46%) of respondents favored a less effective test and would be willing to let patients die to ensure the offering of a more equitable alternative. Most neurologists recognize the need to ration health care, and although they think cost-effectiveness research is one method to achieve efficient distribution of resources, many think that considerable attention should also be given to equity.

An information system to improve financial management, resource allocation and activity planning: evaluation results.

PubMed

Ruland, C M; Ravn, I H

2001-01-01

An important strategy for improving resource management and cost containment in health care is to develop information systems that assist hospital managers in financial management, resource allocation, and activity planning. A crucial part of such development is a rigorous evaluation to assess whether the system accomplishes it's intended goals. To evaluate CLASSICA, a Decision Support System (DSS), that assists nurse managers in financial management, resource allocation, staffing, and activity planning. Using a pre-post test design with control units, CLASSICA was evaluated in four test units. Baseline data and simultaneous parallel measures were collected prior to system implementation at test sites and control units. Using expense reports, staffing and financial statistics, surveys, interviews with nurse managers, and logs as data sources, CLASSICA was evaluated on: cost reduction, quality of management information; usefulness as decision support for improved financial management and decision-making; user satisfaction; and ease of use. Evaluation results showed a 41% reduction in expenditures for overtime and extra hours as compared to a 1.8% reduction in control units during the same time period. Users reported a significant improvement in management information; nurse managers stated that they had gained control over costs. The system helped them analyze the relationships between patient activity staffing, and cost of care. Users reported high satisfaction with the system, the information and decision support it provided, and its ease of use. These results suggest that CLASSICA is a DSS that successfully assists nurse managers in cost effective management of their units.

Establishing a baseline to measure change in political will and the use of data for decision-making in maternal and newborn health in six African countries.

PubMed

Nove, Andrea; Hulton, Louise; Martin-Hilber, Adriane; Matthews, Zoe

2014-10-01

The Evidence for Action (E4A) program assumes that both resource allocation and quality of care can improve via a strategy that combines evidence and advocacy to stimulate accountability. The present paper explains the methods used to collect baseline monitoring data using two tools developed to inform program design in six focus countries. The first tool is designed to understand the extent to which decision-makers have access to the data they need, when they need it, and in meaningful formats, and then to use the data to prioritize, plan, and allocate resources. The second tool seeks the views of people working in the area of maternal and newborn health (MNH) about political will, including: quality of care, the political and financial priority accorded to MNH, and the extent to which MNH decision-makers are accountable to service users. Findings indicate significant potential to improve access to and use of data for decision-making, particularly at subnational levels. Respondents across all six program countries reported lack of access by ordinary citizens to information on the health and MNH budget, and data on MNH outcomes. In all six countries there was a perceived inequity in the distribution of resources and a perception that politicians do not fully understand the priorities of their constituents. Copyright © 2014. Published by Elsevier Ireland Ltd.

An intuitionistic fuzzy multi-objective non-linear programming model for sustainable irrigation water allocation under the combination of dry and wet conditions

NASA Astrophysics Data System (ADS)

Li, Mo; Fu, Qiang; Singh, Vijay P.; Ma, Mingwei; Liu, Xiao

2017-12-01

Water scarcity causes conflicts among natural resources, society and economy and reinforces the need for optimal allocation of irrigation water resources in a sustainable way. Uncertainties caused by natural conditions and human activities make optimal allocation more complex. An intuitionistic fuzzy multi-objective non-linear programming (IFMONLP) model for irrigation water allocation under the combination of dry and wet conditions is developed to help decision makers mitigate water scarcity. The model is capable of quantitatively solving multiple problems including crop yield increase, blue water saving, and water supply cost reduction to obtain a balanced water allocation scheme using a multi-objective non-linear programming technique. Moreover, it can deal with uncertainty as well as hesitation based on the introduction of intuitionistic fuzzy numbers. Consideration of the combination of dry and wet conditions for water availability and precipitation makes it possible to gain insights into the various irrigation water allocations, and joint probabilities based on copula functions provide decision makers an average standard for irrigation. A case study on optimally allocating both surface water and groundwater to different growth periods of rice in different subareas in Heping irrigation area, Qing'an County, northeast China shows the potential and applicability of the developed model. Results show that the crop yield increase target especially in tillering and elongation stages is a prevailing concern when more water is available, and trading schemes can mitigate water supply cost and save water with an increased grain output. Results also reveal that the water allocation schemes are sensitive to the variation of water availability and precipitation with uncertain characteristics. The IFMONLP model is applicable for most irrigation areas with limited water supplies to determine irrigation water strategies under a fuzzy environment.

Financial Aid Administration Today: Considerations for Campus Leaders.

ERIC Educational Resources Information Center

Hart, Natala K.

1996-01-01

In serving students, financial aid officers must address issues outside the scope of the financial aid program, including admissions, academic policy, institutional bureaucracy, student consumer education, and pricing. These require policy decisions and resource allocations the financial aid administrator cannot make alone. Cooperation and support…

Managerial Accounting in Library and Information Science Education.

ERIC Educational Resources Information Center

Hayes, Robert M.

1983-01-01

Explores meaning of managerial accounting in libraries and discusses instructional program for students of library and information science based on experience in School of Library and Information Science at University of California, Los Angeles. Management decision making (budgeting, performance evaluation, overhead, resource allocation,…

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.

A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

PubMed

Cooke, Mary; Hurley, Ciarán

2008-05-01

We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

Infer More, Describe Less: More Powerful Survey Conclusions through Easy Inferential Tests

ERIC Educational Resources Information Center

Hightower, Christy; Scott, Kerry

2012-01-01

Many librarians use data from surveys to make decisions about how to spend money or allocate staff, often making use of popular online tools like Survey Monkey. In this era of reduced budgets, low staffing, stiff competition for new resources, and increasingly complex choices, it is especially important that librarians know how to get strong,…

Predictive and Prognostic Models: Implications for Healthcare Decision-Making in a Modern Recession

PubMed Central

Vogenberg, F. Randy

2009-01-01

Various modeling tools have been developed to address the lack of standardized processes that incorporate the perspectives of all healthcare stakeholders. Such models can assist in the decision-making process aimed at achieving specific clinical outcomes, as well as guide the allocation of healthcare resources and reduce costs. The current efforts in Congress to change the way healthcare is financed, reimbursed, and delivered have rendered the incorporation of modeling tools into the clinical decision-making all the more important. Prognostic and predictive models are particularly relevant to healthcare, particularly in the clinical decision-making, with implications for payers, patients, and providers. The use of these models is likely to increase, as providers and patients seek to improve their clinical decision process to achieve better outcomes, while reducing overall healthcare costs. PMID:25126292

IS THE LINK BETWEEN HEALTH AND WEALTH CONSIDERED IN DECISION MAKING? RESULTS FROM A QUALITATIVE STUDY.

PubMed

Garau, Martina; Shah, Koonal Kirit; Sharma, Priya; Towse, Adrian

2015-01-01

The aim of this study was to explore whether wealth effects of health interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. To analyze reasons for including, or not including, wealth effects. Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom). There is evidence suggesting that health interventions can produce economic gains for patients and national economies. However, we found that the link between health and wealth does not influence decision making in any country with the exception of Sweden. This is due to a combination of factors, including system fragmentation, methodological issues, and the economic recession forcing national governments to focus on short-term measures. In countries with established HTA processes and methods allowing, in principle, the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and see a more systematic consideration of wealth effect in decision making. This would be consistent with principles of efficient priority setting. Barriers for the consideration of wealth effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, governments should consider all relevant effects from public investments, including healthcare, even when benefits can only be captured in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns.

Multiresource allocation and scheduling for periodic soft real-time applications

NASA Astrophysics Data System (ADS)

Gopalan, Kartik; Chiueh, Tzi-cker

2001-12-01

Real-time applications that utilize multiple system resources, such as CPU, disks, and network links, require coordinated scheduling of these resources in order to meet their end-to-end performance requirements. Most state-of-the-art operating systems support independent resource allocation and deadline-driven scheduling but lack coordination among multiple heterogeneous resources. This paper describes the design and implementation of an Integrated Real-time Resource Scheduler (IRS) that performs coordinated allocation and scheduling of multiple heterogeneous resources on the same machine for periodic soft real-time application. The principal feature of IRS is a heuristic multi-resource allocation algorithm that reserves multiple resources for real-time applications in a manner that can maximize the number of applications admitted into the system in the long run. At run-time, a global scheduler dispatches the tasks of the soft real-time application to individual resource schedulers according to the precedence constraints between tasks. The individual resource schedulers, which could be any deadline based schedulers, can make scheduling decisions locally and yet collectively satisfy a real-time application's performance requirements. The tightness of overall timing guarantees is ultimately determined by the properties of individual resource schedulers. However, IRS maximizes overall system resource utilization efficiency by coordinating deadline assignment across multiple tasks in a soft real-time application.

Efficiency of Fiscal Allocations in Site-Based Empowered Schools

ERIC Educational Resources Information Center

Meyer, Jerome Jay

2011-01-01

This study implemented a two phase concurrent mixed-methods design to generate a greater understanding of how elementary schools with increased autonomy in fiscal decision making allocated their money, how their site-based decisions affected allocative efficiency, and how increased autonomy affected site-based decision making when compared with a…

Integrating rangeland and pastureland assessment methods into a national grazingland assessment approach

USDA-ARS?s Scientific Manuscript database

Grazingland resource allocation and decision making at the national scale need to be based on comparable metrics. However, in the USA, rangelands and pasturelands have traditionally been assessed using different methods and indicators. These differences in assessment methods limit the ability to con...

76 FR 32217 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... for an indepth understanding of individuals' attitudes, beliefs, motivations, and feelings. The... develop messages and other communications but will generally conduct further research before making important decisions, such as adopting new policies and allocating or redirecting significant resources to...

[The impact of ethical and moral competence in decision making on rationalism and rationing nursing interventions].

PubMed

Schwerdt, R

2005-08-01

The intraprofessional discourse about economical aspects in nursing from an ethical point of view has not taken place yet. To cope with the increasing restriction of resources, some preconditions have to be met: It is necessary to communicate issues in rationalizing and rationing in nursing openly. Person-oriented criteria in the nursing process indicate a high level of competence and user-oriented quality in nursing care. But nursing professionals do not decide in favor or against resources to perform this task on a high or poor quality level. Democratic decision-making on providing nursing services depends on a continuous societal discourse about allocation criteria.

Medical resource preparation and allocation for humanitarian assistance based on module organization.

PubMed

Zhu, Min; Chen, Ruxue; Zhong, Shaobo; Qian, Yangming; Huang, Quanyi

2017-02-01

This research aims to associate the allocation of medical resources with the function of the modular organization and the possible needs for humanitarian assistance missions. The overseas humanitarian medical assistance mission, which was sent after a disaster on the hospital ship Peace Ark, part of China's People's Liberation Army (PLA) Navy, was considered as study model. The cases used for clustering and matching sample formation were randomly selected from the existing information related to Peace Ark's mission. Categories of the reusable resources clustered by this research met the requirement of the actual consumption almost completely (more than 95%) and the categories of non-reusable resources met the requirement by more than 80%. In the mission's original resource preparing plan, more than 30% of the non-reusable resource categories remained unused during the mission. In the original resource preparing plan, some key non-reusable resources inventories were completely exhausted at the end of the mission, while 5% to 30% of non-reusable resources remained in the resource allocation plan generated by this research at the end of the mission. The medical resource allocation plan generated here can enhance the supporting level for the humanitarian assistance mission. This research could lay the foundation for an assistant decision-making system for humanitarian assistance mission.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria

PubMed Central

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2017-01-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees’ roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery. PMID:28344984

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

PubMed

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2016-11-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

Defense Analysis: The Decision Process

DTIC Science & Technology

1985-07-01

problems ot resource allocation. Includes chapters on tormulating the problem, the research ettort, evaluation ot alternatives, interpretations of...Economics and Decision Making. He is a graduate of Colgate University (BA, Psychology) and received his Masters degree at the Naval Post Graduate School...Analysis 62 ’, ’The Steps irn Subject iye Aiuslysis 66 " Identify the Factors 66 Discusss the Factors 67 Evaluate Each Factor 67 Summa r y 68 Chapter VII

An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

NASA Technical Reports Server (NTRS)

Elgin, Peter D.; Thomas, Rickey P.

2004-01-01

The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

Numbers Are Not Enough. Why e-Learning Analytics Failed to Inform an Institutional Strategic Plan

ERIC Educational Resources Information Center

Macfadyen, Leah P.; Dawson, Shane

2012-01-01

Learning analytics offers higher education valuable insights that can inform strategic decision-making regarding resource allocation for educational excellence. Research demonstrates that learning management systems (LMSs) can increase student sense of community, support learning communities and enhance student engagement and success, and LMSs…

Cypress College Strategic Plan, 2000-2004.

ERIC Educational Resources Information Center

Cypress Coll., CA.

This document outlines Cypress College's Strategic Plan to be used to guide decision-making and resource allocation for the years 2000 through 2004. The Strategic Plan begins with the Cypress College Vision Statement: building a college-wide learning community for student success. The Mission Statement states that Cypress College is committed to…

Cost Accounting and Accountability for Early Education Programs for Handicapped Children.

ERIC Educational Resources Information Center

Gingold, William

The paper offers some basic information for making decisions about allocating and accounting for resources provided to young handicapped children. Sections address the following topics: reasons for costing, audiences for cost accounting and accountability information, and a process for cost accounting and accountability (defining cost categories,…

Using Data to Advance Learning Outcomes in Schools

ERIC Educational Resources Information Center

VanDerHeyden, Amanda; Harvey, Mark

2013-01-01

This article describes the emergence and influence of evidence-based practice and data-based decision making in educational systems. Increasingly, educators and consumers want to know that resources allocated to educational efforts yield strong effects for all learners. This trend is reflected by the widespread influence of evidence-based practice…

76 FR 6802 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... they allow for a more indepth understanding of consumers' attitudes, beliefs, motivations, and feelings... test and refine their ideas but will generally conduct further research before making important decisions, such as adopting new policies and allocating or redirecting significant resources to support...

On the Efficient Allocation of Resources for Hypothesis Evaluation in Machine Learning: A Statistical Approach

NASA Technical Reports Server (NTRS)

Chien, S.; Gratch, J.; Burl, M.

1994-01-01

In this report we consider a decision-making problem of selecting a strategy from a set of alternatives on the basis of incomplete information (e.g., a finite number of observations): the system can, however, gather additional information at some cost.

Game Theoretic Modeling of Water Resources Allocation Under Hydro-Climatic Uncertainty

NASA Astrophysics Data System (ADS)

Brown, C.; Lall, U.; Siegfried, T.

2005-12-01

Typical hydrologic and economic modeling approaches rely on assumptions of climate stationarity and economic conditions of ideal markets and rational decision-makers. In this study, we incorporate hydroclimatic variability with a game theoretic approach to simulate and evaluate common water allocation paradigms. Game Theory may be particularly appropriate for modeling water allocation decisions. First, a game theoretic approach allows economic analysis in situations where price theory doesn't apply, which is typically the case in water resources where markets are thin, players are few, and rules of exchange are highly constrained by legal or cultural traditions. Previous studies confirm that game theory is applicable to water resources decision problems, yet applications and modeling based on these principles is only rarely observed in the literature. Second, there are numerous existing theoretical and empirical studies of specific games and human behavior that may be applied in the development of predictive water allocation models. With this framework, one can evaluate alternative orderings and rules regarding the fraction of available water that one is allowed to appropriate. Specific attributes of the players involved in water resources management complicate the determination of solutions to game theory models. While an analytical approach will be useful for providing general insights, the variety of preference structures of individual players in a realistic water scenario will likely require a simulation approach. We propose a simulation approach incorporating the rationality, self-interest and equilibrium concepts of game theory with an agent-based modeling framework that allows the distinct properties of each player to be expressed and allows the performance of the system to manifest the integrative effect of these factors. Underlying this framework, we apply a realistic representation of spatio-temporal hydrologic variability and incorporate the impact of decision-making a priori to hydrologic realizations and those made a posteriori on alternative allocation mechanisms. Outcomes are evaluated in terms of water productivity, net social benefit and equity. The performance of hydro-climate prediction modeling in each allocation mechanism will be assessed. Finally, year-to-year system performance and feedback pathways are explored. In this way, the system can be adaptively managed toward equitable and efficient water use.

Allocating health care: cost-utility analysis, informed democratic decision making, or the veil of ignorance?

PubMed

Goold, S D

1996-01-01

Assuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.

Investigation of Multi-Criteria Decision Consistency: A Triplex Approach to Optimal Oilfield Portfolio Investment Decisions

NASA Astrophysics Data System (ADS)

Qaradaghi, Mohammed

Complexity of the capital intensive oil and gas portfolio investments is continuously growing. It is manifested in the constant increase in the type, number and degree of risks and uncertainties, which consequently lead to more challenging decision making problems. A typical complex decision making problem in petroleum exploration and production (E&P) is the selection and prioritization of oilfields/projects in a portfolio investment. Prioritizing oilfields maybe required for different purposes, including the achievement of a targeted production and allocation of limited available development resources. These resources cannot be distributed evenly nor can they be allocated based on the oilfield size or production capacity alone since various other factors need to be considered simultaneously. These factors may include subsurface complexity, size of reservoir, plateau production and needed infrastructure in addition to other issues of strategic concern, such as socio-economic, environmental and fiscal policies, particularly when the decision making involves governments or national oil companies. Therefore, it would be imperative to employ decision aiding tools that not only address these factors, but also incorporate the decision makers' preferences clearly and accurately. However, the tools commonly used in project portfolio selection and optimization, including intuitive approaches, vary in their focus and strength in addressing the different criteria involved in such decision problems. They are also disadvantaged by a number of drawbacks, which may include lacking the capacity to address multiple and interrelated criteria, uncertainty and risk, project relationship with regard to value contribution and optimum resource utilization, non-monetary attributes, decision maker's knowledge and expertise, in addition to varying levels of ease of use and other practical and theoretical drawbacks. These drawbacks have motivated researchers to investigate other tools and techniques that can provide more flexibility and inclusiveness in the decision making process, such as Multi-Criteria Decision Making (MCDM) methods. However, it can be observed that the MCDM literature: 1) is primarily focused on suggesting certain MCDM techniques to specific problems without providing sufficient evidence for their selection, 2) is inadequate in addressing MCDM in E&P portfolio selection and prioritization compared with other fields, and 3) does not address prioritizing brownfields (i.e., developed oilfields). This research study aims at addressing the above drawbacks through combining three MCDM methods (i.e., AHP, PROMETHEE and TOPSIS) into a single decision making tool that can support optimal oilfield portfolio investment decisions by helping determine the share of each oilfield of the total development resources allocated. Selecting these methods is reinforced by a pre-deployment and post-deployment validation framework. In addition, this study proposes a two-dimensional consistency test to verify the output coherence or prioritization stability of the MCDM methods in comparison with an intuitive approach. Nine scenarios representing all possible outcomes of the internal and external consistency tests are further proposed to reach a conclusion. The methodology is applied to a case study of six major oilfields in Iraq to generate percentage shares of each oilfield of a total production target that is in line with Iraq's aspiration to increase oil production. However, the methodology is intended to be applicable to other E&P portfolio investment prioritization scenarios by taking the specific contextual characteristics into consideration.

GIS and Game Theory for Water Resource Management

NASA Astrophysics Data System (ADS)

Ganjali, N.; Guney, C.

2017-11-01

In this study, aspects of Game theory and its application on water resources management combined with GIS techniques are detailed. First, each term is explained and the advantages and limitations of its aspect is discussed. Then, the nature of combinations between each pair and literature on the previous studies are given. Several cases were investigated and results were magnified in order to conclude with the applicability and combination of GIS- Game Theory- Water Resources Management. It is concluded that the game theory is used relatively in limited studies of water management fields such as cost/benefit allocation among users, water allocation among trans-boundary users in water resources, water quality management, groundwater management, analysis of water policies, fair allocation of water resources development cost and some other narrow fields. Also, Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Most of the literature on water allocation and conflict problems uses traditional optimization models to identify the most efficient scheme while the Game Theory, as an optimization method, combined GIS are beneficial platforms for agent based models to be used in solving Water Resources Management problems in the further studies.

[Allocation decisions of health insurance rehabilitation managers--An explorative case study concerning stroke rehabilitation].

PubMed

Hasenbein, U; Wallesch, C-W

2003-12-01

We investigated processes of and subjective reasons for resource allocation in three out of four rehabilitation specialists of a regional office of a major health insurance. Decisions of health insurance personnel include approval of and duration of rehabilitation treatment and choice of clinical provider. Insurance specialists are mainly involved in documentation and coordination, whereas decisions mainly follow expert recommendations, mainly of the medical service. Allocation is based primarily on somatic impairment and disability, psychosocial function, motivation and rehabilitation potential are regarded as secondary. Goals and expected results of rehabilitation are neither individually defined nor their achievement evaluated. Decision processes are dominated by routines and agreements. Only exceptionally, defined rules and procedures are applied. Active case management is hampered by a highly specialized internal structure of the investigated insurance fund. The optimal fulfillment of individual requirements for a limited-time rehabilitation treatment is the central criterion for decision making. However, the specialists lack detailed information concerning appropriateness, quality and efficacy of rehabilitation providers, especially when taking patient-related variables into account. Instead, they trust that only high-quality institutions are contracted. Systematic control and feedback of rehabilitation results is not available. The surveyed rehabilitation managers do not include cost aspects in their decision-making. They would regard this as alien to a member- and patient-oriented policy. Improvement potentials with respect to rehabilitation case management are being reviewed.

Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

PubMed

Peacock, Stuart J; Mitton, Craig; Ruta, Danny; Donaldson, Cam; Bate, Angela; Hedden, Lindsay

2010-10-01

Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice. In particular, local health service organizations - such as health authorities, health maintenance organizations, hospitals and healthcare trusts - have had difficulty implementing evidence from economic appraisals. Yet, in the context of making decisions between competing claims on scarce health service resources, economic tools and thinking have much to offer. The purpose of this article is to describe and discuss ten evidence-based guidelines for the successful design and implementation of a program budgeting and marginal analysis (PBMA) priority setting exercise. PBMA is a framework that explicitly recognizes the need to balance pragmatic and ethical considerations with economic rationality when making resource allocation decisions. While the ten guidelines are drawn from the PBMA framework, they may be generalized across a range of economic approaches to priority setting.

Decision making for multiple utilization of water resources in New Zealand

NASA Astrophysics Data System (ADS)

Memon, Pyar Ali

1989-09-01

The Clutha is the largest river in New Zealand. The last two decades have witnessed major conflicts centered on the utilization of the water resources of the upper Clutha river. These conflicts have by no means been finally resolved. The focus of this article is on institutional arrangements for water resource management on the Clutha, with particular reference to the decision-making processes that have culminated in the building of the high dam. It critically evaluates recent experiences and comments on future prospects for resolving resource use conflicts rationally through planning for multiple utilization in a climate of market led policies of the present government. The study demonstrates the inevitable conflicts that can arise within a public bureaucracy that combines dual responsibilities for policy making and operational functions. Hitherto, central government has been able to manipulate the water resource allocation process to its advantage because of a lack of clear separation between its two roles as a policy maker and developer. The conflicts that have manifested themselves during the last two decades over the Clutha should be seen as part of a wider public debate during the last two decades concerning resource utilization in New Zealand. The Clutha controversy was preceded by comparable concerns over the rising of the level of Lake Manapouri during the 1960s and has been followed by the debate over the “think big” resource development projects during the 1980s. The election of the fourth Labour government in 1983 has heralded a political and economic policy shift in New Zealand towards minimizing the role of public intervention in resource allocation and major structural reforms in the relative roles of central and regional government in resource management. The significance of these changes pose important implications for the future management of the Clutha.

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.

PubMed

Smith, Neale; Mitton, Craig; Bryan, Stirling; Davidson, Alan; Urquhart, Bonnie; Gibson, Jennifer L; Peacock, Stuart; Donaldson, Cam

2013-07-02

Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as 'good' or 'very good'. This paper explores these findings in greater detail and assesses them in context of the larger literature. Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada's health system leadership teams.

Automated Pollution Control

NASA Technical Reports Server (NTRS)

1997-01-01

Patterned after the Cassini Resource Exchange (CRE), Sholtz and Associates established the Automated Credit Exchange (ACE), an Internet-based concept that automates the auctioning of "pollution credits" in Southern California. An early challenge of the Jet Propulsion Laboratory's Cassini mission was allocating the spacecraft's resources. To support the decision-making process, the CRE was developed. The system removes the need for the science instrument manager to know the individual instruments' requirements for the spacecraft resources. Instead, by utilizing principles of exchange, the CRE induces the instrument teams to reveal their requirements. In doing so, they arrive at an efficient allocation of spacecraft resources by trading among themselves. A Southern California RECLAIM air pollution credit trading market has been set up using same bartering methods utilized in the Cassini mission in order to help companies keep pollution and costs down.

Tailoring Configuration to User’s Tasks under Uncertainty

DTIC Science & Technology

2008-04-28

CARISMA is the problem being solved. CARISMA applies microeconom- ics and game theory to make runtime decisions about allocating scarce resources among...scarce resources, these applications are running on be- half of one user. Thus, our problem has no game theoretic aspects. 2.2 Task Oriented...prediction tool [15] is based on the RPS tool and allows prediction of bandwidth online . There is additional evidence (see, for example [49

Human Views: Extensions to the Department of Defense Architecture Framework

DTIC Science & Technology

2008-09-01

évaluent et prédisent les implications. Étant donné la complexité inhérente aux relations dans les S de S, l’absence de VH bien définies et universellement ...n.d.): 1. A Planning, Programming, Budgeting, and Execution process is used to conduct strategic planning and make resource allocation decisions; 2...Responsibilities in the form of functions and tasks have been allocated to each MMEV crew member. In addition, a set of competency requirements (e.g., KSA) has

Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.

PubMed

Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique

2017-05-01

The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.

Managing the Risks of Climate Change and Terrorism

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

Rosa, Eugene; Dietz, Tom; Moss, Richard H.

2012-04-07

Society has difficult decisions to make about how best to allocate its resources to ensure future sustainability. Risk assessment can be a valuable tool: it has long been used to support decisions to address environmental problems. But in a time when the risks to sustainability range from climate change to terrorism, applying risk assessment to sustainability will require careful rethinking. For new threats, we will need a new approach to risk assessment.

A Multi-Objective Decision-Making Model for Resources Allocation in Humanitarian Relief

DTIC Science & Technology

2007-03-01

Applied Mathematics and Computation 163, 2005, pp756 19. Malczewski, J., GIS and Multicriteria Decision Analysis , John Wiley and Sons, New York... used when interpreting the results of the analysis . (Raimo et al. 2002) (7) Sensitivity analysis Sensitivity analysis in a DA process answers...Budget Scenario Analysis The MILP is solved ( using LINDO 6.1) for high, medium and low budget scenarios in both damage degree levels. Tables 17 and

Allocating health care resources: a questionnaire experiment on the predictive success of rules.

PubMed

Ahlert, Marlies; Schwettmann, Lars

2017-06-26

The topic of this paper is related to equity in health within a country. In public health care sectors of many countries decisions on priority setting with respect to treatment of different types of diseases or patient groups are implicitly or explicitly made. Priorities are realized by allocation decisions for medical resources where moral judgments play an important role with respect to goals and measures that should be applied. The aim of this study is to explore the moral intuitions held in the German society related to priorities in medical treatment. We use an experimental questionnaire method established in the Empirical Social Choice literature. Participants are asked to make decisions in a sequence of distributive problems where a limited amount of treatment time has to be allocated to hypothetically described patients. The decision problems serve as an intuition pump. Situations are systematically varied with respect to patients' initial health levels, their ability to benefit from treatment time, and the amount of treatment time available. Subjects are also asked to describe their deliberations. We focus on the acceptance of different allocation principles including equity concepts and utilitarian properties. We investigate rule characteristics like order preservation or monotonicity with respect to resources, severity, or effectiveness. We check the consistency of individual choices with stated reasoning. The goals and allocation principles revealed show that the moral intuitions held by our experimental subjects are much more complex than the principles commonly applied in health economic theory. Especially, cost-utility principles are rarely applied, whereas the goal of equality of health gain is observed more often. The principle not to leave any patient untreated is very dominant. We also observe the degrees to which extent certain monotonicity principles, known from welfare economics, are followed. Subjects were able to describe their moral judgments in written statements. We also find evidence that they followed their respective intuitions very consistently in their decisions. Findings of the kind presented in this paper may serve as an important input for the public and political discussion when decisions on priorities in the public health care sector are formed.

Land Resources Allocation Strategies in an Urban Area Involving Uncertainty: A Case Study of Suzhou, in the Yangtze River Delta of China

NASA Astrophysics Data System (ADS)

Lu, Shasha; Guan, Xingliang; Zhou, Min; Wang, Yang

2014-05-01

A large number of mathematical models have been developed to support land resource allocation decisions and land management needs; however, few of them can address various uncertainties that exist in relation to many factors presented in such decisions (e.g., land resource availabilities, land demands, land-use patterns, and social demands, as well as ecological requirements). In this study, a multi-objective interval-stochastic land resource allocation model (MOISLAM) was developed for tackling uncertainty that presents as discrete intervals and/or probability distributions. The developed model improves upon the existing multi-objective programming and inexact optimization approaches. The MOISLAM not only considers economic factors, but also involves food security and eco-environmental constraints; it can, therefore, effectively reflect various interrelations among different aspects in a land resource management system. Moreover, the model can also help examine the reliability of satisfying (or the risk of violating) system constraints under uncertainty. In this study, the MOISLAM was applied to a real case of long-term urban land resource allocation planning in Suzhou, in the Yangtze River Delta of China. Interval solutions associated with different risk levels of constraint violation were obtained. The results are considered useful for generating a range of decision alternatives under various system conditions, and thus helping decision makers to identify a desirable land resource allocation strategy under uncertainty.

The Struggle to Satisfy Need: Exploring the Institutional Cues for Teaching Support Staff

ERIC Educational Resources Information Center

Winslett, Greg

2016-01-01

The decision-making around resource allocation in universities is complex. It plays out through the structures of governance and bureaucracy, through interactions with colleagues, workplace cultures and through day-to-day individual work practices. To survive and succeed within this complex environment, teaching support staff need to be sensitive…

Estimating the Difference between Published and Unpublished Effect Sizes: A Meta-Review

ERIC Educational Resources Information Center

Polanin, Joshua R.; Tanner-Smith, Emily E.; Hennessy, Emily A.

2016-01-01

Practitioners and policymakers rely on meta-analyses to inform decision making around the allocation of resources to individuals and organizations. It is therefore paramount to consider the validity of these results. A well-documented threat to the validity of research synthesis results is the presence of publication bias, a phenomenon where…

Estimating the Difference between Published and Unpublished Effect Sizes: A Meta-Review

ERIC Educational Resources Information Center

Polanin, Joshua R.; Tanner-Smith, Emily E.; Hennessy, Emily A.

2016-01-01

Practitioners and policymakers rely on meta-analyses to inform decision-making around the allocation of resources to individuals and organizations. It is therefore paramount to consider the validity of these results. A well-documented threat to the validity of research synthesis results is the presence of publication bias, a phenomenon where…

Conflicting Pressures That Impinge Upon the Operational Effectiveness of Institutional Researchers: Challenges to the Practitioner.

ERIC Educational Resources Information Center

Gubasta, Joseph L.

The numerous issues and problems facing college and university decisionmakers and the ever increasing information needs of external agency representatives place conflicting pressures on institutional research personnel, forcing them to make difficult decisions regarding the allocation of their resources. Outlined are several such pressures. It is…

Updating Rurality Index for Small Areas in Spain

ERIC Educational Resources Information Center

Prieto-Lara, Elisa; Ocana-Riola, Ricardo

2010-01-01

Nowadays, there is a wide debate about what rural means. An operational definition of rural concept is essential in order to measure health problems, optimize resource allocation and facilitate decision making aimed at closing the gap on inequity between areas. In 2005, the rurality index for Small Areas in Spain (IRAP) was developed using the…

A neotropical migratory bird prioritization for National Forests and Grasslands

Treesearch

Dick Roth; Richard Peterson

1997-01-01

The Rocky Mountain Region of the USDA Forest Service provides nesting habitat for 146 species of neotropical migratory birds. Interactive, prioritization databases were developed for each National Forest and National Grassland in the Region to assist land managers in making informed decisions about resource allocations. The data was processed using Paradox software....

Building Support for Student Success: A Framework for Achieving the Dream's State Policy Work

ERIC Educational Resources Information Center

Jobs for the Future, 2005

2005-01-01

This document is designed to help accelerate and strengthen state policy initiatives that promote student success; and derive lessons from this work about strategies for influencing the allocation of resources, the transparency of and accountability for results, and the rules that shape how institutions make decisions about priorities and…

Male-female differences in households' resource allocation and decision to seek healthcare in south-eastern Nigeria: Results from a mixed methods study.

PubMed

Onah, Michael Nnachebe; Horton, Susan

2018-05-01

Ability to influence household decision-making has been shown to increase with improved social capital and power and is linked to better access to household financial resources and other services outside the household including healthcare. To examine the male-female differences in household custody of financial resources, decision-making, and type of healthcare utilised, we used a mixed methods approach of cross-sectional household surveys and focus-group discussions (FGDs). Data was collected between 10 January-28 February 2011. We analyzed a sample of 411 households and a sub-sample of 223 households with a currently married head. We conducted six single-sex FGDs in 3 communities (1 urban, 2 rural) among a random sub-sample of participants in the survey. We performed univariate, bivariate, and logistic regression analyses with a 95% confidence interval. For the qualitative data, we performed thematic analysis where broad themes relevant to the research objective were abstracted. In all households and in those with a married head, sick male members were less likely to forgo healthcare (aOR all 0.87, 95% CI 0.80-0.90; aOR married 0.52, 95% CI 0.18-0.83) and more likely to utilise formal healthcare relative to female sick members (aOR all 3.36, 95% CI 3.20-3.87; aOR married 19.50, 95% CI 9.62-39.52). Formal healthcare providers are medically trained while informal providers are untrained vendors that dispense medications for profit. There were more reports of sole custody of household resources among men within households with married heads. Joint decision-making on healthcare expenditure improved women's access to healthcare but is not reflective of unhindered access to household financial resources. Qualitatively, women spoke of seeking permission from male household head before expenditure was incurred, while male heads spoke of concealing household financial resources from their spouse. Gender constructs and male-female differences have important effects on household resource allocation and healthcare utilisation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Health researchers' ancillary care obligations in low-resource settings: how can we tell what is morally required?

PubMed

Merritt, Maria W

2011-12-01

Health researchers working in low-resource settings often encounter serious unmet health needs among participants. What is the nature and extent of researchers' obligations to respond to such needs? Competing accounts have been proposed, but there is no independent standard by which to assess them or to guide future inquiry. I propose an independent standard and demonstrate its use. In conclusion I recommend two areas of focus for future inquiry: what makes an account of researchers' obligations reasonable from the standpoint of both participants and researchers and how general duties of rescue apply to researchers' resource-allocation decision making in low-resource settings.

A conceptual framework for economic optimization of an animal health surveillance portfolio.

PubMed

Guo, X; Claassen, G D H; Oude Lansink, A G J M; Saatkamp, H W

2016-04-01

Decision making on hazard surveillance in livestock product chains is a multi-hazard, multi-stakeholder, and multi-criteria process that includes a variety of decision alternatives. The multi-hazard aspect means that the allocation of the scarce resource for surveillance should be optimized from the point of view of a surveillance portfolio (SP) rather than a single hazard. In this paper, we present a novel conceptual approach for economic optimization of a SP to address the resource allocation problem for a surveillance organization from a theoretical perspective. This approach uses multi-criteria techniques to evaluate the performances of different settings of a SP, taking cost-benefit aspects of surveillance and stakeholders' preferences into account. The credibility of the approach has also been checked for conceptual validity, data needs and operational validity; the application potentials of the approach are also discussed.

Assessing the Influence of Farm Women's Self-Identity on Task Allocation and Decision Making.

ERIC Educational Resources Information Center

Bokemeier, Janet; Garkovich, Lorraine

1987-01-01

Uses data from survey of 880 Kentucky farm women to present theoretical framework integrating microsocial, household economy, and farm structural perspectives to explain gender allocation of farm-specific tasks and decision making. Finds self-identity validated by participation in farm tasks/decision making, but, overall, women indicate low levels…

Adaptive Allocation of Decision Making Responsibility Between Human and Computer in Multi-Task Situations. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Chu, Y. Y.

1978-01-01

A unified formulation of computer-aided, multi-task, decision making is presented. Strategy for the allocation of decision making responsibility between human and computer is developed. The plans of a flight management systems are studied. A model based on the queueing theory was implemented.

The social power of regret: the effect of social appraisal and anticipated emotions on fair and unfair allocations in resource dilemmas.

PubMed

van der Schalk, Job; Kuppens, Toon; Bruder, Martin; Manstead, Antony S R

2015-02-01

We investigated how another person's emotions about resource allocation decisions influence observers' resource allocations by influencing the emotions that observers anticipate feeling if they were to act in the same way. Participants were exposed to an exemplar who made a fair or unfair division in an economic game and expressed pride or regret about this decision. Participants then made their own resource allocation decisions. Exemplar regret about acting fairly decreased the incidence of fair behavior (Studies 1A and 1B). Likewise, exemplar regret about acting unfairly increased the incidence of fair behavior (Study 2). The effect of others' emotions on observers' behavior was mediated by the observers' anticipated emotions. We discuss our findings in light of the view that social appraisal and anticipated emotions are important tools for social learning and may contribute to the formation and maintenance of social norms about greed and fairness.

Probabilistic resource allocation system with self-adaptive capability

NASA Technical Reports Server (NTRS)

Yufik, Yan M. (Inventor)

1996-01-01

A probabilistic resource allocation system is disclosed containing a low capacity computational module (Short Term Memory or STM) and a self-organizing associative network (Long Term Memory or LTM) where nodes represent elementary resources, terminal end nodes represent goals, and directed links represent the order of resource association in different allocation episodes. Goals and their priorities are indicated by the user, and allocation decisions are made in the STM, while candidate associations of resources are supplied by the LTM based on the association strength (reliability). Reliability values are automatically assigned to the network links based on the frequency and relative success of exercising those links in the previous allocation decisions. Accumulation of allocation history in the form of an associative network in the LTM reduces computational demands on subsequent allocations. For this purpose, the network automatically partitions itself into strongly associated high reliability packets, allowing fast approximate computation and display of allocation solutions satisfying the overall reliability and other user-imposed constraints. System performance improves in time due to modification of network parameters and partitioning criteria based on the performance feedback.

Probabilistic resource allocation system with self-adaptive capability

NASA Technical Reports Server (NTRS)

Yufik, Yan M. (Inventor)

1998-01-01

A probabilistic resource allocation system is disclosed containing a low capacity computational module (Short Term Memory or STM) and a self-organizing associative network (Long Term Memory or LTM) where nodes represent elementary resources, terminal end nodes represent goals, and weighted links represent the order of resource association in different allocation episodes. Goals and their priorities are indicated by the user, and allocation decisions are made in the STM, while candidate associations of resources are supplied by the LTM based on the association strength (reliability). Weights are automatically assigned to the network links based on the frequency and relative success of exercising those links in the previous allocation decisions. Accumulation of allocation history in the form of an associative network in the LTM reduces computational demands on subsequent allocations. For this purpose, the network automatically partitions itself into strongly associated high reliability packets, allowing fast approximate computation and display of allocation solutions satisfying the overall reliability and other user-imposed constraints. System performance improves in time due to modification of network parameters and partitioning criteria based on the performance feedback.

Decentralization in Zambia: resource allocation and district performance.

PubMed

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or negative impact on services.

Allocating Resources for Learning Support: A Case Study.

ERIC Educational Resources Information Center

Sharp, Stephen

2000-01-01

Examines how learning-support resources are allocated to Scottish secondary schools, drawing on data from an Edinburgh education authority. Although a rationale for allocating resources based on socioeconomic indices can be constructed, basing decisions on a combination of standardized attainment tests and special-needs audits is preferable.…

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

PubMed Central

2013-01-01

Background Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Methods Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. Results About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as ‘good’ or ‘very good’. This paper explores these findings in greater detail and assesses them in context of the larger literature. Conclusion Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada’s health system leadership teams. PMID:23819598

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

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

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

DOE PAGES

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu; ...

2017-10-11

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

Resource allocation decisions in low-income rural households.

PubMed

Franklin, D L; Harrell, M W

1985-05-01

This paper is based on the theory that a society's nutritional well-being is both a cause and a consequence of the developmental process within that society. An approach to the choices made by poor rural households regarding food acquisition and nurturing behavior is emerging from recent research based on the new economic theory of household production. The central thesis of this approach is that household decisions related to the fulfillment of basic needs are strongly determined by decisions on the allocation of time to household production activities. Summarized are the results of the estimation of a model of household production and consumption behavior with data from a cross-sectional survey of 30 rural communities in Veraguas Province, Panama. The struture of the model consists of allocation of resources to nurturing activities and to production activities. The resources to be allocated are time and market goods, and in theory, these are allocated according to relative prices. The empirical results of this study are generally consistent with the predictions of the neoclassical economic model of household resource allocation. The major conclusions that time allocations and market price conditions matter in the determination of well-being in low-income rural households and, importantly, that nurturing decisions significantly affect the product and factor market behavior of these households form the basis for a discussion on implucations for agricultural and rural development. Programs and policies that seek nutritional improvement should be determined with explicit recognition of the value of time and the importance of timing in the decisions of the poor.

Digital Geography and the Race for the White House

ERIC Educational Resources Information Center

Kenreich, Todd W.

2016-01-01

With the 2016 presidential election right around the corner, geography provides a dynamic view of the spatial patterns and processes that shape the electorate. The major presidential campaigns know that a winning strategy must use geography to make informed decisions about where to allocate limited resources such as money and staff. In the end,…

An Examination of the Relationships among Student Services Expenditures, Pell Grant Funding, and Completion Rates at Public Community Colleges

ERIC Educational Resources Information Center

Racioppi, Gerald William

2014-01-01

Because of shrinking budgets, increasing demand, and calls for more graduates, community college leaders are forced to make difficult resource allocation decisions. In many states, sizable percentages of the state funds available to community colleges are conditional on performance measures, including graduations; the number of states with funding…

Decision Making in Intercollegiate Athletics: One Institution's Journey to Maintain Title IX Compliance

ERIC Educational Resources Information Center

Rowland, John W.

2012-01-01

The allocation of resources and participation opportunities in intercollegiate athletics has been a debate among researchers for nearly 40 years. Title IX and traditionally male-dominated budgeting practices continue to be opposing forces that shape the financial and gender makeup of university athletic departments. In fact, the need to be Title…

Unmet Needs of Families of School-Aged Children with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Brown, Hilary K.; Ouellette-Kuntz, Helene; Hunter, Duncan; Kelley, Elizabeth; Cobigo, Virginie

2012-01-01

Background: To aid decision making regarding the allocation of limited resources, information is needed on the perceived unmet needs of parents of school-aged children with an autism spectrum disorder. Materials and Methods: A cross-sectional survey was conducted of 101 Canadian families of school-aged children with an autism spectrum disorder.…

Introduction to Strategic Planning in Student Affairs: A Model for Process and Elements of a Plan

ERIC Educational Resources Information Center

Ellis, Shannon E.

2010-01-01

Planning from a strategic perspective has been a mainstay of organizational management for decades. Founded in the private sector, strategic planning is now embraced by the nonprofit world as a catalyst for sound resource allocation, transformative decision making, and motivating staff. Student affairs professionals who think, plan, and act…

WEALTH, EXPENDITURES AND DECISION-MAKING FOR EDUCATION.

ERIC Educational Resources Information Center

JAMES, H. THOMAS; AND OTHERS

THE SECOND IN A SERIES OF STUDIES OF THE PROCESSES BY WHICH RESOURCES IN THE UNITED STATES ARE ALLOCATED TO THE SUPPORT OF PUBLIC EDUCATION IS PRESENTED. A RATIONALE FOR THE STUDY OF SCHOOL FINANCE WAS FORMULATED AND APPLIED TO EXPLAIN VARIATIONS IN EXPENDITURES ASSOCIATED WITH STATE EFFORTS TO EQUALIZE BOTH EDUCATIONAL BENEFITS AND TAX LOADS.…

State Plan for Technology for the State Board of Education of Ohio.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus.

The state plan for educational technology in Ohio has been developed to facilitate a basic understanding of the broad scope of technology and how it can affect learning positively. It is also intended to provide a framework for policy and resource allocation decision making. Massive systemic changes in curriculum, professional development, and…

Two-stage seasonal streamflow forecasts to guide water resources decisions and water rights allocation

NASA Astrophysics Data System (ADS)

Block, P. J.; Gonzalez, E.; Bonnafous, L.

2011-12-01

Decision-making in water resources is inherently uncertain producing copious risks, ranging from operational (present) to planning (season-ahead) to design/adaptation (decadal) time-scales. These risks include human activity and climate variability/change. As the risks in designing and operating water systems and allocating available supplies vary systematically in time, prospects for predicting and managing such risks become increasingly attractive. Considerable effort has been undertaken to improve seasonal forecast skill and advocate for integration to reduce risk, however only minimal adoption is evident. Impediments are well defined, yet tailoring forecast products and allowing for flexible adoption assist in overcoming some obstacles. The semi-arid Elqui River basin in Chile is contending with increasing levels of water stress and demand coupled with insufficient investment in infrastructure, taxing its ability to meet agriculture, hydropower, and environmental requirements. The basin is fed from a retreating glacier, with allocation principles founded on a system of water rights and markets. A two-stage seasonal streamflow forecast at leads of one and two seasons prescribes the probability of reductions in the value of each water right, allowing water managers to inform their constituents in advance. A tool linking the streamflow forecast to a simple reservoir decision model also allows water managers to select a level of confidence in the forecast information.

New algorithms for optimal reduction of technical risks

NASA Astrophysics Data System (ADS)

Todinov, M. T.

2013-06-01

The article features exact algorithms for reduction of technical risk by (1) optimal allocation of resources in the case where the total potential loss from several sources of risk is a sum of the potential losses from the individual sources; (2) optimal allocation of resources to achieve a maximum reduction of system failure; and (3) making an optimal choice among competing risky prospects. The article demonstrates that the number of activities in a risky prospect is a key consideration in selecting the risky prospect. As a result, the maximum expected profit criterion, widely used for making risk decisions, is fundamentally flawed, because it does not consider the impact of the number of risk-reward activities in the risky prospects. A popular view, that if a single risk-reward bet with positive expected profit is unacceptable then a sequence of such identical risk-reward bets is also unacceptable, has been analysed and proved incorrect.

The SIMRAND methodology - Simulation of Research and Development Projects

NASA Technical Reports Server (NTRS)

Miles, R. F., Jr.

1984-01-01

In research and development projects, a commonly occurring management decision is concerned with the optimum allocation of resources to achieve the project goals. Because of resource constraints, management has to make a decision regarding the set of proposed systems or tasks which should be undertaken. SIMRAND (Simulation of Research and Development Projects) is a methodology which was developed for aiding management in this decision. Attention is given to a problem description, aspects of model formulation, the reduction phase of the model solution, the simulation phase, and the evaluation phase. The implementation of the considered approach is illustrated with the aid of an example which involves a simplified network of the type used to determine the price of silicon solar cells.

Exposing ecological and economic costs of the research-implementation gap and compromises in decision making.

PubMed

Kareksela, Santtu; Moilanen, Atte; Ristaniemi, Olli; Välivaara, Reima; Kotiaho, Janne S

2018-02-01

The frequently discussed gap between conservation science and practice is manifest in the gap between spatial conservation prioritization plans and their implementation. We analyzed the research-implementation gap of one zoning case by comparing results of a spatial prioritization analysis aimed at avoiding ecological impact of peat mining in a regional zoning process with the final zoning plan. We examined the relatively complex planning process to determine the gaps among research, zoning, and decision making. We quantified the ecological costs of the differing trade-offs between ecological and socioeconomic factors included in the different zoning suggestions by comparing the landscape-level loss of ecological features (species occurrences, habitat area, etc.) between the different solutions for spatial allocation of peat mining. We also discussed with the scientists and planners the reasons for differing zoning suggestions. The implemented plan differed from the scientists suggestion in that its focus was individual ecological features rather than all the ecological features for which there were data; planners and decision makers considered effects of peat mining on areas not included in the prioritization analysis; zoning was not truly seen as a resource-allocation process and not emphasized in general minimizing ecological losses while satisfying economic needs (peat-mining potential); and decision makers based their prioritization of sites on site-level information showing high ecological value and on single legislative factors instead of finding a cost-effective landscape-level solution. We believe that if the zoning and decision-making processes are very complex, then the usefulness of science-based prioritization tools is likely to be reduced. Nevertheless, we found that high-end tools were useful in clearly exposing trade-offs between conservation and resource utilization. © 2017 Society for Conservation Biology.

Water Market-scale Agricultural Planning: Promoting Competing Water Resource Use Efficiency Through Agro-Economics

NASA Astrophysics Data System (ADS)

Delorit, J. D.; Block, P. J.

2017-12-01

Where strong water rights law and corresponding markets exist as a coupled econo-legal mechanism, water rights holders are permitted to trade allocations to promote economic water resource use efficiency. In locations where hydrologic uncertainty drives the assignment of annual per-water right allocation values by water resource managers, collaborative water resource decision making by water rights holders, specifically those involved in agricultural production, can result in both resource and economic Pareto efficiency. Such is the case in semi-arid North Chile, where interactions between representative farmer groups, treated as competitive bilateral monopolies, and modeled at water market-scale, can provide both price and water right allocation distribution signals for unregulated, temporary water right leasing markets. For the range of feasible per-water right allocation values, a coupled agricultural-economic model is developed to describe the equilibrium distribution of water, the corresponding market price of water rights and the net surplus generated by collaboration between competing agricultural uses. Further, this research describes a per-water right inflection point for allocations where economic efficiency is not possible, and where price negotiation among competing agricultural uses is required. An investigation of the effects of water right supply and demand inequality at the market-scale is completed to characterize optimal market performance under existing water rights law. The broader insights of this research suggest that water rights holders engaged in agriculture can achieve economic benefits from forming crop-type cooperatives and by accurately assessing the economic value of allocation.

A model of interaction between anticorruption authority and corruption groups

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

Neverova, Elena G.; Malafeyef, Oleg A.

The paper provides a model of interaction between anticorruption unit and corruption groups. The main policy functions of the anticorruption unit involve reducing corrupt practices in some entities through an optimal approach to resource allocation and effective anticorruption policy. We develop a model based on Markov decision-making process and use Howard’s policy-improvement algorithm for solving an optimal decision strategy. We examine the assumption that corruption groups retaliate against the anticorruption authority to protect themselves. This model was implemented through stochastic game.

Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

PubMed

Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Wilkinson, Thomas; Thiboonboon, Kittiphong; Rattanavipapong, Waranya; Walker, Damian G; Chalkidou, Kalipso; Teerawattananon, Yot

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

The Social Power of Regret: The Effect of Social Appraisal and Anticipated Emotions on Fair and Unfair Allocations in Resource Dilemmas

PubMed Central

2014-01-01

We investigated how another person’s emotions about resource allocation decisions influence observers’ resource allocations by influencing the emotions that observers anticipate feeling if they were to act in the same way. Participants were exposed to an exemplar who made a fair or unfair division in an economic game and expressed pride or regret about this decision. Participants then made their own resource allocation decisions. Exemplar regret about acting fairly decreased the incidence of fair behavior (Studies 1A and 1B). Likewise, exemplar regret about acting unfairly increased the incidence of fair behavior (Study 2). The effect of others’ emotions on observers’ behavior was mediated by the observers’ anticipated emotions. We discuss our findings in light of the view that social appraisal and anticipated emotions are important tools for social learning and may contribute to the formation and maintenance of social norms about greed and fairness. PMID:25384163

Decision support system for health care resources allocation

PubMed Central

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-01-01

Background A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. Aim The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. Methods To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. Results A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. Conclusion In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff. PMID:28848645

Decision support system for health care resources allocation.

PubMed

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-06-01

A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

Making the right decisions about new technologies: a perspective on criteria and preferences in hospitals.

PubMed

Gurtner, Sebastian

2014-01-01

Decision makers in hospitals are regularly faced with choices about the adoption of new technologies. Wrong decisions lead to a waste of resources and can have serious effects on the patients' and hospital's well-being. The goal of this research was to contribute to the understanding of decision making in hospitals. This study produced insights regarding relevant decision criteria and explored their specific relevance. An initial empirical survey was used to collect the relevant criteria for technological decision making in hospitals. In total, 220 experts in the field of health technology assessment from 34 countries participated in the survey. As a second step, the abovementioned criteria were used to form the basis of an analytic hierarchy process model. A group of 115 physicians, medical technical assistants, and other staff, all of whom worked in the field of radiooncology, prioritized the criteria. An analysis of variance was performed to explore differences among groups in terms of institutional and personal categorization variables. The first part of the research revealed seven key criteria for technological decision making in hospitals. The analytic hierarchy process model revealed that organizational impact was the most important criterion, followed by budget impact. The analysis of variance indicated that there were differences in the perceptions of the importance of the identified criteria. This exploration of the criteria for technological decision making in hospitals will help decision makers consider all of the relevant aspects, leading to more structured and rational decisions. For the optimal resource allocation, all of the relevant stakeholder perspectives and local issues must be considered appropriately.

Investigation of Education Databases in Four States To Support Policy Research on Resource Allocation. Policy Report

ERIC Educational Resources Information Center

Pan, Diane; Smith-Hansen, Lotte; Jones, Debra Hughes; Rudo, Zena H.; Alexander, Celeste; Kahlert, Rahel Kahlert, Rahel

2004-01-01

Information is one of the most important tools education decision makers need to help them effectively spend taxpayer money, allocate qualified staff, and determine the effectiveness of education investments. Decision makers must understand the role and influence of monetary and staff resources on the education system, and they must have…

Results from a preliminary study to develop the quality adjustments for quality adjusted life year values for Trinidad and Tobago.

PubMed

Bailey, H

2013-07-01

No country can afford to provide all necessary healthcare for its citizens, so prioritization among interventions must feature in all health systems. Resources in health should be allocated among interventions/facilities/patients in such a way as to be in line with the objectives of the health system. To achieve this, resource allocation decisions must be informed by the relative contributions that prospective interventions will make to societal health and to costs. Internationally, the EQ-5D based quality adjusted life year (QALY) now dominates this kind of analysis. This paper reports on a pilot study to develop an EQ-5D-3L value set for Trinidad and Tobago based on a protocol that avoids some of the issues that are associated with other approaches to developing such value sets such as the complex elicitation tasks that respondents must carry out, and the large respondent samples required for collecting multiple valuation subset values using blocked designs. An orthogonal discrete choice experiment design was used to elicit a set of choices from a sample of respondents. The choice data were analysed using mixed multinomial logistic regression to produce an internally valid model that predicts well. This paper marks an important milestone in the development of health resource allocation in the Caribbean. It sets out the importance of incorporating the impact of health interventions to inform health resource allocation decisions, describes the elicitation and analysis methods used in the pilot and provides an illustration of the use of the EQ-5D value set.

Theory of Mind is Related to Children’s Resource Allocations in Gender Stereotypic Contexts

PubMed Central

Rizzo, Michael T.; Killen, Melanie

2017-01-01

The present study investigated the relations between 4- to 6-year-old children’s (N = 67) gender stereotypes, resource allocations, and mental state knowledge in gender stereotypic contexts. Participants were told vignettes about female and male characters completing gender-stereotyped activities (making dolls or trucks). Children held stereotypic expectations regarding doll- and truck-making abilities, and these expectations predicted the degree of bias in their allocations of resources to the characters. Critically, children’s performance on a ToM scale (Diverse Desires, Contents False-Belief, Belief-Emotion) was significantly related to their allocations of resources to individuals whose effort did not fit existing gender stereotypes (e.g., a boy who was good at making dolls). With increasing ToM competence, children allocated resources based on merit (even when the character’s effort did not fit existing gender stereotypes) rather than based on stereotypes. The present results provide novel information regarding the emergence of gender stereotypes about abilities, the influence of stereotypes on children’s resource allocations, and the role of ToM in children’s ability to challenge gender stereotypes when allocating resources. PMID:29083217

How Managers' everyday decisions create or destroy your company's strategy.

PubMed

Bower, Joseph L; Gilbert, Clark G

2007-02-01

Senior executives have long been frustrated by the disconnection between the plans and strategies they devise and the actual behavior of the managers throughout the company. This article approaches the problem from the ground up, recognizing that every time a manager allocates resources, that decision moves the company either into or out of alignment with its announced strategy. A well-known story--Intel's exit from the memory business--illustrates this point. When discussing what businesses Intel should be in, Andy Grove asked Gordon Moore what they would do if Intel were a company that they had just acquired. When Moore answered, "Get out of memory," they decided to do just that. It turned out, though, that Intel's revenues from memory were by this time only 4% of total sales. Intel's lower-level managers had already exited the business. What Intel hadn't done was to shut down the flow of research funding into memory (which was still eating up one-third of all research expenditures); nor had the company announced its exit to the outside world. Because divisional and operating managers-as well as customers and capital markets-have such a powerful impact on the realized strategy of the firm, senior management might consider focusing less on the company's formal strategy and more on the processes by which the company allocates resources. Top managers must know the track record of the people who are making resource allocation proposals; recognize the strategic issues at stake; reach down to operational managers to work across division lines; frame resource questions to reflect the corporate perspective, especially when large sums of money are involved and conditions are highly uncertain; and create a new context that allows top executives to circumvent the regular resource allocation process when necessary.

Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol.

PubMed

Sarkies, Mitchell N; White, Jennifer; Morris, Meg E; Taylor, Nicholas F; Williams, Cylie; O'Brien, Lisa; Martin, Jenny; Bardoel, Anne; Holland, Anne E; Carey, Leeanne; Skinner, Elizabeth H; Bowles, Kelly-Ann; Grant, Kellie; Philip, Kathleen; Haines, Terry P

2018-04-24

It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers. This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up. Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice. This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ( ACTRN12618000029291 ). Universal Trial Number (UTN): U1111-1205-2621.

Gender roles and relationships: Implications for water management

NASA Astrophysics Data System (ADS)

Peter, G.

This study mainstreams gender at household level by showing how the gendered roles and relations between women and men influence access, allocation and use of resources in a rural community, Makhosini, in Swaziland. Implications of the identified gender roles and relationships for water management in Swaziland are highlighted. The working hypotheses of this study are (i) that gender-neutral development initiatives will benefit equally women and men at household level; and (ii) in Swaziland the trend toward irrigated agriculture for food security will have unequal impacts on men and women as access, allocation and use of key resources is highly gendered, privileging men as the value of the resource increases. In this study, a questionnaire was administered to sampled male and female heads of household as well as women under male heads. The heads were asked to indicate the roles they play and key decisions they make in resource use as heads of households. The women under male heads were also asked to indicate their roles and key decision responsibilities. The key resources considered were land and crops produced. Comparative analysis on roles and decisions made as well as access and use of resources and production was done by gender and between the women groups. The results show marked gender differences within households and across resources. Men were overwhelmingly involved in productive roles, giving low priority to reproductive roles. In contrast, priority of women’s roles were reproductive in nature. The key findings are that there were no significant differences in the roles of men and women as heads of households. Women as heads of households assume the same roles as those of men heads suggesting relative gender-neutrality. Also all women played “double-day” roles. However, the data reveals that men dominate decisions on crops to be grown, inputs to be used, disposal of the products and use of income obtained. Only a small percentage of women claimed influence over decisions on high-income generating crops such as sugarcane. A majority of women did demonstrate influence in the areas of key rainfed crops such as sweet potatoes and maize. The only area where women had full control was on grass used for making handicrafts. The implications for water resources management are that gender-blind decisions regarding the importance of irrigated crop production for household security may in fact remove decision-making capacity out of the hands of women so increasing the gendered-nature of food insecurity. At the same time, however, women household heads do show some influence in irrigated crop production and in high-value rainfed crop production. This suggests possibilities for in-building gender-neutral practices where high value crops are concerned.

Public health equity in refugee situations

PubMed Central

2011-01-01

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions. PMID:21575218

Public health equity in refugee situations.

PubMed

Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

2011-05-16

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

Resource allocation for mitigating regional air pollution–related mortality: A summertime case study for five cities in the United States

PubMed Central

Liao, Kuo-Jen; Hou, Xiangting; Strickland, Matthew J.

2016-01-01

ABSTRACT An important issue of regional air quality management is to allocate air quality management funds to maximize environmental and human health benefits. In this study, we use an innovative approach to tackle this air quality management issue. We develop an innovative resource allocation model that allows identification of air pollutant emission control strategies that maximize mortality avoidances subject to a resource constraint. We first present the development of the resource allocation model and then a case study to show how the model can be used to identify resource allocation strategies that maximize mortality avoidances for top five Metropolitan Statistical Areas (MSAs) (i.e., New York, Los Angeles, Chicago, Dallas-Fort Worth, and Philadelphia) in the continental United States collectively. Given budget constraints in the U.S. Environmental Protection Agency’s (EPA) Clean Air Act assessment, the results of the case study suggest that controls of sulfur dioxide (SO2) and primary carbon (PC) emissions from EPA Regions 2, 3, 5, 6, and 9 would have significant health benefits for the five selected cities collectively. Around 30,800 air pollution–related mortalities could be avoided during the selected 2-week summertime episode for the five cities collectively if the budget could be allocated based on the results of the resource allocation model. Although only five U.S. cities during a 2-week episode are considered in the case study, the resource allocation model can be used by decision-makers to plan air pollution mitigation strategies to achieve the most significant health benefits for other seasons and more cities over a region or the continental U.S.Implications: Effective allocations of air quality management resources are challenging and complicated, and it is desired to have a tool that can help decision-makers better allocate the funds to maximize health benefits of air pollution mitigation. An innovative resource allocation model developed in this study can help decision-makers identify the best resource allocation strategies for multiple cities collectively. The results of a case study suggest that controls of primary carbon and sulfur dioxides emissions would achieve the most significant health benefits for five selected cities collectively. PMID:27441782

Optimized maritime emergency resource allocation under dynamic demand.

PubMed

Zhang, Wenfen; Yan, Xinping; Yang, Jiaqi

2017-01-01

Emergency resource is important for people evacuation and property rescue when accident occurs. The relief efforts could be promoted by a reasonable emergency resource allocation schedule in advance. As the marine environment is complicated and changeful, the place, type, severity of maritime accident is uncertain and stochastic, bringing about dynamic demand of emergency resource. Considering dynamic demand, how to make a reasonable emergency resource allocation schedule is challenging. The key problem is to determine the optimal stock of emergency resource for supplier centers to improve relief efforts. This paper studies the dynamic demand, and which is defined as a set. Then a maritime emergency resource allocation model with uncertain data is presented. Afterwards, a robust approach is developed and used to make sure that the resource allocation schedule performs well with dynamic demand. Finally, a case study shows that the proposed methodology is feasible in maritime emergency resource allocation. The findings could help emergency manager to schedule the emergency resource allocation more flexibly in terms of dynamic demand.

Optimized maritime emergency resource allocation under dynamic demand

PubMed Central

Yan, Xinping; Yang, Jiaqi

2017-01-01

Emergency resource is important for people evacuation and property rescue when accident occurs. The relief efforts could be promoted by a reasonable emergency resource allocation schedule in advance. As the marine environment is complicated and changeful, the place, type, severity of maritime accident is uncertain and stochastic, bringing about dynamic demand of emergency resource. Considering dynamic demand, how to make a reasonable emergency resource allocation schedule is challenging. The key problem is to determine the optimal stock of emergency resource for supplier centers to improve relief efforts. This paper studies the dynamic demand, and which is defined as a set. Then a maritime emergency resource allocation model with uncertain data is presented. Afterwards, a robust approach is developed and used to make sure that the resource allocation schedule performs well with dynamic demand. Finally, a case study shows that the proposed methodology is feasible in maritime emergency resource allocation. The findings could help emergency manager to schedule the emergency resource allocation more flexibly in terms of dynamic demand. PMID:29240792

Modeling Resource Hotspots: Critical Linkages and Processes

NASA Astrophysics Data System (ADS)

Daher, B.; Mohtar, R.; Pistikopoulos, E.; McCarl, B. A.; Yang, Y.

2017-12-01

Growing demands for interconnected resources emerge in the form of hotspots of varying characteristics. The business as usual allocation model cannot address the current, let alone anticipated, complex and highly interconnected resource challenges we face. A new paradigm for resource allocation must be adopted: one that identifies cross-sectoral synergies and, that moves away from silos to recognition of the nexus and integration of it. Doing so will result in new opportunities for business growth, economic development, and improved social well-being. Solutions and interventions must be multi-faceted; opportunities should be identified with holistic trade-offs in mind. No single solution fits all: different hotspots will require distinct interventions. Hotspots have varying resource constraints, stakeholders, goals and targets. The San Antonio region represents a complex resource hotspot with promising potential: its rapidly growing population, the Eagle Ford shale play, and the major agricultural activity there makes it a hotspot with many competing demands. Stakeholders need tools to allow them to knowledgeably address impending resource challenges. This study will identify contemporary WEF nexus questions and critical system interlinkages that will inform the modeling of the tightly interconnected resource systems and stresses using the San Antonio Region as a base; it will conceptualize a WEF nexus modeling framework, and develop assessment criteria to inform integrative planning and decision making.

[Basic principles and methodological considerations of health economic evaluations].

PubMed

Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

2011-01-01

Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

Demystifying governance and its role for transitions in urban social–ecological systems

Treesearch

T.A. Muñoz-Erickson; L.K. Campbell; D.L. Childers; J.M. Grove; D.M. Iwaniec; S.T.A. Pickett; Michelle Romolini; Erika S. Svendsen

2016-01-01

Governance is key to sustainable urban transitions. Governance is a system of social, power, and decision-making processes that acts as a key driver of resource allocation and use, yet ecologists even urban ecologists–seldom consider governance concepts in their work. Transitions to more sustainable futures are becoming increasingly important to the management of many...

Fostering Innovation: How User-Centered Design Can Help Us Get the Local Control Funding Formula Right. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel; Ramanathan, Arun; Carter, Allison; O'Day, Jennifer

2017-01-01

The Local Control Funding Formula (LCFF) has introduced positive and much-needed change to California's approach to K-12 education funding by allocating resources according to student need and freeing districts to make decisions that address local priorities. For all of LCFF's advantages, however, the Local Control Accountability Plans (LCAPs) in…

Roadmap for K-12 and Postsecondary Linkages: Key Focus Areas to Ensure Quality Implementation. Data for Action

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

States rely on data from both the K-12 and postsecondary sectors to inform policy discussions; chart the progress of students, schools, districts, colleges, and the state; pinpoint best practices and areas of need; allocate scarce resources; and make other important education decisions every day. However, states need to securely link limited, but…

Application of a Dynamic Programming Algorithm for Weapon Target Assignment

DTIC Science & Technology

2016-02-01

25] A . Turan , “Techniques for the Allocation of Resources Under Uncertainty,” Middle Eastern Technical University, Ankara, Turkey, 2012. [26] K...UNCLASSIFIED UNCLASSIFIED Application of a Dynamic Programming Algorithm for Weapon Target Assignment Lloyd Hammond Weapons and...optimisation techniques to support the decision making process. This report documents the methodology used to identify, develop and assess a

The Use of Linear Models for Determining School Workload and Activity Level.

ERIC Educational Resources Information Center

Vicino, Frank L.

This paper outlines the design and use of two linear models as decision-making tools in a school district. The problem to be solved was the allocation of resources for both clerical and custodial personnel. A solution was desired that could be quantified and documented and objectively serve the needs of the district. A clerical support model was…

Preserving Range and Airspace Access for the Air Force Mission: Striving for a Strategic Vantage Point

DTIC Science & Technology

2011-01-01

before public and private entities . This is one in a series of RAND reports that addresses improving the Air Force’s ability to connect operational...53 C. Joint Mission Framework ...by the lack of a common framework for making decisions about range use and resource allocation. This situation requires managers at all levels to

Portfolio evaluation of health programs: a reply to Sendi et al.

PubMed

Bridges, John F P; Terris, Darcey D

2004-05-01

Sendi et al. (Soc. Sci. Med. 57 (2003) 2207) extend previous research on cost-effectiveness analysis to the evaluation of a portfolio of interventions with risky outcomes using a "second best" approach that can identify improvements in efficiency in the allocation of resources. This method, however, cannot be used to directly identify the optimal solution to the resource allocation problem. Theoretically, a stricter adherence to the foundations of portfolio theory would permit direct optimization in portfolio selection, however, when we include uncertainty in our analysis in addition to the traditional concept of risk (which is often mislabelled uncertainty) complexities are introduced that create significant hurdles in the development of practical applications of portfolio theory for health care policy decision making.

Bringing ecosystem services into integrated water resources management.

PubMed

Liu, Shuang; Crossman, Neville D; Nolan, Martin; Ghirmay, Hiyoba

2013-11-15

In this paper we propose an ecosystem service framework to support integrated water resource management and apply it to the Murray-Darling Basin in Australia. Water resources in the Murray-Darling Basin have been over-allocated for irrigation use with the consequent degradation of freshwater ecosystems. In line with integrated water resource management principles, Australian Government reforms are reducing the amount of water diverted for irrigation to improve ecosystem health. However, limited understanding of the broader benefits and trade-offs associated with reducing irrigation diversions has hampered the planning process supporting this reform. Ecosystem services offer an integrative framework to identify the broader benefits associated with integrated water resource management in the Murray-Darling Basin, thereby providing support for the Government to reform decision-making. We conducted a multi-criteria decision analysis for ranking regional potentials to provide ecosystem services at river basin scale. We surveyed the wider public about their understanding of, and priorities for, managing ecosystem services and then integrated the results with spatially explicit indicators of ecosystem service provision. The preliminary results of this work identified the sub-catchments with the greatest potential synergies and trade-offs of ecosystem service provision under the integrated water resources management reform process. With future development, our framework could be used as a decision support tool by those grappling with the challenge of the sustainable allocation of water between irrigation and the environment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Reflecting on the efficacy of cognitive mapping for decision-making in intellectual disability care: a case study.

PubMed

Duryan, Meri; Nikolik, Dragan; van Merode, Godefridus; Curfs, Leopold M G

2015-01-01

The central aspect of this study is a set of reflections on the efficacy of soft operational research techniques in understanding the dynamics of a complex system such as intellectual disability (ID) care providers. Organizations providing services to ID patients are complex and have many interacting stakeholders with often different and competing interests. Understanding the causes for failures in complex systems is crucial for appreciating the multiple perspectives of the key stakeholders of the system. Knowing the factors that adversely affect delivery of a patient-centred care by ID provider organizations offers the potential for identifying more effective resource-allocation solutions. The authors suggest cognitive mapping as a starting point for system dynamics modelling of optimal resource-allocation projects in ID care. The application of the method is illustrated via a case study in one of the ID care providers in the Netherlands. The paper discusses some of the practical implications of applying problem-structuring methods that support gathering feedback from vulnerable service users and front-line workers. The authors concluded that cognitive mapping technique can assist the management of healthcare organizations in strategic decision-making. Copyright © 2013 John Wiley & Sons, Ltd.

Single-room usage patterns and allocation decision-making in an Australian public hospital: a sequential exploratory study.

PubMed

Bloomer, Melissa J; Lee, Susan F; Lewis, David P; Biro, Mary Anne; Moss, Cheryle

2016-08-01

The aims are to (1) measure occupancy rates of single and shared rooms; (2) compare single room usage patterns and (3) explore the practice, rationale and decision-making processes associated with single rooms; across one Australian public health service. There is a tendency in Australia and internationally to increase the proportion of single patient rooms in hospitals. To date there have been no Australian studies that investigate the use of single rooms in clinical practice. This study used a sequential exploratory design with data collected in 2014. A descriptive survey was used to measure the use of single rooms across a two-week time frame. Semi-structured interviews were undertaken with occupancy decision-makers to explore the practices, rationale decision-making process associated with single-room allocation. Total bed occupancy did not fall below 99·4% during the period of data collection. Infection control was the primary reason for patients to be allocated to a single room, however, the patterns varied according to ward type and single-room availability. For occupancy decision-makers, decisions about patient allocation was a complex and challenging process, influenced and complicated by numerous factors including occupancy rates, the infection status of the patient/s, funding and patient/family preference. Bed moves were common resulting from frequent re-evaluation of need. Apart from infection control mandates, there was little tangible evidence to guide decision-making about single-room allocation. Further work is necessary to assist nurses in their decision-making. There is a trend towards increasing the proportion of single rooms in new hospital builds. Coupled with the competing clinical demands for single room care, this study highlights the complexity of nursing decision-making about patient allocation to single rooms, an issue urgently requiring further attention. © 2016 John Wiley & Sons Ltd.

Don't tell on me: Experimental evidence of asymmetric information in transnational households*

PubMed Central

Ambler, Kate

2014-01-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information. PMID:25558123

Don't tell on me: Experimental evidence of asymmetric information in transnational households.

PubMed

Ambler, Kate

2015-03-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information.

Summary of Research 1997 Department of Systems Management.

DTIC Science & Technology

1999-01-01

formulation and execution; impacts of budget allocation , reallocation, and reduction; imple- mentation of Defense Resource Management Systems; and the...flexible structure that can be applied to a wide range of resource allocation problems. PUBLICATIONS: Dolk, D., Murphy, M., and Thomas, G...policies, procedures, and rationale in deter- mining recruiting resource allocation decisions. The methodology relies on a review of the literature

Organizational values in the provision of access to care for the uninsured

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Background For the last 20 years, health provider organizations have made efforts to align mission, values, and everyday practices to ensure high-quality, high-value, and ethical care. However, little attention has been paid to the organizational values and practices of community-based programs that organize and facilitate access to care for uninsured populations. This study aimed to identify and describe organizational values relevant to resource allocation and policy decisions that affect the services offered to members, using the case of community access programs: county-based programs that provide access to care for the uninsured working poor. Methods Comparative and qualitative case study methodology was used, including document review, observations, and key informant interviews, at two geographically diverse programs. Results Nine values were identified as relevant to decision making: stewardship, quality care, access to care, service to others, community well-being, member independence, organizational excellence, decency, and fairness. The way these values were deployed in resource allocation decisions that affected services offered to the uninsured are illustrated in one example per site. Conclusions This study addresses the previous dearth in the literature regarding an empirical description of organizational values employed in decision making of community organizations. To assess the transferability of the values identified, we compared our empirical results to prior empirical and conceptual work in the United States and internationally and found substantial alignment. Future studies can examine whether the identified organizational values are reflective of those at other health care organizations. PMID:28781981

Exploring decision-making for environmental health services: perspectives from four cities.

PubMed

Hunt, C; Lewin, S

2000-01-01

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Interest representation in soviet policymaking: A case study of a West Siberian energy coalition

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

Chung, H.

1986-01-01

Dr. Chung examines a little-known facet of Soviet decision making - pressure group politics and policy formation. He focuses on the ''pro-Siberian'' forces involved with the development of energy resources in West Siberia, an area rich in oil and natural gas. Because West Siberia is a remote and relatively unexplored region, controversy arose over the location of the highest-yielding fields and the allocation of funds and materials. Dr. Chung shows that the decision to accelerate the development of the West Siberian energy complex was influenced strongly by a ''policy coalition'' composed primarily of local officials, enterprise managers, professionals, and academics.more » Demonstrating that this coalition is a stable and highly active pressure group, he illustrates how it gradually established ascendancy and eventually outflanked opposing elements in the government and planning agencies. He identifies key elements of the coalition's strategy, tracing the steps by which it swung the leadership over to its views on resource allocation.« less

Decision science: a scientific approach to enhance public health budgeting.

PubMed

Honoré, Peggy A; Fos, Peter J; Smith, Torney; Riley, Michael; Kramarz, Kim

2010-01-01

The allocation of resources for public health programming is a complicated and daunting responsibility. Financial decision-making processes within public health agencies are especially difficult when not supported with techniques for prioritizing and ranking alternatives. This article presents a case study of a decision analysis software model that was applied to the process of identifying funding priorities for public health services in the Spokane Regional Health District. Results on the use of this decision support system provide insights into how decision science models, which have been used for decades in business and industry, can be successfully applied to public health budgeting as a means of strengthening agency financial management processes.

Directional Slack-Based Measure for the Inverse Data Envelopment Analysis

PubMed Central

Abu Bakar, Mohd Rizam; Lee, Lai Soon; Jaafar, Azmi B.; Heydar, Maryam

2014-01-01

A novel technique has been introduced in this research which lends its basis to the Directional Slack-Based Measure for the inverse Data Envelopment Analysis. In practice, the current research endeavors to elucidate the inverse directional slack-based measure model within a new production possibility set. On one occasion, there is a modification imposed on the output (input) quantities of an efficient decision making unit. In detail, the efficient decision making unit in this method was omitted from the present production possibility set but substituted by the considered efficient decision making unit while its input and output quantities were subsequently modified. The efficiency score of the entire DMUs will be retained in this approach. Also, there would be an improvement in the efficiency score. The proposed approach was investigated in this study with reference to a resource allocation problem. It is possible to simultaneously consider any upsurges (declines) of certain outputs associated with the efficient decision making unit. The significance of the represented model is accentuated by presenting numerical examples. PMID:24883350

Research priorities in health economics and funding for palliative care: views of an international think tank.

PubMed

Harding, Richard; Gomes, Barbara; Foley, Kathleen M; Higginson, Irene J

2009-07-01

At the conclusion of the November 2007 meeting, the assembled international expert group identified the research agenda. The adoption of this agenda would take forward health economic research in palliative care, and generate the necessary data for improved funding decision making, and resource allocation. Recommendations for study included international comparative research into the components of care and settings, evaluative studies, methodologic development and strategies to initiate studies, and make better use of data.

Optimal Resource Allocation in Library Systems

ERIC Educational Resources Information Center

Rouse, William B.

1975-01-01

Queueing theory is used to model processes as either waiting or balking processes. The optimal allocation of resources to these processes is defined as that which maximizes the expected value of the decision-maker's utility function. (Author)

Budgeting by Objectives--How Goals and Objectives, Operational Activities, and Resource Allocation Are Integrated in a Planning System. AIR 1984 Annual Forum Paper.

ERIC Educational Resources Information Center

Capoor, Madan

The Objective-Based Assessment, Planning, and Resource Allocation System (OAPRAS) that was developed and implemented at Middlesex County College is described. The integrated self-assessment planning and budgeting system was developed in 1981. The central purpose of OAPRAS was to link resource allocation decisions to the prioritized objectives that…

Going All In: Unfavorable Sex Ratios Attenuate Choice Diversification.

PubMed

Ackerman, Joshua M; Maner, Jon K; Carpenter, Stephanie M

2016-06-01

When faced with risky decisions, people typically choose to diversify their choices by allocating resources across a variety of options and thus avoid putting "all their eggs in one basket." The current research revealed that this tendency is reversed when people face an important cue to mating-related risk: skew in the operational sex ratio, or the ratio of men to women in the local environment. Counter to the typical strategy of choice diversification, findings from four studies demonstrated that the presence of romantically unfavorable sex ratios (those featuring more same-sex than opposite-sex individuals) led heterosexual people to diversify financial resources less and instead concentrate investment in high-risk/high-return options when making lottery, stock-pool, retirement-account, and research-funding decisions. These studies shed light on a key process by which people manage risks to mating success implied by unfavorable interpersonal environments. These choice patterns have important implications for mating behavior as well as other everyday forms of decision making. © The Author(s) 2016.

Resource allocation. The cost of care: two troublesome cases in health care ethics.

PubMed

Armstrong, C R; Whitlock, R

1998-01-01

With the cost of health care rising rapidly, both physicians and administrators regularly face resource allocation decisions. Under these conditions of relative scarcity, the equitable and appropriate distribution of limited resources becomes an ethical as well as a financial issue. Through ethical analysis, physician executives can assist their physician colleagues and fellow administrators to find rationally defensible answers to questions regarding the distribution of limited resources. Six criteria are frequently "weighted in the balance" by ethicists when analyzing whether justice is served in the distribution of a limited resource: need, equality, contribution, ability to pay, effort, and merit. The authors argue that, from an ethical standpoint, the best single criterion upon which one can base an allocation decision is that of merit, defined as the potential to benefit from the investment of additional resources.

A system dynamics model of a large R&D program

NASA Astrophysics Data System (ADS)

Ahn, Namsung

Organizations with large R&D activities must deal with a hierarchy of decision regarding resource allocation. At the highest level of allocation, the decision is related to the total allocation to R&D as some portion of revenue. The middle level of allocation deals with the allocation among phases of the R&D process. The lowest level of decisions relates to the resource allocation to specific projects within a specific phase. This study focuses on developing an R&D model to deal with the middle level of allocation, i.e., the allocation among phases of research such as basic research, development, and demonstration. The methodology used to develop the R&D model is System Dynamics. Our modeling concept is innovative in representing each phase of R&D as consisting of two parts: projects under way, and an inventory of successful but not-yet- exploited projects. In a simple world, this concept can yield an exact analytical solution for allocation of resources among phases. But in a real world, the concept should be improved by adding more complex structures with nonlinear behaviors. Two particular nonlinear feedbacks are incorporated into the R&D model. The probability of success for any specific project is assumed partly dependent upon resources allocated to the project. Further, the time required to reach a conclusion regarding the success or failure of a project is also assumed dependent upon the level of resources allocated. In addition, the number of successful projects partly depends on the inventory of potential ideas in the previous stage that can be exploited. This model can provide R&D management with insights into the effect of changing allocations to phases whether those changes are internally or externally driven. With this model, it is possible to study the effectiveness of management decisions in a continuous fashion. Managers can predict payoffs for a host of different policies. In addition, as new research results accumulate, a re- assessment of program goals can be implemented easily and allocations adjusted to enhance continuously the likelihood of success, and to optimize payoffs. Finally, this model can give managers a quantitative rationale for program evaluation and permit the quantitative assessment of various externally imposed changes. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)

Role of the anesthesiologist in the wider governance of healthcare and health economics.

PubMed

Martin, Janet; Cheng, Davy

2013-09-01

Healthcare resources will always be limited, and as a result, difficult decisions must be made about how to allocate limited resources across unlimited demands in order to maximize health gains per resource expended. Governments and hospitals now in severe financial deficits recognize that reengagement of physicians is central to their ability to contain the runaway healthcare costs. Health economic analysis provides tools and techniques to assess which investments in healthcare provide good value for money vs which options should be forgone. Robust decision-making in healthcare requires objective consideration of evidence in order to balance clinical and economic benefits vs risks. Surveys of the literature reveal very few economic analyses related to anesthesia and perioperative medicine despite increasing recognition of the need. Now is an opportune time for anesthesiologists to become familiar with the tools and methodologies of health economics in order to facilitate and lead robust decision-making in quality-based procedures. For most technologies used in anesthesia and perioperative medicine, the responsibility to determine cost-effectiveness falls to those tasked with the governance and stewardship of limited resources for unlimited demands using best evidence plus economics at the local, regional, and national levels. Applicable cost-effectiveness, cost-utility, and cost-benefits in health economics are reviewed in this article with clinical examples in anesthesia. Anesthesiologists can make a difference in the wider governance of healthcare and health economics if we advance our knowledge and skills beyond the technical to address the "other" dimensions of decision-making--most notably, the economic aspects in a value-based healthcare system.

A political economy analysis of decision-making on natural disaster preparedness in Kenya.

PubMed

Rono-Bett, Karen C

2018-01-01

Most deaths from natural disasters occur in low- or middle-income countries; among them, countries in the Horn of Africa - where Kenya lies. Between September 2015 and September 2016, 23.4 million people in this region faced food insecurity because of the 2015 El Niño, characterised by floods and droughts. The importance of effective government decision-making on preparedness and response are critical to saving lives during such disasters. But this decision-making process occurs in a political context which is marred by uncertainty with other factors at play. Yet, good practice requires making investments on a 'no-regrets' basis. This article looks at the factors influencing Kenya's decision-making process for natural disasters, the preparedness for the 2015 El Niño as a case study. I explored what stakeholders understand by 'no-regrets investments' and its application. I assessed financial allocations by government and donors to disaster preparedness. Based on key informant interviews, focus group discussions and financial analyses, this article presents evidence at national and subnational levels. The findings indicate that in making decisions relating to preparedness, the government seeks information primarily from sources it trusts - other government departments, its communities and the media. With no existing legal frameworks guiding Kenya's disaster preparedness, the coordination of preparedness is not strong. It appears that there is a lack of political will to prioritise these frameworks. The no-regrets approach is applied predominantly by non-state actors. Because there have been 'non-events' in the past, government has become overcautious in committing resources on a no-regrets basis. Government allocation to preparedness exceeds donor funding by almost tenfold.

Trade-offs, fairness, and funding for cancer drugs: key findings from a deliberative public engagement event in British Columbia, Canada.

PubMed

Bentley, Colene; Costa, Sarah; Burgess, Michael M; Regier, Dean; McTaggart-Cowan, Helen; Peacock, Stuart J

2018-05-08

Spending on cancer drugs has risen dramatically in recent years compared to other areas of health care, due in part to higher prices associated with newly approved drugs and increased demand for these drugs. Addressing this situation requires making difficult trade-offs between cost, harms, and ability to benefit when using public resources, making it important for policy makers to have input from many people affected by the issue, including citizens. In September 2014, a deliberative public engagement event was conducted in Vancouver, British Columbia (BC), on the topic of priority setting and costly cancer drugs. The aim of the study was to gain citizens' input on the topic and have them generate recommendations that could inform cancer drug funding decisions in BC. A market research company was engaged to recruit members of the BC general public to deliberate over two weekends (four days) on how best to allocate resources for expensive cancer treatments. Participants were stratified based on the 2006 census data for BC. Participants were asked to discuss disinvestment, intravenous versus oral chemotherapy delivery, and decision governance. All sessions were audio recorded and transcribed. Transcripts were analyzed using NVivo 11 software. Twenty-four individuals participated in the event and generated 30 recommendations. Participants accepted the principle of resource scarcity and the need of governments to make difficult trade-offs when allocating health-care resources. They supported the view that cost-benefit thresholds must be set for high-cost drugs. They also expected reasonable health benefits in return for large expenditures, and supported the view that some drugs do not merit funding. Participants also wanted drug funding decisions to be made in a non-partisan and transparent way. The recommendations from the Vancouver deliberation can provide guidance to policy makers in BC and may be useful in challenging pricing by pharmaceutical companies.

Some aspects of control of a large-scale dynamic system

NASA Technical Reports Server (NTRS)

Aoki, M.

1975-01-01

Techniques of predicting and/or controlling the dynamic behavior of large scale systems are discussed in terms of decentralized decision making. Topics discussed include: (1) control of large scale systems by dynamic team with delayed information sharing; (2) dynamic resource allocation problems by a team (hierarchical structure with a coordinator); and (3) some problems related to the construction of a model of reduced dimension.

The new form 990: taking a closer look.

PubMed

Speizman, Richard A

2008-04-01

The revised Form 990 will allow the IRS to better assess the risk presented by not-for-profit organizations. The forms will also allow for increased transparency and accountability. Ultimately, the information collected on Form 990 may influence important tax policy changes. Healthcare organizations should keep the varied purposes of the form in mind when making resource allocations and other decisions involving tax compliance.

Developing Cost Accounting and Decision Support Software for Comprehensive Community-Based Support Systems: An Analysis of Needs, Interest, and Readiness in the Field.

ERIC Educational Resources Information Center

Harrington, Robert; Jenkins, Peter; Marzke, Carolyn; Cohen, Carol

Prominent among the new models of social service delivery are organizations providing comprehensive, community-based supports and services (CCBSS) to children and their families. A needs analysis explored CCBSS sites' interest in and readiness to use a software tool designed to help them make more effective internal resource allocation decisions…

Gender of Children, Bargaining Power, and Intrahousehold Resource Allocation in China

ERIC Educational Resources Information Center

Li, Lixing; Wu, Xiaoyu

2011-01-01

Based on the prevalent son preference in China, this paper proposes a new measure of relative bargaining power within the household. Using data from China Health and Nutrition Survey, we show that a woman with a first-born son has a 3.9 percentage points' greater role in household decision-making than a woman with a first-born daughter. Having a…

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Green, Sally; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-10

This is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in Melbourne Australia, sought to establish an organisation-wide systematic evidence-based program for disinvestment. In the absence of guidance from the literature, the Centre for Clinical Effectiveness, an in-house 'Evidence Based Practice Support Unit', was asked to explore concepts and practices related to disinvestment, consider the implications for a local health service and identify potential settings and methods for decision-making. Mixed methods were used to capture the relevant information. These included literature reviews; online questionnaire, interviews and structured workshops with a range of stakeholders; and consultation with experts in disinvestment, health economics and health program evaluation. Using the principles of evidence-based change, the project team worked with health service staff, consumers and external experts to synthesise the findings from published literature and local research and develop proposals, frameworks and plans. Multiple influencing factors were extracted from these findings. The implications were both positive and negative and addressed aspects of the internal and external environments, human factors, empirical decision-making, and practical applications. These factors were considered in establishment of the new program; decisions reached through consultation with stakeholders were used to define four program components, their aims and objectives, relationships between components, principles that underpin the program, implementation and evaluation plans, and preconditions for success and sustainability. The components were Systems and processes, Disinvestment projects, Support services, and Program evaluation and research. A model for a systematic approach to evidence-based resource allocation in a local health service was developed. A robust evidence-based investigation of the research literature and local knowledge with a range of stakeholders resulted in rich information with strong consistent messages. At the completion of Phase One, synthesis of the findings enabled development of frameworks and plans and all preconditions for exploration of the four main aims in Phase Two were met.

[Allocating resources for cancer control--resolving multicriteria decision-making using the analytic hierarchy process].

PubMed

Gróf, Agnes

2007-01-01

When competing programs ought to be financed simultaneously for the same purpose, an allocation problem occurs due to scarce resources, and different perspectives and preferences. Facing the problem needs determining criteria which the decision might be based on. Those criteria form the objectives (the scope) of the different participants, and are relevant for the achievement of the goal, providing a comprehensive resource allocation that bridges and integrates the different perspectives. In case of cancer control primary prevention, secondary prevention, therapy and tertiary prevention, education, basic sciences, and clinical trials form the alternatives. An analytic hierarchy process (AHP) is used for supporting decision-making in the resource allocation problem. AHP is a method for setting priorities, but can only work out the implications of what was declared through the pairwise-ranking process, namely the relative preferences, weighing the criteria and rating the alternatives two by two. In the first analysis the relative weights to criteria were 0.099 for 'distributive justice'; 0.120 for constitutional and human rights; 0.251 for lay opinion; 0.393 for EBM; 0.137 for cost-effectiveness. Ranking the alternatives using 'judgements' resulted in relative preference of 0.238 for therapy, 0.204 for primary prevention, 0.201 for secondary prevention, 0.135 for clinical trials, 0.111 for tertiary prevention, 0.066 for basic sciences and 0.045 for education. In the second analysis the relative importance of "cost-effectiveness" was doubled, thus resulting in 0.234 for therapy, 0.216 for secondary prevention, 0.183 for primary prevention, 0.145 for clinical trials, 0.113 for tertiary prevention, 0.063 for basic sciences and 0.046 for education. Sensitivity analysis has shown that increasing the relative weight of cost-effectiveness up to approximately 0.4 changes the rank of alternatives, and above 0.4 this criterion gives secondary prevention preferences. According to the relative rates computed in both of the models all criteria vote for therapy, but these preferences change at the high level of weights, in case of EBM, 'rights', and cost-effectiveness. Cost-effectiveness prefers secondary prevention to therapy; the criterion of constitutional and human rights and the criterion of evidence-based medicine vote for primary prevention.

Are Indirect Benefits Relevant to Health Care Allocation Decisions?

PubMed Central

Du Toit, Jessica; Millum, Joseph

2016-01-01

Abstract When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we distinguish different conceptions of direct and indirect benefits and argue that only a recipient conception could be morally relevant. We analyze four arguments for thinking that indirect benefits should not count and argue that none is successful in showing that the indirectness of a benefit is a good reason not to count it. We conclude that direct and indirect benefits should be evaluated in the same way. PMID:27465773

Decentralisation of Health Services in Fiji: A Decision Space Analysis.

PubMed

Mohammed, Jalal; North, Nicola; Ashton, Toni

2015-11-15

Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Fiji's centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji's deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. © 2016 by Kerman University of Medical Sciences.

Enhancing stakeholder involvement in environmental decision making: Active Response Geographic Information System

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

Faber, B.G.; Thomas, V.L.; Thomas, M.R.

This paper describes a spatial decision support system that facilitates land-related negotiations and resolving conflicts. This system, called Active Response Geographic Information System (AR/GIS), uses a geographic information system to examine land resource management issues which involve multiple stakeholder groups. In this process, participants are given the opportunity and tools needed to share ideas in a facilitated land resource allocation negotiation session. Participants are able to assess current land status, develop objectives, propose alternative planning scenarios, and evaluate the effects or impacts of each alternative. AR/GIS is a unique tool that puts geographic information directly at the fingertips of non-technicalmore » policy analysts, decision makers, and representatives of stakeholder groups during the negotiation process. AR/GIS enhances individual comprehension and ownership of the decision making process and increasing the efficiency and effectiveness of group debate. It is most beneficial to planning tasks which are inherently geographic in nature, which require consideration of a large number of physical constraints and economic implications, and which involve publicly sensitive tradeoffs.« less

Young children are more willing to accept group decisions in which they have had a voice.

PubMed

Grocke, Patricia; Rossano, Federico; Tomasello, Michael

2018-02-01

People accept an unequal distribution of resources if they judge that the decision-making process was fair. In this study, 3- and 5-year-old children played an allocation game with two puppets. The puppets decided against a fair distribution in all conditions, but they allowed children to have various degrees of participation in the decision-making process. Children of both ages protested less when they were first asked to agree with the puppets' decision compared with when there was no agreement. When ignored, the younger children protested less than the older children-perhaps because they did not expect to have a say in the process-whereas they protested more when they were given an opportunity to voice their opinion-perhaps because their stated opinion was ignored. These results suggest that during the preschool years, children begin to expect to be asked for their opinion in a decision, and they accept disadvantageous decisions if they feel that they have had a voice in the decision-making process. Copyright © 2017 Elsevier Inc. All rights reserved.

A hybrid fuzzy logic/constraint satisfaction problem approach to automatic decision making in simulation game models.

PubMed

Braathen, Sverre; Sendstad, Ole Jakob

2004-08-01

Possible techniques for representing automatic decision-making behavior approximating human experts in complex simulation model experiments are of interest. Here, fuzzy logic (FL) and constraint satisfaction problem (CSP) methods are applied in a hybrid design of automatic decision making in simulation game models. The decision processes of a military headquarters are used as a model for the FL/CSP decision agents choice of variables and rulebases. The hybrid decision agent design is applied in two different types of simulation games to test the general applicability of the design. The first application is a two-sided zero-sum sequential resource allocation game with imperfect information interpreted as an air campaign game. The second example is a network flow stochastic board game designed to capture important aspects of land manoeuvre operations. The proposed design is shown to perform well also in this complex game with a very large (billionsize) action set. Training of the automatic FL/CSP decision agents against selected performance measures is also shown and results are presented together with directions for future research.

Fort Benning Land-Use Planning and Management Study

DTIC Science & Technology

1990-04-01

process is three-tiered: (a) an initial phase that results in preliminary allocations for natural resources, (b) a second phase that focuses on...allocations of military training requirements, and (c) a final phase that resolves conflicts between the military and natural resource requirements and...assigns final allocations. 34. Initial phase : Natural resource allocations. The first step in this phase was to make allocations among natural resource

HIV epidemic control-a model for optimal allocation of prevention and treatment resources.

PubMed

Alistar, Sabina S; Long, Elisa F; Brandeau, Margaret L; Beck, Eduard J

2014-06-01

With 33 million people living with human immunodeficiency virus (HIV) worldwide and 2.7 million new infections occurring annually, additional HIV prevention and treatment efforts are urgently needed. However, available resources for HIV control are limited and must be used efficiently to minimize the future spread of the epidemic. We develop a model to determine the appropriate resource allocation between expanded HIV prevention and treatment services. We create an epidemic model that incorporates multiple key populations with different transmission modes, as well as production functions that relate investment in prevention and treatment programs to changes in transmission and treatment rates. The goal is to allocate resources to minimize R 0, the reproductive rate of infection. We first develop a single-population model and determine the optimal resource allocation between HIV prevention and treatment. We extend the analysis to multiple independent populations, with resource allocation among interventions and populations. We then include the effects of HIV transmission between key populations. We apply our model to examine HIV epidemic control in two different settings, Uganda and Russia. As part of these applications, we develop a novel approach for estimating empirical HIV program production functions. Our study provides insights into the important question of resource allocation for a country's optimal response to its HIV epidemic and provides a practical approach for decision makers. Better decisions about allocating limited HIV resources can improve response to the epidemic and increase access to HIV prevention and treatment services for millions of people worldwide.

Physicians' perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting.

PubMed

Giannini, A; Consonni, D

2006-01-01

Physicians' perceptions regarding intensive care unit (ICU) resource allocation and the problem of inappropriate admissions are unknown. We carried out an anonymous, self-administered questionnaire survey to assess the perceptions and attitudes of ICU physicians at all 20 ICUs in Milan, Italy, regarding inappropriate admissions and resource allocation. Eighty-seven percent (225/259) of physicians responded. Inappropriate admissions were acknowledged by 86% of respondents. The reasons given were clinical doubt (33%); limited decision time (32%); assessment error (25%); pressure from superiors (13%), referring clinician (11%) or family (5%); threat of legal action (5%); and an economically advantageous 'Diagnosis Related Group' (1%). Respondents reported being pressurized to make more 'productive' use of ICU beds by Unit heads (frequently 16%), hospital management (frequently 10%) and colleagues (frequently 4%). Five percent reported refusing appropriate admissions following 'indications' not to admit financially disadvantageous cases. Admissions after elective surgery prioritized patients from profitable surgical departments: frequently for 6% of respondents and occasionally for 15%. Sixty-seven percent said they frequently received requests for appropriate admissions when no beds were available. This was considered sufficient reason to withdraw treatment from patients with lower survival probability (sometimes 21%) or for whom nothing more could be done (sometimes 51%, frequently 11%). Inappropriate ICU admissions were perceived as a common event but were mainly attributed to difficulties in assessing suitability. Physicians were aware that their decisions were often influenced by factors other than medical necessity. Economic influences were perceived as limited but not negligible. Decisions to forgo treatment could be influenced by the need to admit other patients.

Ethical dilemmas concerning decision-making within health care leadership: a systematic literature review.

PubMed

Zydziūnaite, Vilma; Suominen, Tarja; Astedt-Kurki, Päivi; Lepaite, Daiva

2010-01-01

The objective was to describe the research methods and research focuses on ethical dilemmas concerning decision-making within health care leadership. The search was conducted on Medline and PubMed databases (1998-2008). The systematic review included 21 selected articles. The ethical dilemmas concerning decision-making within health care leadership are related to three levels: institutional (particular organization), political and local interface (local governmental structure), and national (professional expertise and system). The terms that are used as adequate to the term of "ethical dilemma" are the following: "continuous balancing," "result of resource allocation," "gap between professional obligations and possibilities," "ethically controversial situation," "concern about interactions," "ethical difficulty," "outcome of medical choices," "concern about society access to health care resources," "ethically difficult/challenging situation," "(the consequence of) ethical concern/ethical issue." In qualitative studies, a semi-structured interview and qualitative content analysis are the most commonly applied methods; in quantitative studies, questionnaire surveys are employed. In the research literature, there is a lack of specification according to professional qualification of health care professionals concerning ethical dilemmas by decision-making within health care management/administration. The research on ethical dilemmas in health care leadership, management, and administration should integrate data about levels at which ethical dilemmas occur and investigate ethical dilemmas as complex phenomena because those are attached to decision-making and specific nuances of health care management/administration. In this article, the presented scientific problem requires extensive scientific discussions and research on ethical dilemmas concerning decision-making within health care leadership at various levels.

A Review of the Impacts of Different Approaches for Diabetes Prevention and a Framework for Making Investment Decisions

PubMed Central

2018-01-01

This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions. This framework should also assist in the discussion of what parameters are needed from research to inform decision-making on what might be the optimal mix of strategies to reduce diabetes prevalence. PMID:29543711

The invisible hands made visible: recognizing the value of informal care in healthcare decision-making.

PubMed

van Exel, Job; Bobinac, Ana; Koopmanschap, Marc; Brouwer, Werner

2008-12-01

The healthcare sector depends heavily on the informal care provided by families and friends of those who are ill. Informal caregivers may experience significant burden as well as health and well-being effects. Resource allocation decisions, in particular from a societal perspective, should account explicitly for these effects in the social environment of patients. This is not only important to make a complete welfare economic assessment of treatments, but also to ensure the lasting involvement of informal caregivers in the care-giving process. Measurement and valuation techniques for the costs and effects of informal care have been developed and their use is becoming more common. Decision-makers in healthcare - and eventually families and patients - would be helped by more uniformity in methods.

A Review of the Impacts of Different Approaches for Diabetes Prevention and a Framework for Making Investment Decisions.

PubMed

Alva, Maria L

2018-03-15

This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions. This framework should also assist in the discussion of what parameters are needed from research to inform decision-making on what might be the optimal mix of strategies to reduce diabetes prevalence.

Sex differences in the effects of juvenile and adult diet on age-dependent reproductive effort.

PubMed

Houslay, T M; Hunt, J; Tinsley, M C; Bussière, L F

2015-05-01

Sexual selection should cause sex differences in patterns of resource allocation. When current and future reproductive effort trade off, variation in resource acquisition might further cause sex differences in age-dependent investment, or in sensitivity to changes in resource availability over time. However, the nature and prevalence of sex differences in age-dependent investment remain unclear. We manipulated resource acquisition at juvenile and adult stages in decorated crickets, Gryllodes sigillatus, and assessed effects on sex-specific allocation to age-dependent reproductive effort (calling in males, fecundity in females) and longevity. We predicted that the resource and time demands of egg production would result in relatively consistent female strategies across treatments, whereas male investment should depend sharply on diet. Contrary to expectations, female age-dependent reproductive effort diverged substantially across treatments, with resource-limited females showing much lower and later investment in reproduction; the highest fecundity was associated with intermediate lifespans. In contrast, long-lived males always signalled more than short-lived males, and male age-dependent reproductive effort did not depend on diet. We found consistently positive covariance between male reproductive effort and lifespan, whereas diet altered this covariance in females, revealing sex differences in the benefits of allocation to longevity. Our results support sex-specific selection on allocation patterns, but also suggest a simpler alternative: males may use social feedback to make allocation decisions and preferentially store resources as energetic reserves in its absence. Increased calling effort with age therefore could be caused by gradual resource accumulation, heightened mortality risk over time, and a lack of feedback from available mates. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

Resource allocation in road infrastructure using ANP priorities with ZOGP formulation-A case study

NASA Astrophysics Data System (ADS)

Alias, Suriana; Adna, Norfarziah; Soid, Siti Khuzaimah; Kardri, Mahani

2013-09-01

Road Infrastructure (RI) project evaluation and selection is concern with the allocation of scarce organizational resources. In this paper, it is suggest an improved RI project selection methodology which reflects interdependencies among evaluation criteria and candidate projects. Fuzzy Delphi Method (FDM) is use to evoking expert group opinion and also to determine a degree of interdependences relationship between the alternative projects. In order to provide a systematic approach to set priorities among multi-criteria and trade-off among objectives, Analytic Network Process (ANP) is suggested to be applied prior to Zero-One Goal Programming (ZOGP) formulation. Specifically, this paper demonstrated how to combined FDM and ANP with ZOGP through a real-world RI empirical example on an ongoing decision-making project in Johor, Malaysia.

Satisficing in split-second decision making is characterized by strategic cue discounting.

PubMed

Oh, Hanna; Beck, Jeffrey M; Zhu, Pingping; Sommer, Marc A; Ferrari, Silvia; Egner, Tobias

2016-12-01

Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through satisficing, fast but "good-enough" heuristic decision making that prioritizes some sources of information (cues) while ignoring others. However, the decision-making strategies we adopt under uncertainty and time pressure, for example during emergencies that demand split-second choices, are presently unknown. To characterize these decision strategies quantitatively, the present study examined how people solve a novel multicue probabilistic classification task under varying time pressure, by tracking shifts in decision strategies using variational Bayesian inference. We found that under low time pressure, participants correctly weighted and integrated all available cues to arrive at near-optimal decisions. With increasingly demanding, subsecond time pressures, however, participants systematically discounted a subset of the cue information by dropping the least informative cue(s) from their decision making process. Thus, the human cognitive apparatus copes with uncertainty and severe time pressure by adopting a "drop-the-worst" cue decision making strategy that minimizes cognitive time and effort investment while preserving the consideration of the most diagnostic cue information, thus maintaining "good-enough" accuracy. This advance in our understanding of satisficing strategies could form the basis of predicting human choices in high time pressure scenarios. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

How Qualitative Research Informs Clinical and Policy Decision Making in Transplantation: A Review.

PubMed

Tong, Allison; Morton, Rachael L; Webster, Angela C

2016-09-01

Patient-centered care is no longer just a buzzword. It is now widely touted as a cornerstone in delivering quality care across all fields of medicine. However, patient-centered strategies and interventions necessitate evidence about patients' decision-making processes, values, priorities, and needs. Qualitative research is particularly well suited to understanding the experience and perspective of patients, donors, clinicians, and policy makers on a wide range of transplantation-related topics including organ donation and allocation, adherence to prescribed therapy, pretransplant and posttransplant care, implementation of clinical guidelines, and doctor-patient communication. In transplantation, evidence derived from qualitative research has been integrated into strategies for shared decision-making, patient educational resources, process evaluations of trials, clinical guidelines, and policies. The aim of this article is to outline key concepts and methods used in qualitative research, guide the appraisal of qualitative studies, and assist clinicians to understand how qualitative research may inform their practice and policy.

The ontogeny of postmaturation resource allocation in turtles.

PubMed

Bowden, R M; Paitz, Ryan T; Janzen, Fredric J

2011-01-01

Resource-allocation decisions vary with life-history strategy, and growing evidence suggests that long-lived endothermic vertebrates direct resources toward growth and self-maintenance when young, increasing allocation toward reproductive effort over time. Few studies have tracked the ontogeny of resource allocation (energy, steroid hormones, etc.) in long-lived ectothermic vertebrates, limiting our understanding of the generality of life-history strategies among vertebrates. We investigated how reproductively mature female painted turtles (Chrysemys picta) from two distinct age classes allocated resources over a 4-yr period and whether resource-allocation patterns varied with nesting experience. We examined age-related variation in body size, egg mass, reproductive frequency, and yolk steroids and report that younger females were smaller and allocated fewer resources to reproduction than did older females. Testosterone levels were higher in eggs from younger females, whereas eggs from second (seasonal) clutches contained higher concentrations of progesterone and estradiol. These allocation patterns resulted in older, larger females laying larger eggs and producing second clutches more frequently than their younger counterparts. We conclude that resource-allocation patterns do vary with age in a long-lived ectotherm.

Methodological Variation in Economic Evaluations Conducted in Low- and Middle-Income Countries: Information for Reference Case Development

PubMed Central

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions. PMID:25950443

Resource allocation processes at multilateral organizations working in global health

PubMed Central

Chi, Y-Ling; Bump, Jesse B

2018-01-01

Abstract International institutions provide well over US$10 billion in development assistance for health (DAH) annually and between 1990 and 2014, DAH disbursements totaled $458 billion but how do they decide who gets what, and for what purpose? In this article, we explore how allocation decisions were made by the nine convening agencies of the Equitable Access Initiative. We provide clear, plain language descriptions of the complete process from resource mobilization to allocation for the nine multilateral agencies with prominent agendas in global health. Then, through a comparative analysis we illuminate the choices and strategies employed in the nine international institutions. We find that resource allocation in all reviewed institutions follow a similar pattern, which we categorized in a framework of five steps: strategy definition, resource mobilization, eligibility of countries, support type and funds allocation. All the reviewed institutions generate resource allocation decisions through well-structured and fairly complex processes. Variations in those processes seem to reflect differences in institutional principles and goals. However, these processes have serious shortcomings. Technical problems include inadequate flexibility to account for or meet country needs. Although aid effectiveness and value for money are commonly referenced, we find that neither performance nor impact is a major criterion for allocating resources. We found very little formal consideration of the incentives generated by allocation choices. Political issues include non-transparent influence on allocation processes by donors and bureaucrats, and the common practice of earmarking funds to bypass the normal allocation process entirely. Ethical deficiencies include low accountability and transparency at international institutions, and limited participation by affected citizens or their representatives. We find that recipient countries have low influence on allocation processes themselves, although within these processes they have some influence in relatively narrow areas. PMID:29415239

Cost Accounting for Decision Makers.

ERIC Educational Resources Information Center

Kaneklides, Ann L.

1985-01-01

Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

A leader-follower-interactive method for regional water resources management with considering multiple water demands and eco-environmental constraints

NASA Astrophysics Data System (ADS)

Chen, Yizhong; Lu, Hongwei; Li, Jing; Ren, Lixia; He, Li

2017-05-01

This study presents the mathematical formulation and implementations of a synergistic optimization framework based on an understanding of water availability and reliability together with the characteristics of multiple water demands. This framework simultaneously integrates a set of leader-followers-interactive objectives established by different decision makers during the synergistic optimization. The upper-level model (leader's one) determines the optimal pollutants discharge to satisfy the environmental target. The lower-level model (follower's one) accepts the dispatch requirement from the upper-level one and dominates the optimal water-allocation strategy to maximize economic benefits representing the regional authority. The complicated bi-level model significantly improves upon the conventional programming methods through the mutual influence and restriction between the upper- and lower-level decision processes, particularly when limited water resources are available for multiple completing users. To solve the problem, a bi-level interactive solution algorithm based on satisfactory degree is introduced into the decision-making process for measuring to what extent the constraints are met and the objective reaches its optima. The capabilities of the proposed model are illustrated through a real-world case study of water resources management system in the district of Fengtai located in Beijing, China. Feasible decisions in association with water resources allocation, wastewater emission and pollutants discharge would be sequentially generated for balancing the objectives subject to the given water-related constraints, which can enable Stakeholders to grasp the inherent conflicts and trade-offs between the environmental and economic interests. The performance of the developed bi-level model is enhanced by comparing with single-level models. Moreover, in consideration of the uncertainty in water demand and availability, sensitivity analysis and policy analysis are employed for identifying their impacts on the final decisions and improving the practical applications.

Multi-Stakeholder Dynamic Optimization Framework for System-of-Systems Development and Evolution

NASA Astrophysics Data System (ADS)

Fang, Zhemei

Architecture design for an "acknowledged" System-of-Systems (SoS), under performance uncertainty and constrained resources, remains a difficult problem. Composing an SoS via a proper mix of systems under the special control structure of an "acknowledged" SoS requires efficient distribution of the limited resources. However, due to the special traits of SoS, achieving an efficient distribution of the resources is not a trivial challenge. Currently, the major causes that lead to inefficient resource management for an "acknowledged" SoS include: 1) no central SoS managers with absolute authority to address conflict; 2) difficult balance between current and future decisions; 3) various uncertainties during development and operations (e.g., technology maturation, policy stability); 4) diverse sources of the resources; 5) high complexity in efficient formulation and computation due to the previous four factors. Although it is beyond the scope of this dissertation to simultaneously address all the five items, the thesis will focus on the first, second, and fifth points, and partially cover the third point. In a word, the dissertation aims to develop a generic framework for "acknowledged" SoS that leads to appropriate mathematical formulation and a solution approach that generates a near-optimal set of multi-stage architectural decisions with limited collaboration between conflicted and independent stakeholders. This dissertation proposes a multi-stakeholder dynamic optimization (MUSTDO) method, which integrates approximate dynamic programming and transfer contract coordination mechanism. The method solves a multi-stage architecture selection problem with an embedded formal, but simple, transfer contract coordination mechanism to address resource conflict. Once the values of transfer contract are calculated appropriately, even though the SoS participants make independent decisions, the aggregate solutions are close to the solutions from a hypothetical ideal centralized case where the top-level SoS managers have full authority. In addition, the thesis builds the bridge between a given SoS problem and the mathematical interpretations of the MUSTDO method using a three-phase approach for real world applications. The method is applied to two case studies: one in the defense realm and one in the commercial realm. The first application uses a naval warfare scenario to demonstrate that the aggregated capabilities in the decentralized case using MUSTDO method are close to the aggregated capabilities in a hypothetical centralized case. This evidence demonstrates that the MUSTDO method can help approach the SoS-level optimality with limited funding resource even if the participants make independent decisions. The solution also provides suggestions to the participants about the sequence of architecting decisions and the amount of transfer contract to be sent out to maximize individual capability over time. The suggested decisions incorporate the potential capability increase in the future, which differentiates itself from allocating all the resources to the current development. The quantified numbers of transfer contract in this case study are equivalent capabilities that are relevant to equipment loan or technology transfer. The second case study applies the MUSTDO-based framework to address a multi-airline fleet allocation problem with emissions allowances constraint provided by the regulators. Two representative airlines including the low-cost airline and the legacy airline aim to maximize individual profit by allocating six type of aircraft to a given ten-route network under the emissions constraint. Both the deterministic and stochastic experiments verify the effectiveness of the MUSTDO method by comparing the profit in the decentralized case and profit in a utopian centralized case. Meanwhile, sensitivity studies demonstrate that higher minimum demand requirement and lower discount factor can further improve the efficiency of emissions allowances utilization in MUSTDO method. Comparing to an alternate grandfathering approach, the MUSTDO method can guarantee a high-level efficiency of resource allocation by avoiding failed allocation decisions due to inaccurate information for the regulators. In summary, the framework aids the SoS managers and participants in the selection of the best architecture over a period of time with limited resources; the framework helps the decision makers to understand how they can affect each other and cooperate to achieve a more efficient solution without sharing full information. The major contribution of this dissertation includes: 1) provide a method to address multi-stage SoS composition decisions over time with resource constraint; 2) provide a method to manage resource conflict for stakeholders in an "acknowledged" system-of-systems; 2) provide a new perspective of long-term interactions between stakeholders in an SoS; 3) provide procedural framework to implement the MUSTDO method; 4) provide comparison of different applications of the MUSTDO framework in distinct fields.

The politics of end-of-life decision-making: computerised decision-support tools, physicians' jurisdiction and morality.

PubMed

Jennings, Beth

2006-04-01

With the increasing corporate and governmental rationalisation of medical care, the mandate of efficiency has caused many to fear that concern for the individual patient will be replaced with impersonal, rule-governed allocation of medical resources. Largely ignored is the role of moral principles in medical decision-making. This analysis comes from an ethnographic study conducted from 1999-2001 in three US Intensive Care Units, two of which were using the computerised decision-support tool, APACHE III (Acute Physiological and Chronic Health Evaluation III), which notably predicts the probability that a patient will die. It was found that the use of APACHE presents a paradox regarding concern for the individual patient. To maintain jurisdiction over the care of patients, physicians share the data with the payers and regulators of care to prove they are using resources effectively and efficiently, yet they use the system in conjunction with moral principles to justify treating each patient as unique. Thus, concern for the individual patient is not lessened with the use of this system. However, physicians do not share the data with patients or surrogate decision-makers because they fear they will be viewed as more interested in profits than patients.

Analytic hierarchy process (AHP) as a tool in asset allocation

NASA Astrophysics Data System (ADS)

Zainol Abidin, Siti Nazifah; Mohd Jaffar, Maheran

2013-04-01

Allocation capital investment into different assets is the best way to balance the risk and reward. This can prevent from losing big amount of money. Thus, the aim of this paper is to help investors in making wise investment decision in asset allocation. This paper proposes modifying and adapting Analytic Hierarchy Process (AHP) model. The AHP model is widely used in various fields of study that are related in decision making. The results of the case studies show that the proposed model can categorize stocks and determine the portion of capital investment. Hence, it can assist investors in decision making process and reduce the risk of loss in stock market investment.

Financial management and dental school equity, Part II: Tactics.

PubMed

Chambers, David W; Bergstrom, Roy

2004-04-01

Financial management includes all processes that build organizations' equity through accumulating assets in strategically important areas. The tactical aspects of financial management are budget deployment and monitoring. Budget deployment is the process of making sure that costs are fairly allocated. Budget monitoring addresses issues of effective uses and outcomes of resources. This article describes contemporary deployment and monitoring mechanisms, including revenue positive and marginal analysis, present value, program phases, options logic, activity-based costing, economic value added, cost of quality, variance reconciliation, and balanced scorecards. The way financial decisions are framed affects comparative decision-making and even influences the arithmetic of accounting. Familiarity with these concepts should make it possible for dental educators to more fully participate in discussions about the relationships between budgeting and program strategy.

Improved Acquisition for System Sustainment: Multiobjective Tradeoff Analysis for Condition-Based Decision-Making

DTIC Science & Technology

2013-10-21

depend on the quality of allocating resources. This work uses a reliability model of system and environmental covariates incorporating information at...state space. Further, the use of condition variables allows for the direct modeling of maintenance impact with the assumption that a nominal value ... value ), the model in the application of aviation maintenance can provide a useful estimation of reliability at multiple levels. Adjusted survival

NASA Seminar on Organization and Management

NASA Technical Reports Server (NTRS)

Crawley, R. W.; Kloman, E. H.

1972-01-01

The proceedings of a seminar series of current problems and organization of NASA are presented. The seminar was designed to provide a comparative basis for understanding such recurring problems as delegation of authority, resource allocation and decision making patterns, headquarters organization, systems of program control and evaluation, roles and relations of scientists, engineers, and administrators, headquarters-field center relationships, and the overall management philosophy of the headquarters and field centers.

The Need for Strategic Research and Study Centers (Think Tanks) in the Kingdom of Saudi Arabia

DTIC Science & Technology

2014-03-01

technology issues , or industrial or business policies.27 Evidence-based research has become an indispensable tool for political decision making and...can be used to judge public sentiment on given issues . Government as well as private business gives due consideration during policy or strategy...policy guidance on modern issues like economic growth, resource allocation, job creation, unemployment reduction, financial management, legislation

Yellowjackets use nest-based cues to differentially exploit higher-quality resources

NASA Astrophysics Data System (ADS)

Taylor, Benjamin J.; Schalk, Dane R.; Jeanne, Robert L.

2010-12-01

While foraging, social insects encounter a dynamic array of food resources of varying quality and profitability. Because food acquisition influences colony growth and fitness, natural selection can be expected to favor colonies that allocate their overall foraging effort so as to maximize their intake of high-quality nutrients. Social wasps lack recruitment communication, but previous studies of vespine wasps have shown that olfactory cues influence foraging decisions. Odors associated with food brought into the nest by successful foragers prompt naive foragers to leave the nest and search for the source of those odors. Left unanswered, however, is the question of whether naive foragers take food quality into account in making their decisions about whether or not to search. In this study, two different concentrations of sucrose solutions, scented differently, were inserted directly into each of three Vespula germanica nests. At a feeder away from the nest, arriving foragers were given a choice between two 1.5 M sucrose solutions with the same scents as those in the nest. We show that wasps chose higher-quality resources in the field using information in the form of intranidal food-associated odor cues. By this simple mechanism, the colony can bias the allocation of its foraging effort toward higher-quality resources in the environment.

Elderly Care and Intrafamily Resource Allocation when Children Migrate.

PubMed

Antman, Francisca M

2012-01-01

This paper considers the intrafamily allocation of elderly care in the context of international migration where migrant children may be able to provide financial assistance to their parents, but are unable to offer physical care. To investigate the interaction between siblings, I take a non-cooperative view of family decision-making and estimate best response functions for individual physical and financial contributions as a function of siblings' contributions. I address the endogeneity of siblings' contributions and individual migration decisions by using siblings' characteristics as instrumental variables as well as models including family fixed effects. For both migrants and non-migrants, I find evidence that financial contributions function as strategic complements while siblings' time contributions operate as strategic substitutes. This suggests that children's contributions toward elderly care may be based on both strategic bequest and public good motivations.

Elderly Care and Intrafamily Resource Allocation when Children Migrate *

PubMed Central

Antman, Francisca M.

2012-01-01

This paper considers the intrafamily allocation of elderly care in the context of international migration where migrant children may be able to provide financial assistance to their parents, but are unable to offer physical care. To investigate the interaction between siblings, I take a non-cooperative view of family decision-making and estimate best response functions for individual physical and financial contributions as a function of siblings’ contributions. I address the endogeneity of siblings’ contributions and individual migration decisions by using siblings’ characteristics as instrumental variables as well as models including family fixed effects. For both migrants and non-migrants, I find evidence that financial contributions function as strategic complements while siblings’ time contributions operate as strategic substitutes. This suggests that children’s contributions toward elderly care may be based on both strategic bequest and public good motivations. PMID:22518064

Why orphan drug coverage reimbursement decision-making needs patient and public involvement.

PubMed

Douglas, Conor M W; Wilcox, Elizabeth; Burgess, Michael; Lynd, Larry D

2015-05-01

Recently there has been an increase in the active involvement of publics and patients in healthcare and research, which is extending their roles beyond the passive recipients of medicines. However, there has been noticeably less work engaging them into decision-making for healthcare rationing exercises, priority setting, health technology assessment, and coverage decision-making. This is particularly evident in reimbursement decision-making for 'orphan drugs' or drugs for rare diseases. Medicinal products for rare disease offer particular challenges in coverage decision-making because they often lack the 'evidence of efficacy' profiles of common drugs that have been trialed on larger populations. Furthermore, many of these drugs are priced in the high range, and with limited health care budgets the prospective opportunity costs of funding them means that those resources cannot be allocated elsewhere. Here we outline why decision-making for drugs for rare diseases could benefit from increased levels of publics and patients involvement, suggest some possible forms that involvement could take, and advocate for empirical experimentation in this area to evaluate the effects of such involvement. Focus is given to the Canadian context in which we are based; however, potentialities and challenges relating to involvement in this area are likely to be similar elsewhere. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The perfect family: decision making in biparental care.

PubMed

Akçay, Erol; Roughgarden, Joan

2009-10-13

Previous theoretical work on parental decisions in biparental care has emphasized the role of the conflict between evolutionary interests of parents in these decisions. A prominent prediction from this work is that parents should compensate for decreases in each other's effort, but only partially so. However, experimental tests that manipulate parents and measure their responses fail to confirm this prediction. At the same time, the process of parental decision making has remained unexplored theoretically. We develop a model to address the discrepancy between experiments and the theoretical prediction, and explore how assuming different decision making processes changes the prediction from the theory. We assume that parents make decisions in behavioral time. They have a fixed time budget, and allocate it between two parental tasks: provisioning the offspring and defending the nest. The proximate determinant of the allocation decisions are parents' behavioral objectives. We assume both parents aim to maximize the offspring production from the nest. Experimental manipulations change the shape of the nest production function. We consider two different scenarios for how parents make decisions: one where parents communicate with each other and act together (the perfect family), and one where they do not communicate, and act independently (the almost perfect family). The perfect family model is able to generate all the types of responses seen in experimental studies. The kind of response predicted depends on the nest production function, i.e. how parents' allocations affect offspring production, and the type of experimental manipulation. In particular, we find that complementarity of parents' allocations promotes matching responses. In contrast, the relative responses do not depend on the type of manipulation in the almost perfect family model. These results highlight the importance of the interaction between nest production function and how parents make decisions, factors that have largely been overlooked in previous models.

PROCRU: A model for analyzing flight crew procedures in approach to landing

NASA Technical Reports Server (NTRS)

Baron, S.; Zacharias, G.; Muraidharan, R.; Lancraft, R.

1982-01-01

A model for the human performance of approach and landing tasks that would provide a means for systematic exploration of questions concerning the impact of procedural and equipment design and the allocation of resources in the cockpit on performance and safety in approach-to-landing is discussed. A system model is needed that accounts for the interactions of crew, procedures, vehicle, approach geometry, and environment. The issues of interest revolve principally around allocation of tasks in the cockpit and crew performance with respect to the cognitive aspects of the tasks. The model must, therefore, deal effectively with information processing and decision-making aspects of human performance.

Cost-effectiveness analysis: problems and promise for evaluating medical technology

NASA Astrophysics Data System (ADS)

Juday, Timothy R.

1994-12-01

Although using limited financial resources in the most beneficial way, in principle, a laudable goal, actually developing standards for measuring the cost-effectiveness of medical technologies and incorporating them into the coverage process is a much more difficult proposition. Important methodological difficulties include determining how to compare a technology to its leading alternative, defining costs, incorporating patient preferences, and defining health outcomes. In addition, more practical questions must be addressed. These questions include: who does the analysis? who makes the decisions? which technologies to evaluate? what resources are required? what is the political and legal environment? how much is a health outcome worth? The ultimate question that must be answered is what is a health outcome worth? Cost-effectiveness analysis cannot answer this question; it only enables comparison of cost-effectiveness ratios across technologies. In order to determine whether a technology should be covered, society or individual insurers must determine how much they are willing to pay for the health benefits. Conducting cost-effectiveness analysis will not remove the need to make difficult resource allocation decisions; however, explicitly examining the tradeoffs involved in these decisions should help to improve the process.

Robust allocation of a defensive budget considering an attacker's private information.

PubMed

Nikoofal, Mohammad E; Zhuang, Jun

2012-05-01

Attackers' private information is one of the main issues in defensive resource allocation games in homeland security. The outcome of a defense resource allocation decision critically depends on the accuracy of estimations about the attacker's attributes. However, terrorists' goals may be unknown to the defender, necessitating robust decisions by the defender. This article develops a robust-optimization game-theoretical model for identifying optimal defense resource allocation strategies for a rational defender facing a strategic attacker while the attacker's valuation of targets, being the most critical attribute of the attacker, is unknown but belongs to bounded distribution-free intervals. To our best knowledge, no previous research has applied robust optimization in homeland security resource allocation when uncertainty is defined in bounded distribution-free intervals. The key features of our model include (1) modeling uncertainty in attackers' attributes, where uncertainty is characterized by bounded intervals; (2) finding the robust-optimization equilibrium for the defender using concepts dealing with budget of uncertainty and price of robustness; and (3) applying the proposed model to real data. © 2011 Society for Risk Analysis.

Capturing a Commander's decision making style

NASA Astrophysics Data System (ADS)

Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

2017-05-01

A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.

PubMed

Werntoft, Elisabet; Edberg, Anna-Karin

2011-08-01

To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model. The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

Allocating HIV prevention funds in the United States: recommendations from an optimization model.

PubMed

Lasry, Arielle; Sansom, Stephanie L; Hicks, Katherine A; Uzunangelov, Vladislav

2012-01-01

The Centers for Disease Control and Prevention (CDC) had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 and was estimated at 48,600 cases in 2006 and 48,100 in 2009. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention's extramural budget for HIV testing, and counseling and education programs. The model's data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

Evidence-based human resource management: a study of nurse leaders' resource allocation.

PubMed

Fagerström, Lisbeth

2009-05-01

The aims were to illustrate how the RAFAELA system can be used to facilitate evidence-based human resource management. The theoretical framework of the RAFAELA system is based on a holistic view of humankind and a view of leadership founded on human resource management. Nine wards from three central hospitals in Finland participated in the study. The data, stemming from 2006-2007, were taken from the critical indicators (ward-related and nursing intensity information) for national benchmarking used in the RAFAELA system. The data were analysed descriptively. The daily nursing resources per classified patient ratio is a more specific method of measurement than the nurse-to-patient ratio. For four wards, the nursing intensity per nurse surpassed the optimal level 34% to 62.2% of days. Resource allocation was clearly improved in that a better balance between patients' care needs and available nursing resources was maintained. The RAFAELA system provides a rational, systematic and objective foundation for evidence-based human resource management. Data from a systematic use of the RAFAELA system offer objective facts and motives for evidence-based decision making in human resource management, and will therefore enhance the nurse leaders' evidence and scientific based way of working.

Are Indirect Benefits Relevant to Health Care Allocation Decisions?

PubMed

Du Toit, Jessica; Millum, Joseph

2016-10-01

When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we distinguish different conceptions of direct and indirect benefits and argue that only a recipient conception could be morally relevant. We analyze four arguments for thinking that indirect benefits should not count and argue that none is successful in showing that the indirectness of a benefit is a good reason not to count it. We conclude that direct and indirect benefits should be evaluated in the same way. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy, Inc. 2016.

The Canadian STOP-PAIN project - Part 2: What is the cost of pain for patients on waitlists of multidisciplinary pain treatment facilities?

PubMed

Guerriere, Denise N; Choinière, Manon; Dion, Dominique; Peng, Philip; Stafford-Coyte, Emma; Zagorski, Brandon; Banner, Robert; Barton, Pamela M; Boulanger, Aline; Clark, Alexander J; Gordon, Allan S; Guertin, Marie-Claude; Intrater, Howard M; Lefort, Sandra M; Lynch, Mary E; Moulin, Dwight E; Ong-Lam, May; Racine, Mélanie; Rashiq, Saifee; Shir, Yoram; Taenzer, Paul; Ware, Mark

2010-06-01

The Canadian STOP-PAIN Project was designed to document the human and economic burden of chronic pain in individuals on waitlists of Multidisciplinary Pain Treatment Facilities (MPTF). This paper describes the societal costs of their pain. A subgroup of 370 patients was selected randomly from The Canadian STOP-PAIN Project. Participants completed a self-administered costing tool (the Ambulatory and Home Care Record) on a daily basis for three months. They provided information about publicly financed resources, such as health care professional consultations and diagnostic tests as well as privately financed costs, including out-of-pocket expenditures and time devoted to seeking, receiving, and providing care. To determine the cost of care, resources were valued using various costing methods, and multivariate linear regression was used to predict total cost. Overall, the median monthly cost of care was $1,462 (CDN) per study participant. Ninety-five percent of the total expenditures were privately financed. The final regression model consisted of the following determinants: educational level, employment status, province, pain duration, depression, and health-related quality of life. This model accounted for 35% of the variance in total expenditure (P < 0.001). The economic burden of chronic pain is substantial in patients on waitlists of MPTFs. Consequently, it is essential to consider this burden when making decisions regarding resource allocation and waitlist assignment for a MPTF. Resource allocation decision-making should include the economic implications of having patients wait for an assessment and for care.

Vaccines: from valuation to resource allocation.

PubMed

Bloom, David E; Madhavan, Guruprasad

2015-06-08

This review focuses on selected challenges and opportunities concerning broader valuation of vaccines and immunization. The challenges involve conceptualizing and measuring the value of vaccines, while the opportunities relate to the strategic and systematic use of that information in health policy decisions that range from the adoption of particular vaccines in national immunization plans to the allocation of resources to vaccine research, development, and delivery. Clarifying the demonstrable individual, family, and community-level benefits of vaccines will allow the public health community to make better-informed and more meaningful comparisons of the costs of vaccines in relation to their full benefits. Taking advantage of this opportunity will require enhanced data collection and the development of strategic planning tools for transparently assessing trade-offs among the myriad attributes of different vaccines in various social and economic contexts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health-care decision-making processes in Latin America: problems and prospects for the use of economic evaluation.

PubMed

Iglesias, Cynthia P; Drummond, Michael F; Rovira, Joan

2005-01-01

The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific groups of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.

An inventory-theory-based interval-parameter two-stage stochastic programming model for water resources management

NASA Astrophysics Data System (ADS)

Suo, M. Q.; Li, Y. P.; Huang, G. H.

2011-09-01

In this study, an inventory-theory-based interval-parameter two-stage stochastic programming (IB-ITSP) model is proposed through integrating inventory theory into an interval-parameter two-stage stochastic optimization framework. This method can not only address system uncertainties with complex presentation but also reflect transferring batch (the transferring quantity at once) and period (the corresponding cycle time) in decision making problems. A case of water allocation problems in water resources management planning is studied to demonstrate the applicability of this method. Under different flow levels, different transferring measures are generated by this method when the promised water cannot be met. Moreover, interval solutions associated with different transferring costs also have been provided. They can be used for generating decision alternatives and thus help water resources managers to identify desired policies. Compared with the ITSP method, the IB-ITSP model can provide a positive measure for solving water shortage problems and afford useful information for decision makers under uncertainty.

Incorporating uncertainty of management costs in sensitivity analyses of matrix population models.

PubMed

Salomon, Yacov; McCarthy, Michael A; Taylor, Peter; Wintle, Brendan A

2013-02-01

The importance of accounting for economic costs when making environmental-management decisions subject to resource constraints has been increasingly recognized in recent years. In contrast, uncertainty associated with such costs has often been ignored. We developed a method, on the basis of economic theory, that accounts for the uncertainty in population-management decisions. We considered the case where, rather than taking fixed values, model parameters are random variables that represent the situation when parameters are not precisely known. Hence, the outcome is not precisely known either. Instead of maximizing the expected outcome, we maximized the probability of obtaining an outcome above a threshold of acceptability. We derived explicit analytical expressions for the optimal allocation and its associated probability, as a function of the threshold of acceptability, where the model parameters were distributed according to normal and uniform distributions. To illustrate our approach we revisited a previous study that incorporated cost-efficiency analyses in management decisions that were based on perturbation analyses of matrix population models. Incorporating derivations from this study into our framework, we extended the model to address potential uncertainties. We then applied these results to 2 case studies: management of a Koala (Phascolarctos cinereus) population and conservation of an olive ridley sea turtle (Lepidochelys olivacea) population. For low aspirations, that is, when the threshold of acceptability is relatively low, the optimal strategy was obtained by diversifying the allocation of funds. Conversely, for high aspirations, the budget was directed toward management actions with the highest potential effect on the population. The exact optimal allocation was sensitive to the choice of uncertainty model. Our results highlight the importance of accounting for uncertainty when making decisions and suggest that more effort should be placed on understanding the distributional characteristics of such uncertainty. Our approach provides a tool to improve decision making. © 2013 Society for Conservation Biology.

Improving Resource Allocation Decisions to Reduce the Risk of Terrorist Attacks on Passenger Rail Systems

DTIC Science & Technology

2016-12-01

theory, passenger rail bombing , attacker-defender methodology 15. NUMBER OF PAGES 103 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT...bombers carried out a successful coordinated attack against the London mass transit system in July 2005. Three suicide bombings occurred on trains and...iron rods to make shrapnel. The precise timing indicates the terrorists themselves detonated their own devices. In March 2016, a suicide bomb

Transforming the Air Traffic Management System -- Why Is It So Hard?

DTIC Science & Technology

2012-11-08

Aircraft Systems Integration The Equity Concept Chocolate Cake Problem: How can I distribute this cake equitably among each of the students sitting...net-centric system. – Timely, common information will be available to all (humans and machines ) to help them make their decisions. – While any change...prioritization done when scarce resources must be allocated? (Remember how hard it was to distribute the chocolate cake!) ADS-B In-Trail Procedures

The value of models in informing resource allocation in colorectal cancer screening – 1 the case of the Netherlands

PubMed Central

van Hees, Frank; Zauber, Ann G.; van Veldhuizen, Harriët; Heijnen, Marie-Louise A.; Penning, Corine; de Koning, Harry J.; van Ballegooijen, Marjolein; Lansdorp-Vogelaar, Iris

2015-01-01

In May 2011, the Dutch government decided to implement a national programme for colorectal cancer (CRC) screening using biennial faecal immunochemical test (FIT) screening between ages 55 and 75.[1] Decision modelling played an important role in informing this decision, as well as in the planning and implementation of the programme afterwards. In this overview, we illustrate the value of models in informing resource allocation in CRC screening, using the role that decision modelling has played in the Dutch CRC screening programme as an example. PMID:26063755

Resource Allocation in British Universities. SRHE Monograph 56.

ERIC Educational Resources Information Center

Shattock, Michael, Ed.; Rigby, Gwynneth, Ed.

The ways that British universities allocate their resources are discussed, with attention to different styles, techniques, and decison-making structures. Since the purpose is to describe institutional models of resource allocation, specific universities are not identified by name. After identifying the sources of income and the breakdown of…

The values jury to aid natural resource decisions

Treesearch

Thomas C. Brown; George L. Peterson; Bruce E. Tonn

1995-01-01

Congressional legislation emphasizes that public resource allocation should reflect the values citizens assign to those resources. Yet, information about assigned values and preferences of members of the public, including economic measures of value, required by decision makers is often incomplete or unavailable. Existing sources of information about the public's...

The Influence of Evaluators' Principles on Evaluation Resource Decisions

ERIC Educational Resources Information Center

Crohn, Kara Shea Davis

2009-01-01

This study examines ways in which evaluators' principles influence decisions about evaluation resources. Evaluators must seek-out and allocate (often scarce) resources (e.g., money, time, data, people, places) in a way that allows them to conduct the best possible evaluation given clients' and evaluation participants' constraints. Working within…

Cost-effectiveness analysis and formulary decision making in England: findings from research.

PubMed

Williams, Iestyn P; Bryan, Stirling

2007-11-01

In a context of rapid technological advances in health care and increasing demand for expensive treatments, local formulary committees are key players in the management of scarce resources. However, little is known about the information and processes used when making decisions on the inclusion of new treatments. This paper reports research on the use of economic evaluations in technology coverage decisions in England, although the findings have a relevance to other health care systems with devolved responsibility for resource allocation. It reports a study of four local formulary committees in which both qualitative and quantitative data were collected. Our main research finding is that it is an exception for cost-effectiveness analysis to inform technology coverage decisions. Barriers to use include access and expertise levels, concerns relating to the independence of analyses and problems with implementation of study recommendations. Further barriers derive from the constraints on decision makers, a lack of clarity over functions and aims of local committees, and the challenge of disinvestment in medical technologies. The relative weakness of the research-practice dynamics in this context suggests the need for a rethinking of the role of both analysts and decision makers. Our research supports the view that in order to be useful, analysis needs to better reflect the constraints of the local decision-making environment. We also recommend that local decision-making committees and bodies in the National Health Service more clearly identify the 'problems' which they are charged with solving and how their outputs contribute to broader finance and commissioning functions. This would help to establish the ways in which the routine use of cost-effectiveness analysis might become a reality.

Multimorbidity in chronic disease: impact on health care resources and costs

PubMed Central

McPhail, Steven M

2016-01-01

Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person-specific factors (including social disadvantage and age), which represent important considerations for health service planning. Important priorities for research include economic evaluations of interventions, services, or health system approaches that can remediate the burden of multimorbidity in safe and cost-effective ways. PMID:27462182

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

PubMed Central

2011-01-01

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

Equilibrium approach towards water resource management and pollution control in coal chemical industrial park.

PubMed

Xu, Jiuping; Hou, Shuhua; Xie, Heping; Lv, Chengwei; Yao, Liming

2018-08-01

In this study, an integrated water and waste load allocation model is proposed to assist decision makers in better understanding the trade-offs between economic growth, resource utilization, and environmental protection of coal chemical industries which characteristically have high water consumption and pollution. In the decision framework, decision makers in a same park, each of whom have different goals and preferences, work together to seek a collective benefit. Similar to a Stackelberg-Nash game, the proposed approach illuminates the decision making interrelationships and involves in the conflict coordination between the park authority and the individual coal chemical company stockholders. In the proposed method, to response to climate change and other uncertainties, a risk assessment tool, Conditional Value-at-Risk (CVaR) and uncertainties through reflecting parameters and coefficients using probability and fuzzy set theory are integrated in the modeling process. Then a case study from Yuheng coal chemical park is presented to demonstrate the practicality and efficiency of the optimization model. To reasonable search the potential consequences of different responses to water and waste load allocation strategies, a number of scenario results considering environmental uncertainty and decision maker' attitudes are examined to explore the tradeoffs between economic development and environmental protection and decision makers' objectives. The results are helpful for decision/police makers to adjust current strategies adapting for current changes. Based on the scenario analyses and discussion, some propositions and operational policies are given and sensitive adaptation strategies are presented to support the efficient, balanced and sustainable development of coal chemical industrial parks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Guiding resource allocations based on terrorism risk.

PubMed

Willis, Henry H

2007-06-01

Establishing tolerable levels of risk is one of the most contentious and important risk management decisions. With every regulatory or funding decision for a risk management program, society decides whether or not risk is tolerable. The Urban Area Security Initiative (UASI) is a Department of Homeland Security (DHS) grant program designed to enhance security and overall preparedness to prevent, respond to, and recover from acts of terrorism by providing financial assistance for planning, equipment, training, and exercise needs of large urban areas. After briefly reviewing definitions of terrorism risk and rationales for risk-based resource allocation, this article compares estimates of terrorism risk in urban areas that received UASI funding in 2004 to other federal risk management decisions. This comparison suggests that UASI allocations are generally consistent with other federal risk management decisions. However, terrorism risk in several cities that received funding is below levels that are often tolerated in other risk management contexts. There are several reasons why the conclusions about terrorism risk being de minimis in specific cities should be challenged. Some of these surround the means used to estimate terrorism risk for this study. Others involve the comparison that is made to other risk management decisions. However, many of the observations reported are valid even if reported terrorism risk estimates are several orders of magnitude too low. Discussion of resource allocation should be extended to address risk tolerance and include explicit comparisons, like those presented here, to other risk management decisions.

Children Rectify Inequalities for Disadvantaged Groups

ERIC Educational Resources Information Center

Elenbaas, Laura; Killen, Melanie

2016-01-01

Children's decisions regarding the allocation of societal resources in the context of preexisting inequalities were investigated. African American and European American children ages 5 to 6 years (n = 91) and 10 to 11 years (n = 94) judged the acceptability of a medical resource inequality on the basis of race, allocated medical supplies,…

Mental health economics: insights from Brazil.

PubMed

Cruz, Luciane; Lima, Ana Flavia Da Silva; Graeff-Martins, Ana; Maia, Carlos Renato Moreira; Ziegelmann, Patricia; Miguel, Sandoro; Fleck, Marcelo; Polanczyk, Carisi

2013-04-01

As the responsibility and demand on health care grows and resources do not increase at the same pace, the healthcare system has been forced to reconsider the benefits and costs of their actions, to ensure a rational and effective decision-making process regarding the adoption of interventions and allocation of resources. Cost-effectiveness (CE) studies represent one of the basic tools to achieve this goal. To present the current state of Health Technology Assessment (HTA) and health economics in mental health in Brazil and its importance to the decision-making process. Descriptive paper on HTA and health economics in Brazil. Databases from government and universities as well as some scientific databases to assess the information are presented. Economic analysis to evaluate interventions in mental health care is a relatively recent addition to the field of health economics; in Brazil, it is also considered a topic within Epidemiology research area. There have been an increased number of studies developed in high-income countries. However, there are fewer CE studies in low- and middle-income ones. Psychiatric disorders represent a significant burden in developing countries, where resources devoted to health care are even scarcer.

Tying Resources to Results: Integrating the Resource Allocation Process into Planning and Management in a Public Two-Year College.

ERIC Educational Resources Information Center

Bers, John A.

A budgetary process that serves a college in an era of expansion is likely to break down when the resource base is reduced and tough-minded decisions about priorities are required. This paper describes a resource allocation system that Gadsden State Junior College developed and tested over a two-year period to respond to fiscal contraction. Key…

Resource allocation processes at multilateral organizations working in global health.

PubMed

Chi, Y-Ling; Bump, Jesse B

2018-02-01

International institutions provide well over US$10 billion in development assistance for health (DAH) annually and between 1990 and 2014, DAH disbursements totaled $458 billion but how do they decide who gets what, and for what purpose? In this article, we explore how allocation decisions were made by the nine convening agencies of the Equitable Access Initiative. We provide clear, plain language descriptions of the complete process from resource mobilization to allocation for the nine multilateral agencies with prominent agendas in global health. Then, through a comparative analysis we illuminate the choices and strategies employed in the nine international institutions. We find that resource allocation in all reviewed institutions follow a similar pattern, which we categorized in a framework of five steps: strategy definition, resource mobilization, eligibility of countries, support type and funds allocation. All the reviewed institutions generate resource allocation decisions through well-structured and fairly complex processes. Variations in those processes seem to reflect differences in institutional principles and goals. However, these processes have serious shortcomings. Technical problems include inadequate flexibility to account for or meet country needs. Although aid effectiveness and value for money are commonly referenced, we find that neither performance nor impact is a major criterion for allocating resources. We found very little formal consideration of the incentives generated by allocation choices. Political issues include non-transparent influence on allocation processes by donors and bureaucrats, and the common practice of earmarking funds to bypass the normal allocation process entirely. Ethical deficiencies include low accountability and transparency at international institutions, and limited participation by affected citizens or their representatives. We find that recipient countries have low influence on allocation processes themselves, although within these processes they have some influence in relatively narrow areas. © The Author(s) 2018. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Radar coordination and resource management in a distributed sensor network using emergent control

NASA Astrophysics Data System (ADS)

Weir, B. S.; Sokol, T. M.

2009-05-01

As the list of anti-air warfare and ballistic missile defense missions grows, there is an increasing need to coordinate and optimize usage of radar resources across the netted force. Early attempts at this optimization involved top-down control mechanisms whereby sensors accept resource tasking orders from networked tracking elements. These approaches rely heavily on uncertain knowledge of sensor constraints and capabilities. Furthermore, advanced sensor systems may support self-defense missions of the host platform and are therefore unable to relinquish control to an external function. To surmount these issues, the use of bottom-up emergent control techniques is proposed. The information necessary to make quality, network-wide resource allocations is readily available to sensor nodes with access to a netted track picture. By assessing resource priorities relative to the network (versus local) track picture, sensors can understand the contribution of their resources to the netted force. This allows the sensors to apply resources where most needed and remove waste. Furthermore, simple local rules for resource usage, when properly constructed, allow sensors to obtain a globally optimal resource allocation without direct coordination (emergence). These results are robust to partial implementation (i.e., not all nodes upgraded at once) and failures on individual nodes (whether from casualty or reallocation to other sensor missions), and they leave resource control decisions in the hands of the sensor systems instead of an external function. This paper presents independent research and development work on emergent control of sensor resources and the impact to resource allocation and tracking performance.

Distributive Decisions in Education: Goals, Trade-Offs, and Feasibility Constraints

ERIC Educational Resources Information Center

Shores, Kenneth; Loeb, Susanna

2016-01-01

Educators, policymakers, and citizens face questions of how to allocate scarce resources in the pursuit of competing goals for children and youth. Our goal in this article is to provide decision-makers with a framework for considering allocative problems in education, explicitly highlighting the implications of relevant feasibility constraints. We…

A decision-analytic approach to the optimal allocation of resources for endangered species consultation

USGS Publications Warehouse

Converse, Sarah J.; Shelley, Kevin J.; Morey, Steve; Chan, Jeffrey; LaTier, Andrea; Scafidi, Carolyn; Crouse, Deborah T.; Runge, Michael C.

2011-01-01

The resources available to support conservation work, whether time or money, are limited. Decision makers need methods to help them identify the optimal allocation of limited resources to meet conservation goals, and decision analysis is uniquely suited to assist with the development of such methods. In recent years, a number of case studies have been described that examine optimal conservation decisions under fiscal constraints; here we develop methods to look at other types of constraints, including limited staff and regulatory deadlines. In the US, Section Seven consultation, an important component of protection under the federal Endangered Species Act, requires that federal agencies overseeing projects consult with federal biologists to avoid jeopardizing species. A benefit of consultation is negotiation of project modifications that lessen impacts on species, so staff time allocated to consultation supports conservation. However, some offices have experienced declining staff, potentially reducing the efficacy of consultation. This is true of the US Fish and Wildlife Service's Washington Fish and Wildlife Office (WFWO) and its consultation work on federally-threatened bull trout (Salvelinus confluentus). To improve effectiveness, WFWO managers needed a tool to help allocate this work to maximize conservation benefits. We used a decision-analytic approach to score projects based on the value of staff time investment, and then identified an optimal decision rule for how scored projects would be allocated across bins, where projects in different bins received different time investments. We found that, given current staff, the optimal decision rule placed 80% of informal consultations (those where expected effects are beneficial, insignificant, or discountable) in a short bin where they would be completed without negotiating changes. The remaining 20% would be placed in a long bin, warranting an investment of seven days, including time for negotiation. For formal consultations (those where expected effects are significant), 82% of projects would be placed in a long bin, with an average time investment of 15. days. The WFWO is using this decision-support tool to help allocate staff time. Because workload allocation decisions are iterative, we describe a monitoring plan designed to increase the tool's efficacy over time. This work has general application beyond Section Seven consultation, in that it provides a framework for efficient investment of staff time in conservation when such time is limited and when regulatory deadlines prevent an unconstrained approach. ?? 2010.

Are economic evaluations and health technology assessments increasingly demanded in times of rationing health services? The case of the Argentine financial crisis.

PubMed

Rubinstein, Adolfo; Belizán, María; Discacciati, Vilda

2007-01-01

After 4 years of deepening recession, Argentina's economy plummeted after default in 2002. This crisis critically affected health expenditures and triggered acute rationing. Our objective was to explore health decision-makers' knowledge and attitudes about economic evaluations (EE) and whether health technology assessment (HTA) were increasingly used for decision making. A qualitative design based on semistructured interviews and focus groups was used to explore how decision makers belonging to different health sectors implement resource allocation decisions. Informants were mostly unaware of EE. The most important criteria mentioned to adopt a treatment were evidence of effectiveness, social/stakeholder demand, or resource availability. Despite general positive attitudes about EE, knowledge was rather limited. Although cost considerations were widely accepted by purchasers and managers, clinicians argued about these issues as interfering with the doctor-patient relationship. Other important perceived barriers to HTA use were lack of confidence in the transferability of studies conducted in developed countries and institutional fragmentation of the Argentine healthcare system. The new macroeconomic context was cited as a justification of implicit rationing measures. Although explicit priority setting was implemented by many purchasers and managers, HTA was not used to improve technical and/or allocative efficiency. The crisis seems to be a strong incentive to extend the use of HTA in Argentina, provided decision makers are aware as well as involved in the generation of local studies.

Theories of the price and quantity of physician services. A synthesis and critique.

PubMed

Farley, P J

1986-12-01

In the traditional neoclassical model of supply and demand, prices determine the allocation of economic resources. The difficulty in applying this model to physician services is the rationing of resources directly by physicians themselves, eliminating the allocative function of prices. Welfare consequences are appropriately judged in terms of efficiency and equity, not departures from the structural relationships implied by supply and demand. As interpreted here, both competitive theories and target-income theories of this market imply that physicians consider both their own welfare and the welfare of their patients in their decision-making. All consumer benefits and all producer costs are internalized by physicians. They consequently have an incentive to obtain the maximum possible social benefit from the resources at their disposal, to the extent that they are (implicitly) allowed to share in the resulting social gains. The distribution of gains between patients and physicians is determined by professional ethics within bounds imposed by competitive forces.

An exploration of Bureau of Reclamation approaches for managing conflict over diverging science

USGS Publications Warehouse

Burkardt, Nina; Ruell, Emily; Clark, Douglas

2008-01-01

As a major institutional agent supplying Western water resources, the Bureau of Reclamation (Reclamation) provides important leadership, technical, and financial resources in water management, serving as the West's "water broker" (Bowersox 2000; Pisani 2003). In recent years, growing numbers of constituencies using water and the over-allocation of water resources have contributed to conflict over the resource in the American West (National Research Council 2004). Although the conflicts arise from many sources, one common theme is that Reclamation managers often must make decisions about water use and allocation when scientific studies provide uncertain or competing recommendations. We conducted a preliminary study of Reclamation water managers and water scientists to try to understand the approaches or techniques they use or consider useful for dealing with scientific conflicts over water allocation and how these compare to techniques found in the relevant literature. We report the results of (1) an electronic survey of Reclamation senior managers and (2) a panel discussion amongst Reclamation senior managers as to the current institutional capabilities for managing diverging scientific findings in water dispute resolution processes. We conclude with a discussion of the strengths and weaknesses of the different tools and techniques managers reported in the survey and in the panel discussion.

[Parameter of evidence-based medicine in health care economics].

PubMed

Wasem, J; Siebert, U

1999-08-01

In the view of scarcity of resources, economic evaluations in health care, in which not only effects but also costs related to a medical intervention are examined and a incremental cost-outcome-ratio is build, are an important supplement to the program of evidence based medicine. Outcomes of a medical intervention can be measured by clinical effectiveness, quality-adjusted life years, and monetary evaluation of benefits. As far as costs are concerned, direct medical costs, direct non-medical costs and indirect costs have to be considered in an economic evaluation. Data can be used from primary studies or secondary analysis; metaanalysis for synthesizing of data may be adequate. For calculation of incremental cost-benefit-ratios, models of decision analysis (decision tree models, Markov-models) often are necessary. Methodological and ethical limits for application of the results of economic evaluation in resource allocation decision in health care have to be regarded: Economic evaluations and the calculation of cost-outcome-rations should only support decision making but cannot replace it.

Dynamic versus static allocation policies in multipurpose multireservoir systems

NASA Astrophysics Data System (ADS)

Tilmant, A.; Goor, Q.; Pinte, D.; van der Zaag, P.

2007-12-01

As the competition for water is likely to increase in the near future due to socioeconomic development and population growth, water resources managers will face hard choices when allocating water between competing users. Because water is a vital resource used in multiple sectors, including the environment, the allocation is inherently a political and social process, which is likely to become increasingly scrutinized as the competition grows between the different sectors. Since markets are usually absent or ineffective, the allocation of water between competing demands is achieved administratively taking into account key objectives such as economic efficiency, equity and maintaining the ecological integrity. When crop irrigation is involved, water is usually allocated by a system of annual rights to use a fixed, static, volume of water. In a fully-allocated basin, moving from a static to a dynamic allocation process, whereby the policies are regularly updated according to the hydrologic status of the river basin, is the first step towards the development of river basin management strategies that increase the productivity of water. More specifically, in a multipurpose multireservoir system, continuously adjusting release and withdrawal decisions based on the latest hydrologic information will increase the benefits derived from the system. However, the extent to which such an adjustment can be achieved results from complex spatial and temporal interactions between the physical characteristics of the water resources system (storage, natural flows), the economic and social consequences of rationing and the impacts on natural ecosystems. The complexity of the decision-making process, which requires the continuous evaluation of numerous trade-offs, calls for the use of integrated hydrologic-economic models. This paper compares static and dynamic management approaches for a cascade of hydropower-irrigation reservoirs using stochastic dual dynamic programming (SDDP) formulations. As its name indicates, SDDP is an extension of SDP that removes the curse of dimensionality found in discrete SDP and can therefore be used to analyze large-scale water resources systems. For the static approach, the multiobjective (irrigation-hydropower) optimization problem is solved using the constraint method, i.e. net benefits from hydropower generation are maximized and irrigation water withdrawals are additional constraints. In the dynamic approach, the SDDP model seeks to maximize the net benefits of both hydropower and irrigation crop production. A cascade of 8 reservoirs in the Turkish and Syrian parts of the Euphrates river basin is used as a case study.

Health technology funding decision-making processes around the world: the same, yet different.

PubMed

Stafinski, Tania; Menon, Devidas; Philippon, Donald J; McCabe, Christopher

2011-06-01

All healthcare systems routinely make resource allocation decisions that trade off potential health gains to different patient populations. However, when such trade-offs relate to the introduction of new, promising health technologies, perceived 'winners' and 'losers' are more apparent. In recent years, public scrutiny over such decisions has intensified, raising the need to better understand how they are currently made and how they might be improved. The objective of this paper is to critically review and compare current processes for making health technology funding decisions at the regional, state/provincial and national level in 20 countries. A comprehensive search for published, peer-reviewed and grey literature describing actual national, state/provincial and regional/institutional technology decision-making processes was conducted. Information was extracted by two independent reviewers and tabulated to facilitate qualitative comparative analyses. To identify strengths and weaknesses of processes identified, websites of corresponding organizations were searched for commissioned reviews/evaluations, which were subsequently analysed using standard qualitative methods. A total of 21 national, four provincial/state and six regional/institutional-level processes were found. Although information on each one varied, they could be grouped into four sequential categories: (i) identification of the decision problem; (ii) information inputs; (iii) elements of the decision-making process; and (iv) public accountability and decision implementation. While information requirements of all processes appeared substantial and decision-making factors comprehensive, the way in which they were utilized was often unclear, as were approaches used to incorporate social values or equity arguments into decisions. A comprehensive inventory of approaches to implementing the four main components of all technology funding decision-making processes was compiled, from which areas for future work or research aimed at improving the acceptability of decisions were identified. They include the explication of decision criteria and social values underpinning processes.

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy

PubMed Central

Seixas, Brayan V.

2018-01-01

In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation. PMID:29626402

Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Brooke, Vanessa; Dyer, Tim; Waller, Cara; King, Richard; Ramsey, Wayne; Mortimer, Duncan

2017-05-25

This is the sixth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE program was established to investigate a systematic, integrated, evidence-based approach to disinvestment within a large Australian health service. This paper describes the methods employed in undertaking pilot disinvestment projects. It draws a number of lessons regarding the strengths and weaknesses of these methods; particularly regarding the crucial first step of identifying targets for disinvestment. Literature reviews, survey, interviews, consultation and workshops were used to capture and process the relevant information. A theoretical framework was adapted for evaluation and explication of disinvestment projects, including a taxonomy for the determinants of effectiveness, process of change and outcome measures. Implementation, evaluation and costing plans were developed. Four literature reviews were completed, surveys were received from 15 external experts, 65 interviews were conducted, 18 senior decision-makers attended a data gathering workshop, 22 experts and local informants were consulted, and four decision-making workshops were undertaken. Mechanisms to identify disinvestment targets and criteria for prioritisation and decision-making were investigated. A catalogue containing 184 evidence-based opportunities for disinvestment and an algorithm to identify disinvestment projects were developed. An Expression of Interest process identified two potential disinvestment projects. Seventeen additional projects were proposed through a non-systematic nomination process. Four of the 19 proposals were selected as pilot projects but only one reached the implementation stage. Factors with potential influence on the outcomes of disinvestment projects are discussed and barriers and enablers in the pilot projects are summarised. This study provides an in-depth insight into the experience of disinvestment in one local healthcare service. To our knowledge, this is the first paper to report the process of disinvestment from identification, through prioritisation and decision-making, to implementation and evaluation, and finally explication of the processes and outcomes.

United States Marine Corps 2012 Financial Report. Schedule of Budgetary Activity for Fiscal Year 2012 Appropriations

DTIC Science & Technology

2012-01-01

activity schedule for current year appropriations that is also compliant with Generally Accepted Accounting Principles ( GAAP ). The audit of this financial...are not only fighters, but also who can serve as trainers, mentors and advisers. Marine Corps Value to the Nation For a remarkably small investment ...who are interested in and could use the information in the statements to help them make resource allocation and other decisions and hold the entity

The role of cognitive and emotional perspective taking in economic decision making in the ultimatum game.

PubMed

Takagishi, Haruto; Koizumi, Michiko; Fujii, Takayuki; Schug, Joanna; Kameshima, Shinya; Yamagishi, Toshio

2014-01-01

We conducted a simple resource allocation game known as the ultimatum game (UG) with preschoolers to examine the role of cognitive and emotional perspective-taking ability on allocation and rejection behavior. A total of 146 preschoolers played the UG and completed a false belief task and an emotional perspective-taking test. Results showed that cognitive perspective taking ability had a significant positive effect on the proposer's offer and a negative effect on the responder's rejection behavior, whereas emotional perspective taking ability did not impact either the proposer's or responder's behavior. These results imply that the ability to anticipate the responder's beliefs, but not their emotional state, plays an important role in the proposer's choice of a fair allocation in an UG, and that children who have not acquired theory of mind still reject unfair offers.

If You're a Rawlsian, How Come You're So Close to Utilitarianism and Intuitionism? A Critique of Daniels's Accountability for Reasonableness.

PubMed

Badano, Gabriele

2018-03-01

Norman Daniels's theory of 'accountability for reasonableness' is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls's general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls's argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important role that utilitarian-like cost-effectiveness calculations are allowed to play in resource allocation processes disregards the separateness of persons and is seriously unfair towards individuals whose interests are sacrificed for the sake of groups. Furthermore, the function played by intuitions in settling frequent value conflicts opens the door for sheer custom and vested interests to steer decision-making.

Staff nurse turnover costs: Part II, Measurements and results.

PubMed

Jones, C B

1990-05-01

This study demonstrated that the costs of nursing turnover can be high (over +10,000 per RN turnover), and that the potential for adverse impact on the nursing department, the hospital environment, and the healthcare environment exists. The results of this study are important, particularly in the midst of a national nursing shortage, for several reasons. CNEs are responsible for obtaining, allocating, and managing nursing department resources; knowledge of nursing turnover costs will allow them to make more informed decisions about how best to allocate scarce resources. The findings of this study are also important to hospital administrators because they demonstrate the financial impact of high rates of nursing turnover on healthcare delivery. Finally, these findings provide nurse researchers direction for future research into the costs and benefits of nursing turnover and retention activities, so that cost-effective methods of minimizing organizational costs can be determined.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

Statistical, economic and other tools for assessing natural aggregate

USGS Publications Warehouse

Bliss, J.D.; Moyle, P.R.; Bolm, K.S.

2003-01-01

Quantitative aggregate resource assessment provides resource estimates useful for explorationists, land managers and those who make decisions about land allocation, which may have long-term implications concerning cost and the availability of aggregate resources. Aggregate assessment needs to be systematic and consistent, yet flexible enough to allow updating without invalidating other parts of the assessment. Evaluators need to use standard or consistent aggregate classification and statistic distributions or, in other words, models with geological, geotechnical and economic variables or interrelationships between these variables. These models can be used with subjective estimates, if needed, to estimate how much aggregate may be present in a region or country using distributions generated by Monte Carlo computer simulations.

A Model for Resource Allocation Using Operational Knowledge Assets

ERIC Educational Resources Information Center

Andreou, Andreas N.; Bontis, Nick

2007-01-01

Purpose: The paper seeks to develop a business model that shows the impact of operational knowledge assets on intellectual capital (IC) components and business performance and use the model to show how knowledge assets can be prioritized in driving resource allocation decisions. Design/methodology/approach: Quantitative data were collected from 84…

A Decision Support System For The Real-Time Allocation Of The Water Resource Of The Tarim River Basin, China

NASA Astrophysics Data System (ADS)

Wei, J.; Wang, G.; Liu, R.

2008-12-01

The Tarim River Basin is the longest inland river in China. Due to water scarcity, ecologically-fragile is becoming a significant constraint to sustainable development in this region. To effectively manage the limited water resources for ecological purposes and for conventional water utilization purposes, a real-time water resources allocation Decision Support System (DSS) has been developed. Based on workflows of the water resources regulations and comprehensive analysis of the efficiency and feasibility of water management strategies, the DSS includes information systems that perform data acquisition, management and visualization, and model systems that perform hydrological forecast, water demand prediction, flow routing simulation and water resources optimization of the hydrological and water utilization process. An optimization and process control strategy is employed to dynamically allocate the water resources among the different stakeholders. The competitive targets and constraints are taken into considered by multi-objective optimization and with different priorities. The DSS of the Tarim River Basin has been developed and been successfully utilized to support the water resources management of the Tarim River Basin since 2005.

Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations

PubMed Central

2012-01-01

Background Health economics is increasingly used to inform resource allocation decision-making, however, there is comparatively little evidence relevant to minority groups. In part, this is due to lack of cost and effectiveness data specific to these groups upon which economic evaluations can be based. Consequently, resource allocation decisions often rely on mainstream evidence which may not be representative, resulting in inequitable funding decisions. This paper describes a method to overcome this deficiency for Australia’s Indigenous population. A template has been developed which can adapt mainstream health intervention data to the Indigenous setting. Methods The ‘Indigenous Health Service Delivery Template’ has been constructed using mixed methods, which include literature review, stakeholder discussions and key informant interviews. The template quantifies the differences in intervention delivery between best practice primary health care for the Indigenous population via Aboriginal Community Controlled Health Services (ACCHSs), and mainstream general practitioner (GP) practices. Differences in costs and outcomes have been identified, measured and valued. This template can then be used to adapt mainstream health intervention data to allow its economic evaluation as if delivered from an ACCHS. Results The template indicates that more resources are required in the delivery of health interventions via ACCHSs, due to their comprehensive nature. As a result, the costs of such interventions are greater, however this is accompanied by greater benefits due to improved health service access. In the example case of the polypill intervention, 58% more costs were involved in delivery via ACCHSs, with 50% more benefits. Cost-effectiveness ratios were also altered accordingly. Conclusions The Indigenous Health Service Delivery Template reveals significant differences in the way health interventions are delivered from ACCHSs compared to mainstream GP practices. It is important that these differences are included in the conduct of economic evaluations to ensure results are relevant to Indigenous Australians. Similar techniques would be generalisable to other disadvantaged minority populations. This will allow resource allocation decision-makers access to economic evidence that more accurately represents the needs and context of disadvantaged groups, which is particularly important if addressing health inequities is a stated goal. PMID:22954136

Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules.

PubMed

O'Brien, B J; Sculpher, M J

2000-05-01

Current principles of cost-effectiveness analysis emphasize the rank ordering of programs by expected economic return (eg, quality-adjusted life-years gained per dollar expended). This criterion ignores the variance associated with the cost-effectiveness of a program, yet variance is a common measure of risk when financial investment options are appraised. Variation in health care program return is likely to be a criterion of program selection for health care managers with fixed budgets and outcome performance targets. Characterizing health care resource allocation as a risky investment problem, we show how concepts of portfolio analysis from financial economics can be adopted as a conceptual framework for presenting cost-effectiveness data from multiple programs as mean-variance data. Two specific propositions emerge: (1) the current convention of ranking programs by expected return is a special case of the portfolio selection problem in which the decision maker is assumed to be indifferent to risk, and (2) for risk-averse decision makers, the degree of joint risk or covariation in cost-effectiveness between programs will create incentives to diversify an investment portfolio. The conventional normative assumption of risk neutrality for social-level public investment decisions does not apply to a large number of health care resource allocation decisions in which health care managers seek to maximize returns subject to budget constraints and performance targets. Portfolio theory offers a useful framework for studying mean-variance tradeoffs in cost-effectiveness and offers some positive predictions (and explanations) of actual decision making in the health care sector.

Adversarial reasoning and resource allocation: the LG approach

NASA Astrophysics Data System (ADS)

Stilman, Boris; Yakhnis, Vladimir; Umanskiy, Oleg; Boyd, Ron

2005-05-01

Many existing automated tools purporting to model the intelligent enemy utilize a fixed battle plan for the enemy while using flexible decisions of human players for the friendly side. According to the Naval Studies Board, "It is an open secret and a point of distress ... that too much of the substantive content of such M&S has its origin in anecdote, ..., or a narrow construction tied to stereotypical current practices of 'doctrinally correct behavior.'" Clearly, such runs lack objectivity by being heavily skewed in favor of the friendly forces. Presently, the military branches employ a variety of game-based simulators and synthetic environments, with manual (i.e., user-based) decision-making, for training and other purposes. However, without an ability to automatically generate the best strategies, tactics, and COA, the games serve mostly to display the current situation rather than form a basis for automated decision-making and effective training. We solve the problem of adversarial reasoning as a gaming problem employing Linguistic Geometry (LG), a new type of game theory demonstrating significant increase in size in gaming problems solvable in real and near-real time. It appears to be a viable approach for solving such practical problems as mission planning and battle management. Essentially, LG may be structured into two layers: game construction and game solving. Game construction includes construction of a game called an LG hypergame based on a hierarchy of Abstract Board Games (ABG). Game solving includes resource allocation for constructing an advantageous initial game state and strategy generation to reach a desirable final game state in the course of the game.

Balancing the Fair Treatment of Others While Preserving Group Identity and Autonomy

PubMed Central

Killen, Melanie; Elenbaas, Laura; Rutland, Adam

2016-01-01

Social exclusion and inclusion from groups, as well as the distribution of resources, are fundamental aspects of social life, and serve as sources of conflicts that bear on issues of fairness and equality, beginning in childhood. For the most part, research on social exclusion and allocation of resources has not focused on the issue of group membership. Yet, social exclusion from groups and the denial of resources reflect societal issues pertaining to social inequality and its counterpoint, fair treatment of others. Social inequality occurs when opportunities and resources are distributed unevenly in society, often through group norms about allocation that reflect socially defined categories of persons. This occurs at multiple levels of societal organization, from experiences of exclusion in childhood such as being left out of a play activity, to being denied access to resources as a member of a group. These situations extend to larger level experiences in the adult world concerning social exclusion from voting, for example, or participation in educational institutions. Thus, most decisions regarding social exclusion and the denial of resources involve considerations of group identity and group membership, implicitly or explicitly, which contribute to prejudice and bias, even though this has rarely been investigated in developmental science. Current research illustrating the role of group identity and autonomy regarding decision-making about social exclusion and the denial of resources is reviewed from the Social Reasoning Developmental model, one that integrates social domain theory and developmental social identity theories to investigate how children use moral, conventional, and psychological judgments to evaluate contexts reflecting group identity, group norms, and intergroup dynamics. PMID:27175034

Balancing the Fair Treatment of Others While Preserving Group Identity and Autonomy.

PubMed

Killen, Melanie; Elenbaas, Laura; Rutland, Adam

2016-04-01

Social exclusion and inclusion from groups, as well as the distribution of resources, are fundamental aspects of social life, and serve as sources of conflicts that bear on issues of fairness and equality, beginning in childhood. For the most part, research on social exclusion and allocation of resources has not focused on the issue of group membership. Yet, social exclusion from groups and the denial of resources reflect societal issues pertaining to social inequality and its counterpoint, fair treatment of others. Social inequality occurs when opportunities and resources are distributed unevenly in society, often through group norms about allocation that reflect socially defined categories of persons. This occurs at multiple levels of societal organization, from experiences of exclusion in childhood such as being left out of a play activity, to being denied access to resources as a member of a group. These situations extend to larger level experiences in the adult world concerning social exclusion from voting, for example, or participation in educational institutions. Thus, most decisions regarding social exclusion and the denial of resources involve considerations of group identity and group membership, implicitly or explicitly, which contribute to prejudice and bias, even though this has rarely been investigated in developmental science. Current research illustrating the role of group identity and autonomy regarding decision-making about social exclusion and the denial of resources is reviewed from the Social Reasoning Developmental model, one that integrates social domain theory and developmental social identity theories to investigate how children use moral, conventional, and psychological judgments to evaluate contexts reflecting group identity, group norms, and intergroup dynamics.

2005 8th Annual Systems Engineering Conference. Volume 4, Thursday

DTIC Science & Technology

2005-10-27

requirements, allocation , and utilization statistics Operations Decisions Acquisition Decisions Resource Management — Integrated Requirements/ Allocation ...Quality Improvement Consultants, Inc. “Automated Software Testing Increases Test Quality and Coverage Resulting in Improved Software Reliability.”, Mr...Steven Ligon, SAIC The Return of Discipline, Ms. Jacqueline Townsend, Air Force Materiel Command Track 4 - Net Centric Operations: Testing Net-Centric

Task allocation among multiple intelligent robots

NASA Technical Reports Server (NTRS)

Gasser, L.; Bekey, G.

1987-01-01

Researchers describe the design of a decentralized mechanism for allocating assembly tasks in a multiple robot assembly workstation. Currently, the approach focuses on distributed allocation to explore its feasibility and its potential for adaptability to changing circumstances, rather than for optimizing throughput. Individual greedy robots make their own local allocation decisions using both dynamic allocation policies which propagate through a network of allocation goals, and local static and dynamic constraints describing which robots are elibible for which assembly tasks. Global coherence is achieved by proper weighting of allocation pressures propagating through the assembly plan. Deadlock avoidance and synchronization is achieved using periodic reassessments of local allocation decisions, ageing of allocation goals, and short-term allocation locks on goals.

A model of human decision making in multiple process monitoring situations

NASA Technical Reports Server (NTRS)

Greenstein, J. S.; Rouse, W. B.

1982-01-01

Human decision making in multiple process monitoring situations is considered. It is proposed that human decision making in many multiple process monitoring situations can be modeled in terms of the human's detection of process related events and his allocation of attention among processes once he feels event have occurred. A mathematical model of human event detection and attention allocation performance in multiple process monitoring situations is developed. An assumption made in developing the model is that, in attempting to detect events, the human generates estimates of the probabilities that events have occurred. An elementary pattern recognition technique, discriminant analysis, is used to model the human's generation of these probability estimates. The performance of the model is compared to that of four subjects in a multiple process monitoring situation requiring allocation of attention among processes.

Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2018-04-13

Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

Economic evaluations of point of care testing strategies for active tuberculosis.

PubMed

Zwerling, Alice; Dowdy, David

2013-06-01

Point of care (POC) diagnostics are often hailed as having the potential to transform tuberculosis (TB) control efforts. However, POC testing is better conceptualized as a system of diagnosis and treatment, not simply a test that can provide rapid, deployable results. Economic evaluations may help decision makers allocate scarce resources for TB control, but evaluations of POC testing face unique challenges that include evaluating the full diagnostic system, incorporating implementation costs, translating diagnostic results into health and accounting for downstream treatment costs. For economic evaluations to reach their full potential as decision-making tools for POC testing in TB, these challenges must be understood and addressed.

A queueing model of pilot decision making in a multi-task flight management situation

NASA Technical Reports Server (NTRS)

Walden, R. S.; Rouse, W. B.

1977-01-01

Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

Rawlsian maximin rule operates as a common cognitive anchor in distributive justice and risky decisions

PubMed Central

Kameda, Tatsuya; Inukai, Keigo; Higuchi, Satomi; Ogawa, Akitoshi; Kim, Hackjin; Matsuda, Tetsuya; Sakagami, Masamichi

2016-01-01

Distributive justice concerns the moral principles by which we seek to allocate resources fairly among diverse members of a society. Although the concept of fair allocation is one of the fundamental building blocks for societies, there is no clear consensus on how to achieve “socially just” allocations. Here, we examine neurocognitive commonalities of distributive judgments and risky decisions. We explore the hypothesis that people’s allocation decisions for others are closely related to economic decisions for oneself at behavioral, cognitive, and neural levels, via a concern about the minimum, worst-off position. In a series of experiments using attention-monitoring and brain-imaging techniques, we investigated this “maximin” concern (maximizing the minimum possible payoff) via responses in two seemingly disparate tasks: third-party distribution of rewards for others, and choosing gambles for self. The experiments revealed three robust results: (i) participants’ distributive choices closely matched their risk preferences—“Rawlsians,” who maximized the worst-off position in distributions for others, avoided riskier gambles for themselves, whereas “utilitarians,” who favored the largest-total distributions, preferred riskier but more profitable gambles; (ii) across such individual choice preferences, however, participants generally showed the greatest spontaneous attention to information about the worst possible outcomes in both tasks; and (iii) this robust concern about the minimum outcomes was correlated with activation of the right temporoparietal junction (RTPJ), the region associated with perspective taking. The results provide convergent evidence that social distribution for others is psychologically linked to risky decision making for self, drawing on common cognitive–neural processes with spontaneous perspective taking of the worst-off position. PMID:27688764

Ethical Issues in Public Health Practice in Michigan

PubMed Central

Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

2009-01-01

Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

Counterfactual Evaluation of Outcomes in Social Risk Decision-Making Situations: The Cognitive Developmental Paradox Revisited.

PubMed

Padrón, Iván; Rodrigo, María Jose; de Vega, Manuel

2016-01-01

We report a study that examined the existence of a cognitive developmental paradox in the counterfactual evaluation of decision-making outcomes. According to this paradox adolescents and young adults could be able to apply counterfactual reasoning and, yet, their counterfactual evaluation of outcomes could be biased in a salient socio-emotional context. To this aim, we analyzed the impact of health and social feedback on the counterfactual evaluation of outcomes in a laboratory decision-making task involving short narratives with the presence of peers. Forty risky (e.g., taking or refusing a drug), forty neutral decisions (e.g., eating a hamburger or a hotdog), and emotions felt following positive or negative outcomes were examined in 256 early, mid- and late adolescents, and young adults, evenly distributed. Results showed that emotional ratings to negative outcomes (regret and disappointment) but not to positive outcomes (relief and elation) were attenuated when feedback was provided. Evidence of development of cognitive decision-making capacities did also exist, as the capacity to perform faster emotional ratings and to differentially allocate more resources to the elaboration of emotional ratings when no feedback information was available increased with age. Overall, we interpret these findings as challenging the traditional cognitive developmental assumption that development necessarily proceeds from lesser to greater capacities, reflecting the impact of socio-emotional processes that could bias the counterfactual evaluation of social decision-making outcomes.

[Hospital self-management policy in Chile: perceptions of decision-makers].

PubMed

Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

2013-01-01

To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Influence of biases in numerical magnitude allocation on human prosocial decision making.

PubMed

Arshad, Qadeer; Nigmatullina, Yuliya; Siddiqui, Shuaib; Franka, Mustafa; Mediratta, Saniya; Ramachandaran, Sanjeev; Lobo, Rhannon; Malhotra, Paresh A; Roberts, R E; Bronstein, Adolfo M

2017-12-01

Over the past decade neuroscientific research has attempted to probe the neurobiological underpinnings of human prosocial decision making. Such research has almost ubiquitously employed tasks such as the dictator game or similar variations (i.e., ultimatum game). Considering the explicit numerical nature of such tasks, it is surprising that the influence of numerical cognition on decision making during task performance remains unknown. While performing these tasks, participants typically tend to anchor on a 50:50 split that necessitates an explicit numerical judgement (i.e., number-pair bisection). Accordingly, we hypothesize that the decision-making process during the dictator game recruits overlapping cognitive processes to those known to be engaged during number-pair bisection. We observed that biases in numerical magnitude allocation correlated with the formulation of decisions during the dictator game. That is, intrinsic biases toward smaller numerical magnitudes were associated with the formulation of less favorable decisions, whereas biases toward larger magnitudes were associated with more favorable choices. We proceeded to corroborate this relationship by subliminally and systematically inducing biases in numerical magnitude toward either higher or lower numbers using a visuo-vestibular stimulation paradigm. Such subliminal alterations in numerical magnitude allocation led to proportional and corresponding changes to an individual's decision making during the dictator game. Critically, no relationship was observed between neither intrinsic nor induced biases in numerical magnitude on decision making when assessed using a nonnumerical-based prosocial questionnaire. Our findings demonstrate numerical influences on decisions formulated during the dictator game and highlight the necessity to control for confounds associated with numerical cognition in human decision-making paradigms. NEW & NOTEWORTHY We demonstrate that intrinsic biases in numerical magnitude can directly predict the amount of money donated by an individual to an anonymous stranger during the dictator game. Furthermore, subliminally inducing perceptual biases in numerical-magnitude allocation can actively drive prosocial choices in the corresponding direction. Our findings provide evidence for numerical influences on decision making during performance of the dictator game. Accordingly, without the implementation of an adequate control for numerical influences, the dictator game and other tasks with an inherent numerical component (i.e., ultimatum game) should be employed with caution in the assessment of human behavior. Copyright © 2017 the American Physiological Society.

Multi-Objective, Auto-Optimization Modeling for Resource Allocation Decision Making in the Military Health System

DTIC Science & Technology

2014-01-22

FTEs would need to be reduced by 12.16, expenses reduced by $184.63K, and the number of interns adjusted by 7.67. The reference set for DMU D includes...efficiency: concept, measurement techniques and review of hospital efficiency studies. Malaysian Journal of Public Health Medicine, 10(2), 35-43...REPORT DOCUMENTATION PAGE Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 Form Approved OMB No. 0704-0188 The public reporting burden

Modeling hospitals' adaptive capacity during a loss of infrastructure services.

PubMed

Vugrin, Eric D; Verzi, Stephen J; Finley, Patrick D; Turnquist, Mark A; Griffin, Anne R; Ricci, Karen A; Wyte-Lake, Tamar

2015-01-01

Resilience in hospitals - their ability to withstand, adapt to, and rapidly recover from disruptive events - is vital to their role as part of national critical infrastructure. This paper presents a model to provide planning guidance to decision makers about how to make hospitals more resilient against possible disruption scenarios. This model represents a hospital's adaptive capacities that are leveraged to care for patients during loss of infrastructure services (power, water, etc.). The model is an optimization that reallocates and substitutes resources to keep patients in a high care state or allocates resources to allow evacuation if necessary. An illustrative example demonstrates how the model might be used in practice.

Documenting the decision structure in software development

NASA Technical Reports Server (NTRS)

Wild, J. Christian; Maly, Kurt; Shen, Stewart N.

1990-01-01

Current software development paradigms focus on the products of the development process. Much of the decision making process which produces these products is outside the scope of these paradigms. The Decision-Based Software Development (DBSD) paradigm views the design process as a series of interrelated decisions which involve the identification and articulation of problems, alternates, solutions and justifications. Decisions made by programmers and analysts are recorded in a project data base. Unresolved problems are also recorded and resources for their resolution are allocated by management according to the overall development strategy. This decision structure is linked to the products affected by the relevant decision and provides a process oriented view of the resulted system. Software maintenance uses this decision view of the system to understand the rationale behind the decisions affecting the part of the system to be modified. D-HyperCase, a prototype Decision-Based Hypermedia System is described and results of applying the DBSD approach during its development are presented.

Direct Allocation Costing: Informed Management Decisions in a Changing Environment.

ERIC Educational Resources Information Center

Mancini, Cesidio G.; Goeres, Ernest R.

1995-01-01

It is argued that colleges and universities can use direct allocation costing to provide quantitative information needed for decision making. This method of analysis requires institutions to modify traditional ideas of costing, looking to the private sector for examples of accurate costing techniques. (MSE)

Effect of social influence on effort-allocation for monetary rewards.

PubMed

Gilman, Jodi M; Treadway, Michael T; Curran, Max T; Calderon, Vanessa; Evins, A Eden

2015-01-01

Though decades of research have shown that people are highly influenced by peers, few studies have directly assessed how the value of social conformity is weighed against other types of costs and benefits. Using an effort-based decision-making paradigm with a novel social influence manipulation, we measured how social influence affected individuals' decisions to allocate effort for monetary rewards during trials with either high or low probability of receiving a reward. We found that information about the effort-allocation of peers modulated participant choices, specifically during conditions of low probability of obtaining a reward. This suggests that peer influence affects effort-based choices to obtain rewards especially under conditions of risk. This study provides evidence that people value social conformity in addition to other costs and benefits when allocating effort, and suggests that neuroeconomic studies that assess trade-offs between effort and reward should consider social environment as a factor that can influence decision-making.

Developing inventory and monitoring programs based on multiple objectives

NASA Astrophysics Data System (ADS)

Schmoldt, Daniel L.; Peterson, David L.; Silsbee, David G.

1994-09-01

Resource inventory and monitoring (I&M) programs in national parks combine multiple objectives in order to create a plan of action over a finite time horizon. Because all program activities are constrained by time and money, it is critical to plan I&M activities that make the best use of available agency resources. However, multiple objectives complicate a relatively straightforward allocation process. The analytic hierarchy process (AHP) offers a structure for multiobjective decision making so that decision-makers’ preferences can be formally incorporated in seeking potential solutions. Within the AHP, inventory and monitoring program objectives and decision criteria are organized into a hierarchy. Pairwise comparisons among decision elements at any level of the hierarchy provide a ratio scale ranking of those elements. The resulting priority values for all projects are used as each project’s contribution to the value of an overall I&M program. These priorities, along with budget and personnel constraints, are formulated as a zero/one integer programming problem that can be solved to select those projects that produce the best program. An extensive example illustrates how this approach is being applied to I&M projects in national parks in the Pacific Northwest region of the United States. The proposed planning process provides an analytical framework for multicriteria decisionmaking that is rational, consistent, explicit, and defensible.

How to Fairly Allocate Scarce Medical Resources: Ethical Argumentation under Scrutiny by Health Professionals and Lay People.

PubMed

Krütli, Pius; Rosemann, Thomas; Törnblom, Kjell Y; Smieszek, Timo

2016-01-01

Societies are facing medical resource scarcities, inter alia due to increased life expectancy and limited health budgets and also due to temporal or continuous physical shortages of resources like donor organs. This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair. The purpose of this study was to explore how lay people, general practitioners, medical students and other health professionals evaluate the fairness of ten allocation principles for scarce medical resources: 'sickest first', 'waiting list', 'prognosis', 'behaviour' (i.e., those who engage in risky behaviour should not be prioritized), 'instrumental value' (e.g., health care workers should be favoured during epidemics), 'combination of criteria' (i.e., a sequence of the 'youngest first', 'prognosis', and 'lottery' principles), 'reciprocity' (i.e., those who provided services to the society in the past should be rewarded), 'youngest first', 'lottery', and 'monetary contribution'. 1,267 respondents to an online questionnaire were confronted with hypothetical situations of scarcity regarding (i) donor organs, (ii) hospital beds during an epidemic, and (iii) joint replacements. Nine allocation principles were evaluated in terms of fairness for each type of scarcity along 7-point Likert scales. The relationship between demographic factors (gender, age, religiosity, political orientation, and health status) and fairness evaluations was modelled with logistic regression. Medical background was a major predictor of fairness evaluations. While general practitioners showed different response patterns for all three allocation situations, the responses by lay people were very similar. Lay people rated 'sickest first' and 'waiting list' on top of all allocation principles-e.g., for donor organs 83.8% (95% CI: [81.2%-86.2%]) rated 'sickest first' as fair ('fair' is represented by scale points 5-7), and 69.5% [66.2%-72.4%] rated 'waiting list' as fair. The corresponding results for general practitioners: 'prognosis' 79.7% [74.2%-84.9%], 'combination of criteria' 72.6% [66.4%-78.5%], and 'sickest first' 74.5% [68.6%-80.1%); these were the highest-rated allocation principles for donor organs allocation. Interestingly, only 44.3% [37.7%-50.9%] of the general practitioners rated 'instrumental value' as fair for the allocation of hospital beds during a flu epidemic. The fairness evaluations by general practitioners obtained for joint replacements: 'sickest first' 84.0% [78.8%-88.6%], 'combination of criteria' 65.6% [59.2%-71.8%], and 'prognosis' 63.7% [57.1%-70.0%]. 'Lottery', 'reciprocity', 'instrumental value', and 'monetary contribution' were considered very unfair allocation principles by both groups. Medical students' ratings were similar to those of general practitioners, and the ratings by other health professionals resembled those of lay people. Results are partly at odds with current conclusions proposed by some ethicists. A number of ethicists reject 'sickest first' and 'waiting list' as morally unjustifiable allocation principles, whereas those allocation principles received the highest fairness endorsements by lay people and to some extent also by health professionals. Decision makers are advised to consider whether or not to give ethicists, health professionals, and the general public an equal voice when attempting to arrive at maximally endorsed allocations of scarce medical resources.

Models of resource allocation optimization when solving the control problems in organizational systems

NASA Astrophysics Data System (ADS)

Menshikh, V.; Samorokovskiy, A.; Avsentev, O.

2018-03-01

The mathematical model of optimizing the allocation of resources to reduce the time for management decisions and algorithms to solve the general problem of resource allocation. The optimization problem of choice of resources in organizational systems in order to reduce the total execution time of a job is solved. This problem is a complex three-level combinatorial problem, for the solving of which it is necessary to implement the solution to several specific problems: to estimate the duration of performing each action, depending on the number of performers within the group that performs this action; to estimate the total execution time of all actions depending on the quantitative composition of groups of performers; to find such a distribution of the existing resource of performers in groups to minimize the total execution time of all actions. In addition, algorithms to solve the general problem of resource allocation are proposed.

One and done? Equality of opportunity and repeated access to scarce, indivisible medical resources

PubMed Central

2012-01-01

Background Existing ethical guidelines recommend that, all else equal, past receipt of a medical resource (e.g. a scarce organ) should not be considered in current allocation decisions (e.g. a repeat transplantation). Discussion One stated reason for this ethical consensus is that formal theories of ethics and justice do not persuasively accept or reject repeated access to the same medical resources. Another is that restricting attention to past receipt of a particular medical resource seems arbitrary: why couldn’t one just as well, it is argued, consider receipt of other goods such as income or education? In consequence, simple allocation by lottery or first-come-first-served without consideration of any past receipt is thought to best afford equal opportunity, conditional on equal medical need. There are three issues with this view that need to be addressed. First, public views and patient preferences are less ambiguous than formal theories of ethics. Empirical work shows strong preferences for fairness in health care that have not been taken into account: repeated access to resources has been perceived as unfair. Second, while difficult to consider receipt of many other prior resources including non-medical resources, this should not be used a motive for ignoring the receipt of any and all goods including the focal resource in question. Third, when all claimants to a scarce resource are equally deserving, then use of random allocation seems warranted. However, the converse is not true: mere use of a randomizer does not by itself make the merits of all claimants equal. Summary My conclusion is that not ignoring prior receipt of the same medical resource, and prioritizing those who have not previously had access to the medical resource in question, may be perceived as fairer and more equitable by society. PMID:22624597

One and done? Equality of opportunity and repeated access to scarce, indivisible medical resources.

PubMed

Huesch, Marco D

2012-05-24

Existing ethical guidelines recommend that, all else equal, past receipt of a medical resource (e.g. a scarce organ) should not be considered in current allocation decisions (e.g. a repeat transplantation). One stated reason for this ethical consensus is that formal theories of ethics and justice do not persuasively accept or reject repeated access to the same medical resources. Another is that restricting attention to past receipt of a particular medical resource seems arbitrary: why couldn't one just as well, it is argued, consider receipt of other goods such as income or education? In consequence, simple allocation by lottery or first-come-first-served without consideration of any past receipt is thought to best afford equal opportunity, conditional on equal medical need.There are three issues with this view that need to be addressed. First, public views and patient preferences are less ambiguous than formal theories of ethics. Empirical work shows strong preferences for fairness in health care that have not been taken into account: repeated access to resources has been perceived as unfair. Second, while difficult to consider receipt of many other prior resources including non-medical resources, this should not be used a motive for ignoring the receipt of any and all goods including the focal resource in question. Third, when all claimants to a scarce resource are equally deserving, then use of random allocation seems warranted. However, the converse is not true: mere use of a randomizer does not by itself make the merits of all claimants equal. My conclusion is that not ignoring prior receipt of the same medical resource, and prioritizing those who have not previously had access to the medical resource in question, may be perceived as fairer and more equitable by society.

A community-based randomised controlled trial of three different educational resources for men about prostate cancer screening.

PubMed

Gattellari, Melina; Ward, Jeanette E

2005-05-01

Randomised evaluations of resources to facilitate informed decisions about prostate cancer screening are rarely conducted. In this study, 421 men recruited from the community were randomly allocated to receive a leaflet (n = 140) or one of two resources meeting criteria for a decision-aid: a video (n = 141) or an evidence-based booklet, developed by the authors (n = 140). Men in all three groups demonstrated significant increases in knowledge scores from pre to post-test. Scores were significantly higher at post-test amongst those who had received our evidence-based booklet compared with men who received the leaflet or video (P < 0.001). Scores were significantly modified by men's preferences for decisional control (P = 0.002). Decisional conflict was significantly lower amongst men receiving the evidence-based booklet (P = 0.038). Men receiving the evidence-based booklet also were less likely to accept a recommendation by a GP to undergo prostate-specific-antigen (PSA) screening (P = 0.003). Men require detailed information about the pros and cons of PSA screening in order to make an informed decision. Resources are not equivalent in achieving these outcomes.

A brief history of decision making.

PubMed

Buchanan, Leigh; O'Connell, Andrew

2006-01-01

Sometime around the middle of the past century, telephone executive Chester Barnard imported the term decision making from public administration into the business world. There it began to replace narrower terms, like "resource allocation" and "policy making," shifting the way managers thought about their role from continuous, Hamlet-like deliberation toward a crisp series of conclusions reached and actions taken. Yet, decision making is, of course, a broad and ancient human pursuit, flowing back to a time when people sought guidance from the stars. From those earliest days, we have strived to invent better tools for the purpose, from the Hindu-Arabic systems for numbering and algebra, to Aristotle's systematic empiricism, to friar Occam's advances in logic, to Francis Bacon's inductive reasoning, to Descartes's application of the scientific method. A growing sophistication with managing risk, along with a nuanced understanding of human behavior and advances in technology that support and mimic cognitive processes, has improved decision making in many situations. Even so, the history of decision-making strategies--captured in this time line and examined in the four accompanying essays on risk, group dynamics, technology, and instinct--has not marched steadily toward perfect rationalism. Twentieth-century theorists showed that the costs of acquiring information lead executives to make do with only good-enough decisions. Worse, people decide against their own economic interests even when they know better. And in the absence of emotion, it's impossible to make any decisions at all. Erroneous framing, bounded awareness, excessive optimism: The debunking of Descartes's rational man threatens to swamp our confidence in our choices. Is it really surprising, then, that even as technology dramatically increases our access to information, Malcolm Gladwell extols the virtues of gut decisions made, literally, in the blink of an eye?

Algorithms for synthesizing management solutions based on OLAP-technologies

NASA Astrophysics Data System (ADS)

Pishchukhin, A. M.; Akhmedyanova, G. F.

2018-05-01

OLAP technologies are a convenient means of analyzing large amounts of information. An attempt was made in their work to improve the synthesis of optimal management decisions. The developed algorithms allow forecasting the needs and accepted management decisions on the main types of the enterprise resources. Their advantage is the efficiency, based on the simplicity of quadratic functions and differential equations of only the first order. At the same time, the optimal redistribution of resources between different types of products from the assortment of the enterprise is carried out, and the optimal allocation of allocated resources in time. The proposed solutions can be placed on additional specially entered coordinates of the hypercube representing the data warehouse.

Sharing the cost of river basin adaptation portfolios to climate change: Insights from social justice and cooperative game theory

NASA Astrophysics Data System (ADS)

Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velazquez, Manuel

2016-10-01

The adaptation of water resource systems to the potential impacts of climate change requires mixed portfolios of supply and demand adaptation measures. The issue is not only to select efficient, robust, and flexible adaptation portfolios but also to find equitable strategies of cost allocation among the stakeholders. Our work addresses such cost allocation problems by applying two different theoretical approaches: social justice and cooperative game theory in a real case study. First of all, a cost-effective portfolio of adaptation measures at the basin scale is selected using a least-cost optimization model. Cost allocation solutions are then defined based on economic rationality concepts from cooperative game theory (the Core). Second, interviews are conducted to characterize stakeholders' perceptions of social justice principles associated with the definition of alternatives cost allocation rules. The comparison of the cost allocation scenarios leads to contrasted insights in order to inform the decision-making process at the river basin scale and potentially reap the efficiency gains from cooperation in the design of river basin adaptation portfolios.

Development of a fuzzy-stochastic programming with Green Z-score criterion method for planning water resources systems with a trading mechanism.

PubMed

Zeng, X T; Huang, G H; Li, Y P; Zhang, J L; Cai, Y P; Liu, Z P; Liu, L R

2016-12-01

This study developed a fuzzy-stochastic programming with Green Z-score criterion (FSGZ) method for water resources allocation and water quality management with a trading-mechanism (WAQT) under uncertainties. FSGZ can handle uncertainties expressed as probability distributions, and it can also quantify objective/subjective fuzziness in the decision-making process. Risk-averse attitudes and robustness coefficient are joined to express the relationship between the expected target and outcome under various risk preferences of decision makers and systemic robustness. The developed method is applied to a real-world case of WAQT in the Kaidu-Kongque River Basin in northwest China, where an effective mechanism (e.g., market trading) to simultaneously confront severely diminished water availability and degraded water quality is required. Results of water transaction amounts, water allocation patterns, pollution mitigation schemes, and system benefits under various scenarios are analyzed, which indicate that a trading-mechanism is a more sustainable method to manage water-environment crisis in the study region. Additionally, consideration of anthropogenic (e.g., a risk-averse attitude) and systemic factors (e.g., the robustness coefficient) can support the generation of a robust plan associated with risk control for WAQT when uncertainty is present. These findings assist local policy and decision makers to gain insights into water-environment capacity planning to balance the basin's social and economic growth with protecting the region's ecosystems.

Husband and Wife Perspectives on Farm Household Decision-making Authority and Evidence on Intra-household Accord in Rural Tanzania.

PubMed

Anderson, C Leigh; Reynolds, Travis W; Gugerty, Mary Kay

2017-02-01

We use OLS and logistic regression to investigate variation in husband and wife perspectives on the division of authority over agriculture-related decisions within households in rural Tanzania. Using original data from husbands and wives (interviewed separately) in 1,851 Tanzanian households, the analysis examines differences in the wife's authority over 13 household and farming decisions. The study finds that the level of decision-making authority allocated to wives by their husbands, and the authority allocated by wives to themselves, both vary significantly across households. In addition to commonly considered assets such as women's age and education, in rural agricultural households women's health and labor activities also appear to matter for perceptions of authority. We also find husbands and wives interviewed separately frequently disagree with each other over who holds authority over key farming, family, and livelihood decisions. Further, the results of OLS and logistic regression suggest that even after controlling for various individual, household, and regional characteristics, husband and wife claims to decision-making authority continue to vary systematically by decision-suggesting that decision characteristics themselves also matter. The absence of spousal agreement over the allocation of authority (i.e., a lack of "intra-household accord") over different farm and household decisions is problematic for interventions seeking to use survey data to develop and inform strategies for reducing gender inequalities or empowering women in rural agricultural households. Findings provide policy and program insights into when studies interviewing only a single spouse or considering only a single decision may inaccurately characterize intra-household decision-making dynamics.

Improving equity in the provision of primary health care: lessons from decentralized planning and management in Namibia.

PubMed Central

Bell, Ruth; Ithindi, Taathi; Low, Anne

2002-01-01

This paper draws lessons from a review of primary health care services in Windhoek, the capital of Namibia, undertaken by a regional health management team. The review was carried out because of perceived increases in workload and inadequate staffing levels, arising from the rapid expansion of the city associated with inward migration. A survey of the utilization of government clinics was used to develop a more equitable allocation of primary health care services between localities. The survey revealed disparities between patterns of utilization of the services and the allocation of staff: the poorer localities were relatively underprovided. Decisions made centrally on resource allocation had reinforced the inequities. On the basis of the results of the review, the regional health management team redistributed nursing and medical staff and argued for a shift in the allocation of capital expenditure towards the poorer communities. The review demonstrates the potential for regional and provincial health management teams to make effective assessments of the needs of their populations and to promote the equitable delivery of primary health care services. In order to achieve this they need not only to become effective managers, but also to develop population-based planning skills and the confidence and authority to influence the allocation of resources between and within their regions and provinces. PMID:12219160

Proceduralism and its role in economic evaluation and priority setting in health.

PubMed

Jan, Stephen

2014-05-01

This paper provides a critical overview of Gavin Mooney's proceduralist approach to economic evaluation and priority setting in health. Proceduralism is the notion that the social value attached to alternative courses of action should be determined not only by outcomes, but also processes. Mooney's brand of proceduralism was unique and couched within a broader critique of 'neo-liberal' economics. It operated on a number of levels. At the micro level of the individual program, he pioneered the notion that 'process utility' could be valued and measured within economic evaluation. At a macro level, he developed a framework in which the social objective of equity was defined by procedural justice in which communitarian values were used as the basis for judging how resources should be allocated across the health system. Finally, he applied the notion of procedural justice to further our understanding of the political economy of resource allocation; highlighting how fairness in decision making processes can overcome the sometimes intractable zero-sum resource allocation problem. In summary, his contributions to this field have set the stage for innovative programs of research to help in developing health policies and programs that are both in alignment with community values and implementable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modelling decision-making by pilots

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.

1993-01-01

Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).

Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

PubMed Central

Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

2013-01-01

ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

Cognitive load reducing in destination decision system

NASA Astrophysics Data System (ADS)

Wu, Chunhua; Wang, Cong; Jiang, Qien; Wang, Jian; Chen, Hong

2007-12-01

With limited cognitive resource, the quantity of information can be processed by a person is limited. If the limitation is broken, the whole cognitive process would be affected, so did the final decision. The research of effective ways to reduce the cognitive load is launched from two aspects: cutting down the number of alternatives and directing the user to allocate his limited attention resource based on the selective visual attention theory. Decision-making is such a complex process that people usually have difficulties to express their requirements completely. An effective method to get user's hidden requirements is put forward in this paper. With more requirements be caught, the destination decision system can filtering more quantity of inappropriate alternatives. Different information piece has different utility, if the information with high utility would get attention easily, the decision might be made more easily. After analyzing the current selective visual attention theory, a new presentation style based on user's visual attention also put forward in this paper. This model arranges information presentation according to the movement of sightline. Through visual attention, the user can put their limited attention resource on the important information. Hidden requirements catching and presenting information based on the selective visual attention are effective ways to reducing the cognitive load.

Rewards boost sustained attention through higher effort: A value-based decision making approach.

PubMed

Massar, Stijn A A; Lim, Julian; Sasmita, Karen; Chee, Michael W L

2016-10-01

Maintaining sustained attention over time is an effortful process limited by finite cognitive resources. Recent theories describe the role of motivation in the allocation of such resources as a decision process: the costs of effortful performance are weighed against its gains. We examined this hypothesis by combining methods from attention research and decision neuroscience. Participants first performed a sustained attention task at different levels of reward. They then performed a reward-discounting task, measuring the subjective costs of performance. Results demonstrated that higher rewards led to improved performance (Exp 1-3), and enhanced attentional effort (i.e. pupil diameter; Exp 2 & 3). Moreover, discounting curves constructed from the choice task indicated that subjects devalued rewards that came at the cost of staying vigilant for a longer duration (Exp 1 & 2). Motivation can thus boost sustained attention through increased effort, while sustained performance is regarded as a cost against which rewards are discounted. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Reciprocal Cost Allocation and Decision Making for Universities.

ERIC Educational Resources Information Center

Metzger, Lawrence M.

1994-01-01

Examines the use of the reciprocal method as an alternative to more conventional methods of university service department cost allocation. This method can be used with software that is readily available and with already known data. Reciprocal cost allocation will provide appropriate allocation values for financial reporting and data for university…

Decentralization and equity of resource allocation: evidence from Colombia and Chile.

PubMed Central

Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

2003-01-01

OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417

Stigmatizing attitudes about mental illness and allocation of resources to mental health services.

PubMed

Corrigan, Patrick W; Watson, Amy C; Warpinski, Amy C; Gracia, Gabriela

2004-08-01

This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; [1993]. Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with mental illness and treatment efficacy. Fifty four individuals participated in a larger study of education about mental health stigma. Participants completed various measures of resource allocation preferences for mandated treatment and rehabilitation services, attributions about people with mental illness, and factors that influence allocation preferences including perceived treatment efficacy. Results showed significant attitudinal correlates with resource allocation preferences for mandated treatment, but no correlates to rehabilitation services. In particular, people who pity people with mental illness as well as those that endorse coercive and segregated treatments, were more likely to rate resource allocation to mandated care as important. Perceived treatment efficacy was also positively associated with resource allocation preferences for mandated treatment. A separate behavioral measure that involved donating money to NAMI was found to be inversely associated with blaming people for their mental illness and not being willing to help them. Implications of these findings on strategies that seek to increase resources for mental health programs are discussed.

Cognitive cost as dynamic allocation of energetic resources.

PubMed

Christie, S Thomas; Schrater, Paul

2015-01-01

While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the "cost/benefit" and "limited resource" models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning.

Risk preferences in strategic wildfire decision making: a choice experiment with U.S. wildfire managers.

PubMed

Wibbenmeyer, Matthew J; Hand, Michael S; Calkin, David E; Venn, Tyron J; Thompson, Matthew P

2013-06-01

Federal policy has embraced risa management as an appropriate paradigm for wildfire management. Economic theory suggests that over repeated wildfire events, potential economic costs and risas of ecological damage are optimally balanced when management decisions are free from biases, risa aversion, and risa seeking. Of primary concern in this article is how managers respond to wildfire risa, including the potential effect of wildfires (on ecological values, structures, and safety) and the likelihood of different fire outcomes. We use responses to a choice experiment questionnaire of U.S. federal wildfire managers to measure attitudes toward several components of wildfire risa and to test whether observed risa attitudes are consistent with the efficient allocation of wildfire suppression resources. Our results indicate that fire managers' decisions are consistent with nonexpected utility theories of decisions under risa. Managers may overallocate firefighting resources when the likelihood or potential magnitude of damage from fires is low, and sensitivity to changes in the probability of fire outcomes depends on whether probabilities are close to one or zero and the magnitude of the potential harm. © 2012 Society for Risk Analysis.

A judgment and decision-making model for plant behavior.

PubMed

Karban, Richard; Orrock, John L

2018-06-12

Recently plant biologists have documented that plants, like animals, engage in many activities that can be considered as behaviors, although plant biologists currently lack a conceptual framework to understand these processes. Borrowing the well-established framework developed by psychologists, we propose that plant behaviors can be constructively modeled by identifying four distinct components: 1) a cue or stimulus that provides information, 2) a judgment whereby the plant perceives and processes this informative cue, 3) a decision whereby the plant chooses among several options based on their relative costs and benefits, and 4) action. Judgment for plants can be determined empirically by monitoring signaling associated with electrical, calcium, or hormonal fluxes. Decision-making can be evaluated empirically by monitoring gene expression or differential allocation of resources. We provide examples of the utility of this judgment and decision-making framework by considering cases in which plants either successfully or unsuccessfully induced resistance against attacking herbivores. Separating judgment from decision-making suggests new analytical paradigms (i.e., Bayesian methods for judgment and economic utility models for decision-making). Following this framework, we propose an experimental approach to plant behavior that explicitly manipulates the stimuli provided to plants, uses plants that vary in sensory abilities, and examines how environmental context affects plant responses. The concepts and approaches that follow from the judgment and decision-making framework can shape how we study and understand plant-herbivore interactions, biological invasions, plant responses to climate change, and the susceptibility of plants to evolutionary traps. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A Qualitative Evaluation of Program Budgeting and Marginal Analysis in a Canadian Pediatric Tertiary Care Institution.

PubMed

Smith, Neale; Mitton, Craig; Hiltz, Mary-Ann; Campbell, Matthew; Dowling, Laura; Magee, J Fergall; Gujar, Shashi Ashok

2016-10-01

Hospitals in Canada are being asked by governments to improve efficiency and do more with fewer resources. Healthcare decision makers are thus driven to find better ways to manage budgets and deliver on their mission. Formal processes of priority setting and resource allocation (PSRA) are one means to this end. This paper reports an evaluation of one such approach, Program Budgeting and Marginal Analysis (PBMA), as applied at a children and women's tertiary care facility in Nova Scotia, Canada. A brief evaluation conducted immediately after the conclusion of the PBMA process was supplemented with a larger retrospective evaluation. The retrospective evaluation included 26 face-to-face individual interviews with senior and middle managers who took part in PBMA. Interview transcripts were analyzed against a template consisting of 19 elements of structure, process, attitudes, and outcomes associated with high performance in PSRA. Respondents had a good experience with the implementation of PBMA, and considered it an improvement over past practice. Success was attributed to effective leadership, and substantial efforts to engage staff members. Understanding of economic and ethical principles of decision making was reportedly increased. Areas for improvement included ensuring that everyone participated in good faith, better communication of final results, and stronger follow-through to determine if anticipated changes and benefits in fact occurred. The evaluation framework employed here proved useful in assessing the quality of this resource allocation exercise. The results are directly useful to local decision makers, and the identified strengths and weaknesses are broadly consistent with those reported in studies of other organizations.

Contrasting RCC, RVU, and ABC for managed care decisions. A case study compares three widely used costing methods and finds one superior.

PubMed

West, T D; Balas, E A; West, D A

1996-08-01

To obtain cost data needed to improve managed care decisions and negotiate profitable capitation contracts, most healthcare provider organizations use one of three costing methods: the ratio-of-costs-to-charges method, the relative value unit method, or the activity-based costing method. Although the ratio-of-costs to charges is used by a majority of provider organizations, a case study that applied these three methods in a renal dialysis clinic found that the activity-based costing method provided the most accurate cost data. By using this costing method, healthcare financial managers can obtain the data needed to make optimal decisions regarding resource allocation and cost containment, thus assuring the longterm financial viability of their organizations.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Managing water quality under drought conditions in the Llobregat River Basin.

PubMed

Momblanch, Andrea; Paredes-Arquiola, Javier; Munné, Antoni; Manzano, Andreu; Arnau, Javier; Andreu, Joaquín

2015-01-15

The primary effects of droughts on river basins include both depleted quantity and quality of the available water resources, which can render water resources useless for human needs and simultaneously damage the environment. Isolated water quality analyses limit the action measures that can be proposed. Thus, an integrated evaluation of water management and quality is warranted. In this study, a methodology consisting of two coordinated models is used to combine aspects of water resource allocation and water quality assessment. Water management addresses water allocation issues by considering the storage, transport and consumption elements. Moreover, the water quality model generates time series of concentrations for several pollutants according to the water quality of the runoff and the demand discharges. These two modules are part of the AQUATOOL decision support system shell for water resource management. This tool facilitates the analysis of the effects of water management and quality alternatives and scenarios on the relevant variables in a river basin. This paper illustrates the development of an integrated model for the Llobregat River Basin. The analysis examines the drought from 2004 to 2008, which is an example of a period when the water system was quantitative and qualitatively stressed. The performed simulations encompass a wide variety of water management and water quality measures; the results provide data for making informed decisions. Moreover, the results demonstrated the importance of combining these measures depending on the evolution of a drought event and the state of the water resources system. Copyright © 2014 Elsevier B.V. All rights reserved.

Analysis of strengths, weaknesses, opportunities, and threats in the development of a health technology assessment program in Turkey.

PubMed

Kahveci, Rabia; Meads, Catherine

2008-01-01

The Turkish healthcare system is currently undergoing reform, and efficient use of resources has become a key factor in determining the allocation of resources. The objective of this study was to analyze strengths, weaknesses, opportunities, and threats (SWOT) in the development of a health technology assessment (HTA) program in Turkey. A SWOT analysis was performed using a literature review and interviews with key people in the Turkish Ministry of Health and Ministry of Labor and Social Security. Regarding recent reforms in health care, investments for information network and databank are the strengths, but the traditional "expert-based" decision making, poor availability of data, and poor quality of data could be seen as some of the weaknesses. Another major weakness is lack of general awareness of HTA. Increasing demand for transparency in decision making, demand for evidence, and demand for credibility by decision makers are some of the opportunities, and current healthcare reforms, i.e., restructuring of healthcare and general health insurance, could also be seen as major opportunities. These opportunities unfortunately could be threatened by lack of funding, and resources are challenged by large, recent national investments. There is a good opportunity for Turkey to use the skills in HTA currently being developed through activities in Europe and the Americas to assist in the development of a much more cost-effective and transparent healthcare system in Turkey.

Many-objective robust decision making for water allocation under climate change.

PubMed

Yan, Dan; Ludwig, Fulco; Huang, He Qing; Werners, Saskia E

2017-12-31

Water allocation is facing profound challenges due to climate change uncertainties. To identify adaptive water allocation strategies that are robust to climate change uncertainties, a model framework combining many-objective robust decision making and biophysical modeling is developed for large rivers. The framework was applied to the Pearl River basin (PRB), China where sufficient flow to the delta is required to reduce saltwater intrusion in the dry season. Before identifying and assessing robust water allocation plans for the future, the performance of ten state-of-the-art MOEAs (multi-objective evolutionary algorithms) is evaluated for the water allocation problem in the PRB. The Borg multi-objective evolutionary algorithm (Borg MOEA), which is a self-adaptive optimization algorithm, has the best performance during the historical periods. Therefore it is selected to generate new water allocation plans for the future (2079-2099). This study shows that robust decision making using carefully selected MOEAs can help limit saltwater intrusion in the Pearl River Delta. However, the framework could perform poorly due to larger than expected climate change impacts on water availability. Results also show that subjective design choices from the researchers and/or water managers could potentially affect the ability of the model framework, and cause the most robust water allocation plans to fail under future climate change. Developing robust allocation plans in a river basin suffering from increasing water shortage requires the researchers and water managers to well characterize future climate change of the study regions and vulnerabilities of their tools. Copyright © 2017 Elsevier B.V. All rights reserved.

Amoeba-inspired Tug-of-War algorithms for exploration-exploitation dilemma in extended Bandit Problem.

PubMed

Aono, Masashi; Kim, Song-Ju; Hara, Masahiko; Munakata, Toshinori

2014-03-01

The true slime mold Physarum polycephalum, a single-celled amoeboid organism, is capable of efficiently allocating a constant amount of intracellular resource to its pseudopod-like branches that best fit the environment where dynamic light stimuli are applied. Inspired by the resource allocation process, the authors formulated a concurrent search algorithm, called the Tug-of-War (TOW) model, for maximizing the profit in the multi-armed Bandit Problem (BP). A player (gambler) of the BP should decide as quickly and accurately as possible which slot machine to invest in out of the N machines and faces an "exploration-exploitation dilemma." The dilemma is a trade-off between the speed and accuracy of the decision making that are conflicted objectives. The TOW model maintains a constant intracellular resource volume while collecting environmental information by concurrently expanding and shrinking its branches. The conservation law entails a nonlocal correlation among the branches, i.e., volume increment in one branch is immediately compensated by volume decrement(s) in the other branch(es). Owing to this nonlocal correlation, the TOW model can efficiently manage the dilemma. In this study, we extend the TOW model to apply it to a stretched variant of BP, the Extended Bandit Problem (EBP), which is a problem of selecting the best M-tuple of the N machines. We demonstrate that the extended TOW model exhibits better performances for 2-tuple-3-machine and 2-tuple-4-machine instances of EBP compared with the extended versions of well-known algorithms for BP, the ϵ-Greedy and SoftMax algorithms, particularly in terms of its short-term decision-making capability that is essential for the survival of the amoeba in a hostile environment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[An assessment of the Family Health Program in municipalities of Northeast Brazil: old and new challenges].

PubMed

Rocha, Paulo de Medeiros; Uchoa, Alice da Costa; Rocha, Nadja de Sá Pinto Dantas; Souza, Elizabethe Cristina Fagundes de; Rocha, Marconi de Lima; Pinheiro, Themis Xavier de Albuquerque

2008-01-01

This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

Economic theory and nursing administration research--is this a good combination?

PubMed

Jones, Terry L; Yoder, Linda

2010-01-01

Economic theory is used to describe and explain decision making in the context of scarce resources. This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing.

Economic Theory and Nursing Administration Research—Is This a Good Combination?

PubMed Central

Jones, Terry L.; Yoder, Linda

2017-01-01

TOPIC Economic theory is used to describe and explain decision making in the context of scarce resources. PURPOSE This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. SOURCES OF INFORMATION The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. CONCLUSIONS While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing. PMID:20137023

Adaptive sampling of information in perceptual decision-making.

PubMed

Cassey, Thomas C; Evens, David R; Bogacz, Rafal; Marshall, James A R; Ludwig, Casimir J H

2013-01-01

In many perceptual and cognitive decision-making problems, humans sample multiple noisy information sources serially, and integrate the sampled information to make an overall decision. We derive the optimal decision procedure for two-alternative choice tasks in which the different options are sampled one at a time, sources vary in the quality of the information they provide, and the available time is fixed. To maximize accuracy, the optimal observer allocates time to sampling different information sources in proportion to their noise levels. We tested human observers in a corresponding perceptual decision-making task. Observers compared the direction of two random dot motion patterns that were triggered only when fixated. Observers allocated more time to the noisier pattern, in a manner that correlated with their sensory uncertainty about the direction of the patterns. There were several differences between the optimal observer predictions and human behaviour. These differences point to a number of other factors, beyond the quality of the currently available sources of information, that influences the sampling strategy.

Rectifying Social Inequalities in a Resource Allocation Task

PubMed Central

Elenbaas, Laura; Rizzo, Michael T.; Cooley, Shelby; Killen, Melanie

2016-01-01

To investigate whether children rectify social inequalities in a resource allocation task, participants (N = 185 African-American and European-American 5–6 year-olds and 10–11 year-olds) witnessed an inequality of school supplies between peers of different racial backgrounds. Assessments were conducted on how children judged the wrongfulness of the inequality, allocated new resources to racial ingroup and outgroup recipients, evaluated alternative allocation strategies, and reasoned about their decisions. Younger children showed ingroup favorability; their responses differed depending on whether they had witnessed their ingroup or an outgroup at a disadvantage. With age, children increasingly reasoned about the importance of equal access to school supplies and correcting past disparities. Older children judged the resource inequality negatively, allocated more resources to the disadvantaged group, and positively evaluated the actions of others who did the same, regardless of whether they had seen their racial ingroup or an outgroup at a disadvantage. Thus, balancing moral and social group concerns enabled individuals to rectify inequalities and ensure fair access to important resources regardless of racial group membership. PMID:27423813

Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

PubMed

Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

2012-09-01

The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial opportunity to refine decision making and group dynamics. Making the best possible decisions concerning therapeutics selection for trial testing is a cornerstone of the Network's function.

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

Conceptual Problems.

ERIC Educational Resources Information Center

Foley, Walter J.

A systems theory approach to information requirements in education and in evaluation strategies is applied to decision making. Educational decision making itself involves long range planning, system structuring to implement goals, system allocation (cost), and system monitoring which provides the feedback. Each level requires differential…

Cognition-Action Trade-Offs Reflect Organization of Attention in Infancy.

PubMed

Berger, Sarah E; Harbourne, Regina T; Horger, Melissa N

2018-01-01

This chapter discusses what cognition-action trade-offs in infancy reveal about the organization and developmental trajectory of attention. We focus on internal attention because this aspect is most relevant to the immediate concerns of infancy, such as fluctuating levels of expertise, balancing multiple taxing skills simultaneously, learning how to control attention under variable conditions, and coordinating distinct psychological domains. Cognition-action trade-offs observed across the life span include perseveration during skill emergence, errors and inefficient strategies during decision making, and the allocation of resources when attention is taxed. An embodied cognitive-load account interprets these behavioral patterns as a result of limited attentional resources allocated across simultaneous, taxing task demands. For populations where motor errors could be costly, like infants and the elderly, attention is typically devoted to motor demands with errors occurring in the cognitive domain. In contrast, healthy young adults tend to preserve their cognitive performance by modifying their actions. © 2018 Elsevier Inc. All rights reserved.

The role of informed consent in patient complaints: Reducing hidden health system costs and improving patient engagement through shared decision making.

PubMed

Posner, Karen L; Severson, Julie; Domino, Karen B

2015-09-01

Patient complaints about physicians are strongly associated with malpractice risk. Physicians at high risk for lawsuits tend to have poor communication skills and are more commonly the subject of patient complaints about communication issues. If a malpractice action does not arise, patient complaints nonetheless represent significant prelitigation transaction costs for the healthcare system that have not been previously quantified. Informed consent complaints represent a unique constellation of clinical communication skills clearly tied to malpractice risk. The goal of this study was to measure institutional resource consumption allocated to informed consent (IC) complaints, which are both costly and preventable. We compared IC complaints to other complaints about medical care in a single medical center in the United States, estimating the absolute and relative burden of IC deficiencies within this healthcare system. Resource consumption for the resolution of IC complaints far exceeded their proportional representation of complaints, representing half of all complaints, while disproportionately absorbing two-thirds of staff time devoted to complaint resolution. Complaint resolution represents an unrecognized remediable cost and an underappreciated opportunity for reducing waste in healthcare. We suggest that healthcare systems can reduce costs and elevate their patient-centered care practices by improving patient-provider communication during medical decision making via engagement strategies such as shared decision making. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

Payments for Ecosystem Services for watershed water resource allocations

NASA Astrophysics Data System (ADS)

Fu, Yicheng; Zhang, Jian; Zhang, Chunling; Zang, Wenbin; Guo, Wenxian; Qian, Zhan; Liu, Laisheng; Zhao, Jinyong; Feng, Jian

2018-01-01

Watershed water resource allocation focuses on concrete aspects of the sustainable management of Ecosystem Services (ES) that are related to water and examines the possibility of implementing Payment for Ecosystem Services (PES) for water ES. PES can be executed to satisfy both economic and environmental objectives and demands. Considering the importance of calculating PES schemes at the social equity and cooperative game (CG) levels, to quantitatively solve multi-objective problems, a water resources allocation model and multi-objective optimization are provided. The model consists of three modules that address the following processes: ① social equity mechanisms used to study water consumer associations, ② an optimal decision-making process based on variable intervals and CG theory, and ③ the use of Shapley values of CGs for profit maximization. The effectiveness of the proposed methodology for realizing sustainable development was examined. First, an optimization model with water allocation objective was developed based on sustainable water resources allocation framework that maximizes the net benefit of water use. Then, to meet water quality requirements, PES cost was estimated using trade-off curves among different pollution emission concentration permissions. Finally, to achieve equity and supply sufficient incentives for water resources protection, CG theory approaches were utilized to reallocate PES benefits. The potential of the developed model was examined by its application to a case study in the Yongding River watershed of China. Approximately 128 Mm3 of water flowed from the upper reach (Shanxi and Hebei Provinces) sections of the Yongding River to the lower reach (Beijing) in 2013. According to the calculated results, Beijing should pay USD6.31 M (¥39.03 M) for water-related ES to Shanxi and Hebei Provinces. The results reveal that the proposed methodology is an available tool that can be used for sustainable development with resolving PES amounts among different regions under social and environmental constraints by considering the characteristics of social equity and CGs.

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game.

PubMed

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders' hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders' rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders' rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five.

Pilot interaction with automated airborne decision making systems

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Chu, Y. Y.; Greenstein, J. S.; Walden, R. S.

1976-01-01

An investigation was made of interaction between a human pilot and automated on-board decision making systems. Research was initiated on the topic of pilot problem solving in automated and semi-automated flight management systems and attempts were made to develop a model of human decision making in a multi-task situation. A study was made of allocation of responsibility between human and computer, and discussed were various pilot performance parameters with varying degrees of automation. Optimal allocation of responsibility between human and computer was considered and some theoretical results found in the literature were presented. The pilot as a problem solver was discussed. Finally the design of displays, controls, procedures, and computer aids for problem solving tasks in automated and semi-automated systems was considered.

Solving multi-objective optimization problems in conservation with the reference point method

PubMed Central

Dujardin, Yann; Chadès, Iadine

2018-01-01

Managing the biodiversity extinction crisis requires wise decision-making processes able to account for the limited resources available. In most decision problems in conservation biology, several conflicting objectives have to be taken into account. Most methods used in conservation either provide suboptimal solutions or use strong assumptions about the decision-maker’s preferences. Our paper reviews some of the existing approaches to solve multi-objective decision problems and presents new multi-objective linear programming formulations of two multi-objective optimization problems in conservation, allowing the use of a reference point approach. Reference point approaches solve multi-objective optimization problems by interactively representing the preferences of the decision-maker with a point in the criteria (objectives) space, called the reference point. We modelled and solved the following two problems in conservation: a dynamic multi-species management problem under uncertainty and a spatial allocation resource management problem. Results show that the reference point method outperforms classic methods while illustrating the use of an interactive methodology for solving combinatorial problems with multiple objectives. The method is general and can be adapted to a wide range of ecological combinatorial problems. PMID:29293650

Children Rectify Inequalities for Disadvantaged Groups

PubMed Central

Elenbaas, Laura; Killen, Melanie

2016-01-01

Children’s decisions regarding the allocation of societal resources in the context of preexisting inequalities were investigated. African-American and European-American children ages 5–6 years (n = 91) and 10–11 years (n = 94) judged the acceptability of a medical resource inequality on the basis of race, allocated medical supplies, evaluated different resource allocation strategies, and completed a measure of status awareness based on race. With age, children were increasingly aware of wealth status disparities between African-Americans and European-Americans, and judged a medical resource inequality between groups more negatively. Further, with age, children rectified the resource inequality over perpetuating it, but only when African-American children were disadvantaged. With age, children also referenced rights when reasoning about their judgments concerning the disadvantaged African-American group. When European-American children were disadvantaged, children did not systematically allocate more resources to one group over another. The results are discussed in terms of social inequalities, disadvantaged status, moral judgments, and intergroup attitudes. PMID:27455190

Outsourcing. Health care organizations are considering strategic goals in making outsourcing decisions.

PubMed

Chin, T L

1997-08-01

More health care organizations are outsourcing the management of some or all of their information systems. Executives at many organizations that have tried outsourcing say it enables them to focus on core competencies, better allocate resources, get more information technology at less cost, share risks of implementing information technology with outsourcers and guarantee access to skilled labor. But the information technology outsourcing market remains relatively small in health care because many CIOs still are wary of turning over control of important functions to outsiders.

Know Your Epidemic, Strengthen Your Response: Developing a New HIV Surveillance Architecture to Guide HIV Resource Allocation and Target Decisions

PubMed Central

Sanchez, Travis; Baral, Stefan; Mee, Paul; Sabin, Keith; Garcia-Calleja, Jesus M; Hargreaves, James

2018-01-01

To guide HIV prevention and treatment activities up to 2020, we need to generate and make better use of high quality HIV surveillance data. To highlight our surveillance needs, a special collection of papers in JMIR Public Health and Surveillance has been released under the title “Improving Global and National Responses to the HIV Epidemic Through High Quality HIV Surveillance Data.” We provide a summary of these papers and highlight methods for developing a new HIV surveillance architecture. PMID:29444766

Ranking and Generating Alternatives for the National Air Intelligence Center’s (NAIC) Resource Allocation Strategy.

DTIC Science & Technology

1997-03-10

Unit Managers to the task of supporting this thesis. LTC Kloeber’s ability to direct and focus my efforts kept me on a straight path and allowed me to...demands are placed on the individual units each year [36). These demands require units to continually look for new and innovative means to manage and...and the Senior Management Team’s (SMT) opinion to make this decision. However, he has no tools to help quantify the value of the different choices he

Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY.

PubMed

Brazier, John; Tsuchiya, Aki

2015-12-01

The quality-adjusted life-year (QALY) has become a widely used measure of health outcomes for use in informing decision making in health technology assessment. However, there is growing recognition of outcomes beyond health within the health sector and in related sectors such as social care and public health. This paper presents the advantages and disadvantages of ten possible approaches covering extending the health-related QALY and using well-being and monetary-based methods, in order to address the problem of using multiple outcome measures to inform resource allocation within and between sectors.

Market-stage analysis enhances strategic planning.

PubMed

McDonald, R B

1998-07-01

Changing market conditions are challenging healthcare organizations to determine how to allocate resources and make operational planning decisions to prepare for future changes. A vital part of meeting these challenges is understanding the impact of market stages, and using that knowledge to build effective business strategies. Financial modeling that includes market-stage information provides insight into market opportunities and presents a clearer picture of the organizational changes that will need to be implemented at each stage. Effective strategic action should take into account critical success factors in market responsiveness, organizational responsiveness, operational effectiveness, and financial strength.

Spinning Straw into Gold: How State Education Agencies Can Transform Their Data to Improve Critical School Resource Decisions

ERIC Educational Resources Information Center

Frank, Stephen; Trawick-Smith, Joseph

2014-01-01

K-12 education resources are often allocated non-strategically, with schools spending time and money on activities that have little relationship to student outcomes. Most of these decisions take place within districts, rooted in the processes of setting schedules, staffing levels, and assignments, and creating final budgets. Local Education…

A Decision Theory Approach to College Resource Allocation.

ERIC Educational Resources Information Center

Baldwin, Charles W.

Current budgeting techniques are reviewed in relation to their application to higher education, including (1) incremental budgeting, where decisions are based primarily upon former levels of expenditures, (2) zero-based budgeting, involving the establishment and ranking of "decision packages", (3) Planning and Programming Budgeting…

Assessing School Readiness for a Practice Arrangement Using Decision Tree Methodology.

ERIC Educational Resources Information Center

Barger, Sara E.

1998-01-01

Questions in a decision-tree address mission, faculty interest, administrative support, and practice plan as a way of assessing arrangements for nursing faculty's clinical practice. Decisions should be based on congruence between the human resource allocation and the reward systems. (SK)

Alpha-Fair Resource Allocation under Incomplete Information and Presence of a Jammer

NASA Astrophysics Data System (ADS)

Altman, Eitan; Avrachenkov, Konstantin; Garnaev, Andrey

In the present work we deal with the concept of alpha-fair resource allocation in the situation where the decision maker (in our case, the base station) does not have complete information about the environment. Namely, we develop a concept of α-fairness under uncertainty to allocate power resource in the presence of a jammer under two types of uncertainty: (a) the decision maker does not have complete knowledge about the parameters of the environment, but knows only their distribution, (b) the jammer can come into the environment with some probability bringing extra background noise. The goal of the decision maker is to maximize the α-fairness utility function with respect to the SNIR (signal to noise-plus-interference ratio). Here we consider a concept of the expected α-fairness utility function (short-term fairness) as well as fairness of expectation (long-term fairness). In the scenario with the unknown parameters of the environment the most adequate approach is a zero-sum game since it can also be viewed as a minimax problem for the decision maker playing against the nature where the decision maker has to apply the best allocation under the worst circumstances. In the scenario with the uncertainty about jamming being in the system the Nash equilibrium concept is employed since the agents have non-zero sum payoffs: the decision maker would like to maximize either the expected fairness or the fairness of expectation while the jammer would like to minimize the fairness if he comes in on the scene. For all the plots the equilibrium strategies in closed form are found. We have shown that for all the scenarios the equilibrium has to be constructed into two steps. In the first step the equilibrium jamming strategy has to be constructed based on a solution of the corresponding modification of the water-filling equation. In the second step the decision maker equilibrium strategy has to be constructed equalizing the induced by jammer background noise.

Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers.

PubMed

Zegeye, Elias Asfaw; Mbonigaba, Josue; Kaye, Sylvia Blanche; Wilkinson, Thomas

2017-02-01

Globally, economic evaluation (EE) is increasingly being considered as a critical tool for allocating scarce healthcare resources. However, such considerations are less documented in low-income countries, such as in Ethiopia. In particular, to date there has been no assessment conducted to evaluate the perception and practice of and barriers to health EE. This paper assesses the use and perceptions of EE in healthcare decision-making processes in Ethiopia. In-depth interview sessions with decision makers/healthcare managers and program coordinators across six regional health bureaus were conducted. A qualitative analysis approach was conducted on three thematic areas. A total of 57 decision makers/healthcare managers were interviewed from all tiers of the health sector in Ethiopia, ranging from the Federal Ministry of Health down to the lower levels of the health facility pyramid. At the high-level healthcare decision-making tier, only 56 % of those interviewed showed a good understanding of EE when explaining in terms of cost and consequences of alternative courses of action and value for money. From the specific program perspective, 50 % of the prevention of mother-to-child transmission of HIV/AIDS program coordinators indicated the relevance of EE to program planning and decision making. These respondents reported a limited application of costing studies on the HIV/AIDS prevention and control program, which were most commonly used during annual planning and budgeting. The study uncovered three important barriers to growth of EE in Ethiopia: a lack of awareness, a lack of expertise and skill, and the traditional decision-making culture.

Klamath Basin: A Watershed Approach to Support Habitat Restoration, Species Recovery, and Water Resource Planning

USGS Publications Warehouse

VanderKooi, S.P.; Thorsteinson, L.

2007-01-01

Water allocation among human and natural resource uses in the American West is challenging. Western rivers have been largely managed for hydropower, irrigation, drinking water, and navigation. Today land and water use practices have gained importance, particularly as aging dams are faced with re-licensing requirements and provisions of the Endangered Species and Clean Water Acts. Rising demand for scarce water heightens the need for scientific research to predict consequences of management actions on habitats, human resource use, and fish and wildlife. Climate change, introduction of invasive species, or restoration of fish passage can have large, landscape-scaled consequences - research must expand to encompass the appropriate scale and by applying multiple scientific disciplines to complex ecosystem challenges improve the adaptive management framework for decision-making.

An Analysis and Allocation System for Library Collections Budgets: The Comprehensive Allocation Process (CAP)

ERIC Educational Resources Information Center

Lyons, Lucy Eleonore; Blosser, John

2012-01-01

The "Comprehensive Allocation Process" (CAP) is a reproducible decision-making structure for the allocation of new collections funds, for the reallocation of funds within stagnant budgets, and for budget cuts in the face of reduced funding levels. This system was designed to overcome common shortcomings of current methods. Its philosophical…

Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

PubMed

Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

2017-01-26

The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of economic evaluations include, amongst others, educating decision-makers and the general population about economic evaluations and presenting economic evaluation results in a clearer and more understandable way. This study demonstrated that the current use and impact of economic evaluations in Dutch healthcare decision-making is limited at best. Therefore, strategies are needed to overcome the barriers that currently prevent economic evaluations from being used extensively.

Mathematical programming for the efficient allocation of health care resources.

PubMed

Stinnett, A A; Paltiel, A D

1996-10-01

Previous discussions of methods for the efficient allocation of health care resources subject to a budget constraint have relied on unnecessarily restrictive assumptions. This paper makes use of established optimization techniques to demonstrate that a general mathematical programming framework can accommodate much more complex information regarding returns to scale, partial and complete indivisibility and program interdependence. Methods are also presented for incorporating ethical constraints into the resource allocation process, including explicit identification of the cost of equity.

Allocation of Resources to Communication of Research Result Summaries.

PubMed

Richards, Julie E; Bane, Emmi; Fullerton, Stephanie M; Ludman, Evette J; Jarvik, Gail

2016-10-01

Researchers and policymakers recommend communicating summary research results to biobank participants when feasible. To date, however, there have been few explorations of participant preferences for dedicating resources to this activity. Fifteen semi-structured interviews were conducted with participants of a genetic medicine biobank. Participants were interviewed by phone about their motivation for participation, and opinions about the allocation of resources to communicating summary results. De-identified transcripts were used for a directed content analysis. Most biobank participation was altruistic. All participants were not only interested in receiving summary results but also expressed a clear preference for allocating limited funds to conducting additional genetic research. The results suggest that participants have a nuanced view about the allocation of biobank resources to returning summary results, and asking their opinion is a valuable exercise. Researchers may benefit from transparency about research goals and involving biobank participants in decisions about return of summary results.

Hidden Costs: the ethics of cost-effectiveness analyses for health interventions in resource-limited settings

PubMed Central

Rutstein, Sarah E.; Price, Joan T.; Rosenberg, Nora E.; Rennie, Stuart M.; Biddle, Andrea K.; Miller, William C.

2017-01-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritizing interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of healthcare resources, directly influencing morbidity and mortality for the world’s most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights; implications of CEA thresholds in light of economic uncertainty; and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings. PMID:27141969

Hidden costs: The ethics of cost-effectiveness analyses for health interventions in resource-limited settings.

PubMed

Rutstein, Sarah E; Price, Joan T; Rosenberg, Nora E; Rennie, Stuart M; Biddle, Andrea K; Miller, William C

2017-10-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritising interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of health-care resources, directly influencing morbidity and mortality for the world's most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights, implications of CEA thresholds in light of economic uncertainty, and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings.

76 FR 24548 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... committee uses third-party analyst research and a proprietary fundamental process to make allocation... investment process: Step 1: The Sub-Adviser's use of third-party research consists of analyzing the consensus... analyst research and a proprietary fundamental process to make allocation decisions. Changes to the Fund's...

Multitasking as a choice: a perspective.

PubMed

Broeker, Laura; Liepelt, Roman; Poljac, Edita; Künzell, Stefan; Ewolds, Harald; de Oliveira, Rita F; Raab, Markus

2018-01-01

Performance decrements in multitasking have been explained by limitations in cognitive capacity, either modelled as static structural bottlenecks or as the scarcity of overall cognitive resources that prevent humans, or at least restrict them, from processing two tasks at the same time. However, recent research has shown that individual differences, flexible resource allocation, and prioritization of tasks cannot be fully explained by these accounts. We argue that understanding human multitasking as a choice and examining multitasking performance from the perspective of judgment and decision-making (JDM), may complement current dual-task theories. We outline two prominent theories from the area of JDM, namely Simple Heuristics and the Decision Field Theory, and adapt these theories to multitasking research. Here, we explain how computational modelling techniques and decision-making parameters used in JDM may provide a benefit to understanding multitasking costs and argue that these techniques and parameters have the potential to predict multitasking behavior in general, and also individual differences in behavior. Finally, we present the one-reason choice metaphor to explain a flexible use of limited capacity as well as changes in serial and parallel task processing. Based on this newly combined approach, we outline a concrete interdisciplinary future research program that we think will help to further develop multitasking research.

Cognitive cost as dynamic allocation of energetic resources

PubMed Central

Christie, S. Thomas; Schrater, Paul

2015-01-01

While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the “cost/benefit” and “limited resource” models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning. PMID:26379482

Dynamic equilibrium strategy for drought emergency temporary water transfer and allocation management

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Ma, Ning; Lv, Chengwei

2016-08-01

Efficient water transfer and allocation are critical for disaster mitigation in drought emergencies. This is especially important when the different interests of the multiple decision makers and the fluctuating water resource supply and demand simultaneously cause space and time conflicts. To achieve more effective and efficient water transfers and allocations, this paper proposes a novel optimization method with an integrated bi-level structure and a dynamic strategy, in which the bi-level structure works to deal with space dimension conflicts in drought emergencies, and the dynamic strategy is used to deal with time dimension conflicts. Combining these two optimization methods, however, makes calculation complex, so an integrated interactive fuzzy program and a PSO-POA are combined to develop a hybrid-heuristic algorithm. The successful application of the proposed model in a real world case region demonstrates its practicality and efficiency. Dynamic cooperation between multiple reservoirs under the coordination of a global regulator reflects the model's efficiency and effectiveness in drought emergency water transfer and allocation, especially in a fluctuating environment. On this basis, some corresponding management recommendations are proposed to improve practical operations.

Clinical decision-making of rural novice nurses.

PubMed

Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in their careers. These novice nurses were often working with a limited staff, while managing an ever-changing census and acuity of patients. The significance of interdependence and welcoming relationships with their co-workers and directors of nursing was pivotal in the clinical decision-making process. Despite access to a number of resources at their disposal (including policy books, decision trees, standing orders, textbooks, and in some cases internet resources), the 12 nurses in this study indicated collaboration with co-workers was a major means of facilitating their decision-making. Rural novice nurses require facilitation of social skills as much as critical thinking skills both within their programs of nursing and during their new employee orientation; however, decision-making must be guided by more experienced nurses who are willing to mentor novice nurses and advise them to to reflect upon their decisions as they care for patients using evidenced based practice. In a rural setting, this is especially important because novice nurses are tasked early in their career with decision-making, which often involves ill-structured problems set in dynamic and changing environments, in high-stakes situations where patient safety is a concern.

Optimal allocation of resources among threatened species: a project prioritization protocol.

PubMed

Joseph, Liana N; Maloney, Richard F; Possingham, Hugh P

2009-04-01

Conservation funds are grossly inadequate to address the plight of threatened species. Government and conservation organizations faced with the task of conserving threatened species desperately need simple strategies for allocating limited resources. The academic literature dedicated to systematic priority setting usually recommends ranking species on several criteria, including level of endangerment and metrics of species value such as evolutionary distinctiveness, ecological importance, and social significance. These approaches ignore 2 crucial factors: the cost of management and the likelihood that the management will succeed. These oversights will result in misallocation of scarce conservation resources and possibly unnecessary losses. We devised a project prioritization protocol (PPP) to optimize resource allocation among New Zealand's threatened-species projects, where costs, benefits (including species values), and the likelihood of management success were considered simultaneously. We compared the number of species managed and the expected benefits gained with 5 prioritization criteria: PPP with weightings based on species value; PPP with species weighted equally; management costs; species value; and threat status. We found that the rational use of cost and success information substantially increased the number of species managed, and prioritizing management projects according to species value or threat status in isolation was inefficient and resulted in fewer species managed. In addition, we found a clear trade-off between funding management of a greater number of the most cost-efficient and least risky projects and funding fewer projects to manage the species of higher value. Specifically, 11 of 32 species projects could be funded if projects were weighted by species value compared with 16 projects if projects were not weighted. This highlights the value of a transparent decision-making process, which enables a careful consideration of trade-offs. The use of PPP can substantially improve conservation outcomes for threatened species by increasing efficiency and ensuring transparency of management decisions.

RECOVER: An Automated Cloud-Based Decision Support System for Post-fire Rehabilitation Planning

NASA Technical Reports Server (NTRS)

Schnase, John L.; Carroll, Mark; Weber, K. T.; Brown, Molly E.; Gill, Roger L.; Wooten, Margaret; May J.; Serr, K.; Smith, E.; Goldsby, R.;

RECOVER: An Automated, Cloud-Based Decision Support System for Post-Fire Rehabilitation Planning

NASA Astrophysics Data System (ADS)

Schnase, J. L.; Carroll, M. L.; Weber, K. T.; Brown, M. E.; Gill, R. L.; Wooten, M.; May, J.; Serr, K.; Smith, E.; Goldsby, R.; Newtoff, K.; Bradford, K.; Doyle, C.; Volker, E.; Weber, S.

2014-11-01

RECOVER is a site-specific decision support system that automatically brings together in a single analysis environment the information necessary for post-fire rehabilitation decision-making. After a major wildfire, law requires that the federal land management agencies certify a comprehensive plan for public safety, burned area stabilization, resource protection, and site recovery. These burned area emergency response (BAER) plans are a crucial part of our national response to wildfire disasters and depend heavily on data acquired from a variety of sources. Final plans are due within 21 days of control of a major wildfire and become the guiding document for managing the activities and budgets for all subsequent remediation efforts. There are few instances in the federal government where plans of such wide-ranging scope and importance are assembled on such short notice and translated into action more quickly. RECOVER has been designed in close collaboration with our agency partners and directly addresses their high-priority decision-making requirements. In response to a fire detection event, RECOVER uses the rapid resource allocation capabilities of cloud computing to automatically collect Earth observational data, derived decision products, and historic biophysical data so that when the fire is contained, BAER teams will have a complete and ready-to-use RECOVER dataset and GIS analysis environment customized for the target wildfire. Initial studies suggest that RECOVER can transform this information-intensive process by reducing from days to a matter of minutes the time required to assemble and deliver crucial wildfire-related data.

How Green Water Flows structure be a decision indicator for ecological water allocation in arid Ejina Delta, China.

NASA Astrophysics Data System (ADS)

Yu, J.; Du, C.; Zhang, Y.; Liu, X.

2014-12-01

Green water flows, a key ecohydrological process, dominates the hydrological cycle in arid region. The structure of green water flows reflects the landscape water consumption characteristics and can be easily obtained by means of remote sensing approach. In arid region, limited fresh water and fragile environment resulted in sharp contradictions between economy and natural ecosystem concerning water demands. To rationally allocate economic and ecological water use, to maximize the regional freshwater use efficiency, is the route one must take for sustainable development in arid area. The pursuit of the most necessary ecological protection function and the maximum ecological water use efficiency is the key to ecological water allocation. However, we are short of simple and quick detectable variables or indexes to assess ecological water allocation decision. This paper introduced the green water flows structure as a decision variable, chose Heihe river flow allocation to downstream Ejina Delta for ecological protection as an example, put forward why and how green water flows structure could be used for ecological water allocation decision. The authors expect to provide reference for integrated fresh water resources management practice in arid region.

The impacts of racial group membership on people's distributive justice: an event-related potential study.

PubMed

Wang, Yan; Tang, Yi-Yuan; Deng, Yuqin

2014-04-16

How individuals and societies distribute benefits has long been studied by psychologists and sociologists. Previous work has highlighted the importance of social identity on people's justice concerns. However, it is not entirely clear how racial in-group/out-group relationship affects the brain activity in distributive justice. In this study, event-related potentials were recorded while participants made their decisions about donation allocation. Behavioral results showed that racial in-group factor affected participants' decisions on justice consideration. Participants were more likely to make relatively equity decisions when racial in-group factor was congruent with equity compared with the corresponding incongruent condition. Moreover, this incongruent condition took longer response times than congruent condition. Meanwhile, less equity decisions were made when efficiency was larger in the opposite side to equity than it was equal between the two options. Scalp event-related potential analyses revealed that greater P300 and late positive potential amplitudes were elicited by the incongruent condition compared with the congruent condition. These findings suggest that the decision-making of distributive justice could be modulated by racial group membership, and greater attentional resources or cognitive efforts are required when racial in-group factor and equity conflict with each other.

Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

PubMed Central

2013-01-01

Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to make appropriate decisions regarding the allocation and sustainability of health care resources. PMID:23890185

What Does it Really Cost? Allocating Indirect Costs.

ERIC Educational Resources Information Center

Snyder, Herbert; Davenport, Elisabeth

1997-01-01

Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

Critical insights for researchers and decision-makers.

PubMed

Tomblin, Seven

2004-01-01

Regionalization organizations are essential building blocks of health restructuring and are designed to be agents of change and integration in most provinces in Canada. Yet, despite this, most citizens seem to be unaware of regional health authorities, why they exist, the drivers and constraints involved, or whether these divergent structures and regional governance processes have influenced patterns of restructuring and health outcomes. And even when discussions have taken place, these debates have tended to be more prescriptive than analytical. All of this has complicated the task of conceptualizing and making sense of the determinants that have influenced regionalization forms of health service restructuring in Canada and how these have influenced the way resources have been allocated, decisions reached and accountability exercised.

A System Dynamics Model to Improve Water Resources Allocation in the Conchos River

NASA Astrophysics Data System (ADS)

Gastelum, J. R.; Valdes, J. B.; Stewart, S.

2005-12-01

The Conchos river located in Chihuahua state on a semiarid region is the most important Mexican river contributing water deliveries to USA as established by the Water treaty of 1944 signed between Mexico and USA. Historically, Mexico has delivered to UNITED STATES 550 Hm3 (445,549.5 ACF) per year of water since the treaty was established, which is 25% above the yearly water volume Mexico is required to deliver. The Conchos river has contributed with 54% of the historic Mexican water treaty deliveries to the UNITED STATES, which represents the highest percentage of the 6 Mexican rivers considered on the water treaty. However, during drought situations the basin has proven to be vulnerable, for instance, because of the severe drought of the 90's, several cities in 1992 on Chihuahua state where declared disaster areas, and from 1992 to 2001 Mexico had accumulated a water treaty deficit of 2111.6 Hm3 (1,710,586 ACF). This has conduced to economic, social, and political difficulties in both countries. Because of the cited problematic and considering the poor understanding of the relationship between water supply and demand factors on the basin, a decision support system (DSS) has been developed aimed to improve the decision making process related with the water resources allocation process. This DSS has been created using System Dynamics (SD). It is a semi-distributed model and is running on monthly time step basis. For both the short and long term, three important water resources management strategies have been evaluated: several water allocation policies from reservoirs to water users; bulk water rights transfers inside and outside Irrigation Districts; and improvement of water distribution efficiencies. The model results have provided very useful regard to gain more quantitative understanding of the different strategies being implemented. They have also indicated that the different water resources alternatives change its degree of importance according to the different basin's circumstances such as weather conditions, institutional constraints, etc. The DSS is intended to be a simulation tool that facilitates the education and involvement of stakeholders and decision makers on the basin's water resources management process. Consequently, this will help to identify and to support alternatives or combination of them aimed to improve not only the basin's economy but also Mexican water treaty deliveries.

Economic Analysis of Continued Education by Holders of Short-Cycle Technical Diplomas in French Higher Education

ERIC Educational Resources Information Center

Gendron, Benedicte

2006-01-01

In a context of fierce competition in the labour market and employment system, the decision to continue studying after completing French short-cycle higher vocational education must be distinguished from the simple individual decision for optimum allocation of resources postulated by standard human-resource theory. It has much more to do with a…

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties.

PubMed

Keyonzo, Nelson; Korir, Julius; Abilla, Faith; Sirera, Morine; Nyakwara, Peter; Bazant, Eva; Waka, Charles; Koskei, Nancy; Kabue, Mark

2017-12-01

As international development partners reduce funding for family planning (FP) programs, the need to estimate the financial resources devoted to FP is becoming increasingly important both at all levels. This cross-sectional assessment examined the FP financing sources, agents, and expenditures in two counties of Kenya for fiscal years 2010/2011 and 2011/2012 to guide local decision-making on financial allocations. Data were collected through a participatory process. This involved stakeholder interviews, review of financial records and service statistics, and a survey of facilities offering FP services. Financing sources and agents were identified, and source amounts calculated. Types of FP provider organizations and the amounts spent by expenditure categories were identified. Overall, five financing sources and seven agents for FP were identified. Total two-year expenditures were KSh 307.8 M (US$ 3.62 M). The government's share of funding rose from 12% to 21% over the two years (p=0.029). In 2010/2011, the largest expense categories were administration, commodities, and labor; however, spending on commodities increased by 47% (p=0.042). This study provides local managers with FP financing and expenditure information for use in budget allocation decision-making. These analyses can be done routinely and replicated in other local counties or countries in a context of devolution.

A data-driven allocation tool for in-kind resources distributed by a state health department.

PubMed

Peterson, Cora; Kegler, Scott R; Parker, Wende R; Sullivan, David

2016-10-02

The objective of this study was to leverage a state health department's operational data to allocate in-kind resources (children's car seats) to counties, with the proposition that need-based allocation could ultimately improve public health outcomes. This study used a retrospective analysis of administrative data on car seats distributed to counties statewide by the Georgia Department of Public Health and development of a need-based allocation tool (presented as interactive supplemental digital content, adaptable to other types of in-kind public health resources) that relies on current county-level injury and sociodemographic data. Car seat allocation using public health data and a need-based formula resulted in substantially different recommended allocations to individual counties compared to historic distribution. Results indicate that making an in-kind public health resource like car seats universally available results in a less equitable distribution of that resource compared to deliberate allocation according to public health need. Public health agencies can use local data to allocate in-kind resources consistent with health objectives; that is, in a manner offering the greatest potential health impact. Future analysis can determine whether the change to a more equitable allocation of resources is also more efficient, resulting in measurably improved public health outcomes.

Assessing system reliability and allocating resources: a bayesian approach that integrates multi-level data

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

Graves, Todd L; Hamada, Michael S

2008-01-01

Good estimates of the reliability of a system make use of test data and expert knowledge at all available levels. Furthermore, by integrating all these information sources, one can determine how best to allocate scarce testing resources to reduce uncertainty. Both of these goals are facilitated by modern Bayesian computational methods. We apply these tools to examples that were previously solvable only through the use of ingenious approximations, and use genetic algorithms to guide resource allocation.

Optimization of Land Use Suitability for Agriculture Using Integrated Geospatial Model and Genetic Algorithms

NASA Astrophysics Data System (ADS)

Mansor, S. B.; Pormanafi, S.; Mahmud, A. R. B.; Pirasteh, S.

2012-08-01

In this study, a geospatial model for land use allocation was developed from the view of simulating the biological autonomous adaptability to environment and the infrastructural preference. The model was developed based on multi-agent genetic algorithm. The model was customized to accommodate the constraint set for the study area, namely the resource saving and environmental-friendly. The model was then applied to solve the practical multi-objective spatial optimization allocation problems of land use in the core region of Menderjan Basin in Iran. The first task was to study the dominant crops and economic suitability evaluation of land. Second task was to determine the fitness function for the genetic algorithms. The third objective was to optimize the land use map using economical benefits. The results has indicated that the proposed model has much better performance for solving complex multi-objective spatial optimization allocation problems and it is a promising method for generating land use alternatives for further consideration in spatial decision-making.

Role of GIS in social sector planning: can developing countries benefit from the examples of primary health care (PHC) planning in Britain?

PubMed

Ishfaq, Mohammad; Lodhi, Bilal Khan

2012-04-01

Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.

Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion.

PubMed

Iskrov, Georgi; Dermendzhiev, Svetlan; Miteva-Katrandzhieva, Tsonka; Stefanov, Rumen

2016-01-01

Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies. This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria. Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation. New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies.

Optimal resource allocation for defense of targets based on differing measures of attractiveness.

PubMed

Bier, Vicki M; Haphuriwat, Naraphorn; Menoyo, Jaime; Zimmerman, Rae; Culpen, Alison M

2008-06-01

This article describes the results of applying a rigorous computational model to the problem of the optimal defensive resource allocation among potential terrorist targets. In particular, our study explores how the optimal budget allocation depends on the cost effectiveness of security investments, the defender's valuations of the various targets, and the extent of the defender's uncertainty about the attacker's target valuations. We use expected property damage, expected fatalities, and two metrics of critical infrastructure (airports and bridges) as our measures of target attractiveness. Our results show that the cost effectiveness of security investment has a large impact on the optimal budget allocation. Also, different measures of target attractiveness yield different optimal budget allocations, emphasizing the importance of developing more realistic terrorist objective functions for use in budget allocation decisions for homeland security.

A hybrid system dynamics and optimization approach for supporting sustainable water resources planning in Zhengzhou City, China

NASA Astrophysics Data System (ADS)

Li, Zhi; Li, Chunhui; Wang, Xuan; Peng, Cong; Cai, Yanpeng; Huang, Weichen

2018-01-01

Problems with water resources restrict the sustainable development of a city with water shortages. Based on system dynamics (SD) theory, a model of sustainable utilization of water resources using the STELLA software has been established. This model consists of four subsystems: population system, economic system, water supply system and water demand system. The boundaries of the four subsystems are vague, but they are closely related and interdependent. The model is applied to Zhengzhou City, China, which has a serious water shortage. The difference between the water supply and demand is very prominent in Zhengzhou City. The model was verified with data from 2009 to 2013. The results show that water demand of Zhengzhou City will reach 2.57 billion m3 in 2020. A water resources optimization model is developed based on interval-parameter two-stage stochastic programming. The objective of the model is to allocate water resources to each water sector and make the lowest cost under the minimum water demand. Using the simulation results, decision makers can easily weigh the costs of the system, the water allocation objectives, and the system risk. The hybrid system dynamics method and optimization model is a rational try to support water resources management in many cities, particularly for cities with potential water shortage and it is solidly supported with previous studies and collected data.

Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

PubMed

Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

2018-02-01

Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

Information support for decision making on dispatching control of water distribution in irrigation

NASA Astrophysics Data System (ADS)

Yurchenko, I. F.

2018-05-01

The research has been carried out on developing the technique of supporting decision making for on-line control, operational management of water allocation for the interfarm irrigation projects basing on the analytical patterns of dispatcher control. This technique provides an increase of labour productivity as well as higher management quality due to the improved level of automation, as well as decision making optimization taking into account diagnostics of the issues, solutions classification, information being required to the decision makers.

77 FR 19666 - Office of Financial Resources; Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... Departmental Chief Financial Officer (CFO), Chief Acquisition Officer (CAO) and Performance Improvement Officer... their policy role in resource allocation and decisions affecting financial, grants and procurement... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Office of Financial Resources...

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

PubMed

Hasler, B; Delabouglise, A; Babo Martins, S

2017-04-01

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

Water resources planning based on complex system dynamics: A case study of Tianjin city

NASA Astrophysics Data System (ADS)

Zhang, X. H.; Zhang, H. W.; Chen, B.; Chen, G. Q.; Zhao, X. H.

2008-12-01

A complex system dynamic (SD) model focusing on water resources, termed as TianjinSD, is developed for the integrated and scientific management of the water resources of Tianjin, which contains information feedback that governs interactions in the system and is capable of synthesizing component-level knowledge into system behavior simulation at an integrated level, thus presenting reasonable predictive results for policy-making on water resources allocation and management. As for the Tianjin city, interactions among 96 components for 12 years are explored and four planning alternatives are chosen, one of which is based on the conventional mode assuming that the existing pattern of human activities will be prevailed, while the others are alternative planning designs based on the interaction of local authorities and planning researchers. Optimal mode is therefore obtained according to different scenarios when compared the simulation results for evaluation of different decisions and dynamic consequences.

Analytical group decision making in natural resources: methodology and application

Treesearch

Daniel L. Schmoldt; David L. Peterson

2000-01-01

Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups...

Assessing and Improving Performance: A Longitudinal Evaluation of Priority Setting and Resource Allocation in a Canadian Health Region

PubMed Central

Hall, William; Smith, Neale; Mitton, Craig; Urquhart, Bonnie; Bryan, Stirling

2018-01-01

Background: In order to meet the challenges presented by increasing demand and scarcity of resources, healthcare organizations are faced with difficult decisions related to resource allocation. Tools to facilitate evaluation and improvement of these processes could enable greater transparency and more optimal distribution of resources. Methods: The Resource Allocation Performance Assessment Tool (RAPAT) was implemented in a healthcare organization in British Columbia, Canada. Recommendations for improvement were delivered, and a follow up evaluation exercise was conducted to assess the trajectory of the organization’s priority setting and resource allocation (PSRA) process 2 years post the original evaluation. Results: Implementation of RAPAT in the pilot organization identified strengths and weaknesses of the organization’s PSRA process at the time of the original evaluation. Strengths included the use of criteria and evidence, an ability to reallocate resources, and the involvement of frontline staff in the process. Weaknesses included training, communication, and lack of program budgeting. Although the follow up revealed a regression from a more formal PSRA process, a legacy of explicit resource allocation was reported to be providing ongoing benefit for the organization. Conclusion: While past studies have taken a cross-sectional approach, this paper introduces the first longitudinal evaluation of PSRA in a healthcare organization. By including the strengths, weaknesses, and evolution of one organization’s journey, the authors’ intend that this paper will assist other healthcare leaders in meeting the challenges of allocating scarce resources. PMID:29626400

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game

PubMed Central

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C.; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders’ hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders’ rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders’ rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five. PMID:29184518

Towards an equitable allocation of the cost of a global change adaptation plan at the river basin scale: going beyond the perfect cooperation assumption

NASA Astrophysics Data System (ADS)

Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velázquez, Manuel

2015-04-01

Adaptation to global change is a key issue in the planning of water resource systems in a changing world. Adaptation has to be efficient, but also equitable in the share of the costs of joint adaptation at the river basin scale. Least-cost hydro-economic optimization models have been helpful at defining efficient adaptation strategies. However, they often rely on the assumption of a "perfect cooperation" among the stakeholders, required for reaching the optimal solution. Nowadays, most adaptation decisions have to be agreed among the different actors in charge of their implementation, thus challenging the validity of a perfect command-and-control solution. As a first attempt to over-pass this limitation, our work presents a method to allocate the cost of an efficient adaptation programme of measures among the different stakeholders at the river basin scale. Principles of equity are used to define cost allocation scenarios from different perspectives, combining elements from cooperative game theory and axioms from social justice to bring some "food for thought" in the decision making process of adaptation. To illustrate the type of interactions between stakeholders in a river basin, the method has been applied in a French case study, the Orb river basin. Located on the northern rim of the Mediterranean Sea, this river basin is experiencing changes in demand patterns, and its water resources will be impacted by climate change, calling for the design of an adaptation plan. A least-cost river basin optimization model (LCRBOM) has been developed under GAMS to select the combination of demand- and supply-side adaptation measures that allows meeting quantitative water management targets at the river basin scale in a global change context. The optimal adaptation plan encompasses measures in both agricultural and urban sectors, up-stream and down-stream of the basin, disregarding the individual interests of the stakeholders. In order to ensure equity in the cost allocation of the adaptation plan, different allocation scenarios are considered. The LCRBOM allows defining a solution space based on economic rationality concepts from cooperative game theory (the core of the game), and then, to define equitable allocation of the cost of the programme of measures (the Shapley value and the nucleolus). Moreover, alternative allocation scenarios have been considered based on axiomatic principles of social justice, such as "utilitarian", "prior rights" or "strict equality", applied in the case study area. The comparison of the cost allocation scenarios brings insight to inform the decision making process at the river basin scale and potentially reap the efficiency gains from cooperation in the design of adaptation plan. The study has been partially supported by the IMPADAPT project /CGL2013-48424-C2-1-R) from the Spanish ministry MINECO (Ministerio de Economía y Competitividad) and European FEDER funds. Corentin Girard is supported by a grant from the University Lecturer Training Program (FPU12/03803) of the Ministry of Education, Culture and Sports of Spain.

Management of natural and bioterrorism induced pandemics.

PubMed

Tyshenko, Michael G

2007-09-01

A recent approach for bioterrorism risk management calls for stricter regulations over biotechnology as a way to control subversion of technology that may be used to create a man-made pandemic. This approach is largely unworkable given the increasing pervasiveness of molecular techniques and tools throughout society. Emerging technology has provided the tools to design much deadlier pathogens but concomitantly the ability to respond to emerging pandemics to reduce mortality has also improved significantly in recent decades. In its historical context determining just how 'risky' biological weapons is an important consideration for decision making and resource allocation. Management should attempt to increase capacity, share resources, provide accurate infectious disease reporting, deliver information transparency and improve communications to help mitigate the magnitude of future pandemics.

Health information systems in the Islamic Republic of Iran: a case study in Kerman Province.

PubMed

Zolala, F

2011-09-01

Health information systems provide information for decision-making at all levels, from planning and management to evaluation of health services. Registration of vital events is the most basic level of any health information system. This case study used in-depth interviews, observations and examination of documents to explore the system of births and deaths registration in Kerman province. The findings were evaluated under 3 headings: data input, data processing and data usage. A range of problems were identified concerning legal requirements, staffing, data checking and publication of data. Different approaches are suggested to strengthen the system, such as introducing regulations to oblige different data sources to provide data and allocating sufficient resources, including human resources, and an improved technology infrastructure.

How to Fairly Allocate Scarce Medical Resources: Ethical Argumentation under Scrutiny by Health Professionals and Lay People

PubMed Central

Rosemann, Thomas; Törnblom, Kjell Y.

2016-01-01

Background Societies are facing medical resource scarcities, inter alia due to increased life expectancy and limited health budgets and also due to temporal or continuous physical shortages of resources like donor organs. This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair. The purpose of this study was to explore how lay people, general practitioners, medical students and other health professionals evaluate the fairness of ten allocation principles for scarce medical resources: ‘sickest first’, ‘waiting list’, ‘prognosis’, ‘behaviour’ (i.e., those who engage in risky behaviour should not be prioritized), ‘instrumental value’ (e.g., health care workers should be favoured during epidemics), ‘combination of criteria’ (i.e., a sequence of the ‘youngest first’, ‘prognosis’, and ‘lottery’ principles), ‘reciprocity’ (i.e., those who provided services to the society in the past should be rewarded), ‘youngest first’, ‘lottery’, and ‘monetary contribution’. Methods 1,267 respondents to an online questionnaire were confronted with hypothetical situations of scarcity regarding (i) donor organs, (ii) hospital beds during an epidemic, and (iii) joint replacements. Nine allocation principles were evaluated in terms of fairness for each type of scarcity along 7-point Likert scales. The relationship between demographic factors (gender, age, religiosity, political orientation, and health status) and fairness evaluations was modelled with logistic regression. Results Medical background was a major predictor of fairness evaluations. While general practitioners showed different response patterns for all three allocation situations, the responses by lay people were very similar. Lay people rated ‘sickest first’ and ‘waiting list’ on top of all allocation principles—e.g., for donor organs 83.8% (95% CI: [81.2%–86.2%]) rated ‘sickest first’ as fair (‘fair’ is represented by scale points 5–7), and 69.5% [66.2%–72.4%] rated ‘waiting list’ as fair. The corresponding results for general practitioners: ‘prognosis’ 79.7% [74.2%–84.9%], ‘combination of criteria’ 72.6% [66.4%–78.5%], and ‘sickest first’ 74.5% [68.6%–80.1%); these were the highest-rated allocation principles for donor organs allocation. Interestingly, only 44.3% [37.7%–50.9%] of the general practitioners rated ‘instrumental value’ as fair for the allocation of hospital beds during a flu epidemic. The fairness evaluations by general practitioners obtained for joint replacements: ‘sickest first’ 84.0% [78.8%–88.6%], ‘combination of criteria’ 65.6% [59.2%–71.8%], and ‘prognosis’ 63.7% [57.1%–70.0%]. ‘Lottery’, ‘reciprocity’, ‘instrumental value’, and ‘monetary contribution’ were considered very unfair allocation principles by both groups. Medical students’ ratings were similar to those of general practitioners, and the ratings by other health professionals resembled those of lay people. Conclusions Results are partly at odds with current conclusions proposed by some ethicists. A number of ethicists reject ‘sickest first’ and ‘waiting list’ as morally unjustifiable allocation principles, whereas those allocation principles received the highest fairness endorsements by lay people and to some extent also by health professionals. Decision makers are advised to consider whether or not to give ethicists, health professionals, and the general public an equal voice when attempting to arrive at maximally endorsed allocations of scarce medical resources. PMID:27462880

76 FR 50449 - Fisheries off West Coast States; Pacific Coast Groundfish Fishery Management Plan; Trawl...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... decision making did not clearly state that Amendment 21 allocations supersede the previous limited entry... 21 supersedes the limited entry/open access allocations for groundfish species allocated through... the limited entry trawl fishery. DATES: Comments on Amendment 21-1 must be received no later than 5 p...

Training Decisions Technology Analysis

DTIC Science & Technology

1992-06-01

4.5.1 Relational Data Base Management 69 4.5.2 TASCS Data Content 69 4.5.3 Relationships with TDS 69 4.6 Other Air Force Modeling R&D 70 4.6.1 Time ...executive decision making were first developed by M. S. Scott Morton in the early 1970’s who, at that time , termed them " management decision systems" (Scott...Allocations to Training Settings o Managers ’ Preferences for Task Allocations to Training Settings o Times Required to Training Tasks in Various

Achieving Conservation when Opportunity Costs Are High: Optimizing Reserve Design in Alberta's Oil Sands Region

PubMed Central

Schneider, Richard R.; Hauer, Grant; Farr, Dan; Adamowicz, W. L.; Boutin, Stan

2011-01-01

Recent studies have shown that conservation gains can be achieved when the spatial distributions of biological benefits and economic costs are incorporated in the conservation planning process. Using Alberta, Canada, as a case study we apply these techniques in the context of coarse-filter reserve design. Because targets for ecosystem representation and other coarse-filter design elements are difficult to define objectively we use a trade-off analysis to systematically explore the relationship between conservation targets and economic opportunity costs. We use the Marxan conservation planning software to generate reserve designs at each level of conservation target to ensure that our quantification of conservation and economic outcomes represents the optimal allocation of resources in each case. Opportunity cost is most affected by the ecological representation target and this relationship is nonlinear. Although petroleum resources are present throughout most of Alberta, and include highly valuable oil sands deposits, our analysis indicates that over 30% of public lands could be protected while maintaining access to more than 97% of the value of the region's resources. Our case study demonstrates that optimal resource allocation can be usefully employed to support strategic decision making in the context of land-use planning, even when conservation targets are not well defined. PMID:21858046

A robust optimisation approach to the problem of supplier selection and allocation in outsourcing

NASA Astrophysics Data System (ADS)

Fu, Yelin; Keung Lai, Kin; Liang, Liang

2016-03-01

We formulate the supplier selection and allocation problem in outsourcing under an uncertain environment as a stochastic programming problem. Both the decision-maker's attitude towards risk and the penalty parameters for demand deviation are considered in the objective function. A service level agreement, upper bound for each selected supplier's allocation and the number of selected suppliers are considered as constraints. A novel robust optimisation approach is employed to solve this problem under different economic situations. Illustrative examples are presented with managerial implications highlighted to support decision-making.

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

PubMed

Bentley, J P; Larson, L N; Brenton, M A

1995-03-01

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

The Method for Assigning Priority Levels (MAPLe): A new decision-support system for allocating home care resources

PubMed Central

Hirdes, John P; Poss, Jeff W; Curtin-Telegdi, Nancy

2008-01-01

Background Home care plays a vital role in many health care systems, but there is evidence that appropriate targeting strategies must be used to allocate limited home care resources effectively. The aim of the present study was to develop and validate a methodology for prioritizing access to community and facility-based services for home care clients. Methods Canadian and international data based on the Resident Assessment Instrument – Home Care (RAI-HC) were analyzed to identify predictors for nursing home placement, caregiver distress and for being rated as requiring alternative placement to improve outlook. Results The Method for Assigning Priority Levels (MAPLe) algorithm was a strong predictor of all three outcomes in the derivation sample. The algorithm was validated with additional data from five other countries, three other provinces, and an Ontario sample obtained after the use of the RAI-HC was mandated. Conclusion The MAPLe algorithm provides a psychometrically sound decision-support tool that may be used to inform choices related to allocation of home care resources and prioritization of clients needing community or facility-based services. PMID:18366782

Systematic review of the empirical investigation of resources to support decision-making regarding BRCA1 and BRCA2 genetic testing in women with breast cancer.

PubMed

Grimmett, Chloe; Pickett, Karen; Shepherd, Jonathan; Welch, Karen; Recio-Saucedo, Alejandra; Streit, Elke; Seers, Helen; Armstrong, Anne; Cutress, Ramsey I; Evans, D Gareth; Copson, Ellen; Meiser, Bettina; Eccles, Diana; Foster, Claire

2018-05-01

Identify existing resources developed and/or evaluated empirically in the published literature designed to support women with breast cancer making decisions regarding genetic testing for BRCA1/2 mutations. Systematic review of seven electronic databases. Studies were included if they described or evaluated resources that were designed to support women with breast cancer in making a decision to have genetic counselling or testing for familial breast cancer. Outcome and process evaluations, using any type of study design, as well as articles reporting the development of decision aids, were eligible for inclusion. Total of 9 publications, describing 6 resources were identified. Resources were effective at increasing knowledge or understanding of hereditary breast cancer. Satisfaction with resources was high. There was no evidence that any resource increased distress, worry or decisional conflict. Few resources included active functionalities for example, values-based exercises, to support decision-making. Tailored resources supporting decision-making may be helpful and valued by patients and increase knowledge of hereditary breast cancer, without causing additional distress. Clinicians should provide supportive written information to patients where it is available. However, there is a need for robustly developed decision tools to support decision-making around genetic testing in women with breast cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

The role of risk-based prioritization in total quality management

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

Bennett, C.T.

1994-10-01

The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approachmore » - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.« less

Forecasting of Seasonal Rainfall using ENSO and IOD teleconnection with Classification Models

NASA Astrophysics Data System (ADS)

De Silva, T.; Hornberger, G. M.

2017-12-01

Seasonal to annual forecasts of precipitation patterns are very important for water infrastructure management. In particular, such forecasts can be used to inform decisions about the operation of multipurpose reservoir systems in the face of changing climate conditions. Success in making useful forecasts often is achieved by considering climate teleconnections such as the El-Nino-Southern Oscillation (ENSO), Indian Ocean Dipole (IOD) as related to sea surface temperature variations. We present an analysis to explore the utility of using rainfall relationships in Sri Lanka with ENSO and IOD to predict rainfall to the Mahaweli, river basin. Forecasting of rainfall as classes - above normal, normal, and below normal - can be useful for water resource management decision making. Quadratic discrimination analysis (QDA) and random forest models are used to identify the patterns of rainfall classes with respect to ENSO and IOD indices. These models can be used to forecast the likelihood of areal rainfall anomalies using predicted climate indices. Results can be used for decisions regarding allocation of water for agriculture and electricity generation within the Mahaweli project of Sri Lanka.

Assessment of spatial variation of risks in small populations.

PubMed Central

Riggan, W B; Manton, K G; Creason, J P; Woodbury, M A; Stallard, E

1991-01-01

Often environmental hazards are assessed by examining the spatial variation of disease-specific mortality or morbidity rates. These rates, when estimated for small local populations, can have a high degree of random variation or uncertainty associated with them. If those rate estimates are used to prioritize environmental clean-up actions or to allocate resources, then those decisions may be influenced by this high degree of uncertainty. Unfortunately, the effect of this uncertainty is not to add "random noise" into the decision-making process, but to systematically bias action toward the smallest populations where uncertainty is greatest and where extreme high and low rate deviations are most likely to be manifest by chance. We present a statistical procedure for adjusting rate estimates for differences in variability due to differentials in local area population sizes. Such adjustments produce rate estimates for areas that have better properties than the unadjusted rates for use in making statistically based decisions about the entire set of areas. Examples are provided for county variation in bladder, stomach, and lung cancer mortality rates for U.S. white males for the period 1970 to 1979. PMID:1820268

Resource allocation using ANN in LTE

NASA Astrophysics Data System (ADS)

Yigit, Tuncay; Ersoy, Mevlut

2017-07-01

LTE is the 4th generation wireless network technology, which provides flexible bandwidth, higher data speeds and lower delay. Difficulties may be experienced upon an increase in the number of users in LTE. The objective of this study is to ensure a faster solution to any such resource allocation problems which might arise upon an increase in the number of users. A fast and effective solution has been obtained by making use of Artificial Neural Network. As a result, fast working artificial intelligence methods may be used in resource allocation problems during operation.

Function allocation for humans and automation in the context of team dynamics

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

Jeffrey C. Joe; John O'Hara; Jacques Hugo

Within Human Factors Engineering, a decision-making process called function allocation (FA) is used during the design life cycle of complex systems to distribute the system functions, often identified through a functional requirements analysis, to all human and automated machine agents (or teammates) involved in controlling the system. Most FA methods make allocation decisions primarily by comparing the capabilities of humans and automation, but then also by considering secondary factors such as cost, regulations, and the health and safety of workers. The primary analysis of the strengths and weaknesses of humans and machines, however, is almost always considered in terms ofmore » individual human or machine capabilities. Yet, FA is fundamentally about teamwork in that the goal of the FA decision-making process is to determine what are the optimal allocations of functions among agents. Given this framing of FA, and the increasing use of and sophistication of automation, there are two related social psychological issues that current FA methods need to address more thoroughly. First, many principles for effective human teamwork are not considered as central decision points or in the iterative hypothesis and testing phase in most FA methods, when it is clear that social factors have numerous positive and negative effects on individual and team capabilities. Second, social psychological factors affecting team performance and can be difficult to translate to automated agents, and most FA methods currently do not account for this effect. The implications for these issues are discussed.« less

Lives matter. Do votes? Invited commentary on "Black lives matter: Differential mortality and the racial composition of the U.S. electorate, 1970-2004".

PubMed

Purtle, Jonathan

2015-07-01

Racial health disparities in the United States are produced and perpetuated through public policies that differentially allocate risks and resources for health. Elected officials have the ability modify the structural determinants of racial health disparities through policy decisions and, through voting, the electorate can influence the extent to which these policy decisions promote health equity. In this commentary, I synthesize research on the voting behavior of electorates and policy decisions and present strategies to foster sociopolitical environments that are conducive to the implementation and enforcement of racial health disparity reduction initiatives. There is a need for research that contributes to a more comprehensive understanding of the role of voting in health policy making processes and further development of empirically-based policy advocacy strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Online decision support system for surface irrigation management

NASA Astrophysics Data System (ADS)

Wang, Wenchao; Cui, Yuanlai

2017-04-01

Irrigation has played an important role in agricultural production. Irrigation decision support system is developed for irrigation water management, which can raise irrigation efficiency with few added engineering services. An online irrigation decision support system (OIDSS), in consist of in-field sensors and central computer system, is designed for surface irrigation management in large irrigation district. Many functions have acquired in OIDSS, such as data acquisition and detection, real-time irrigation forecast, water allocation decision and irrigation information management. The OIDSS contains four parts: Data acquisition terminals, Web server, Client browser and Communication system. Data acquisition terminals are designed to measure paddy water level, soil water content in dry land, ponds water level, underground water level, and canals water level. A web server is responsible for collecting meteorological data, weather forecast data, the real-time field data, and manager's feedback data. Water allocation decisions are made in the web server. Client browser is responsible for friendly displaying, interacting with managers, and collecting managers' irrigation intention. Communication system includes internet and the GPRS network used by monitoring stations. The OIDSS's model is based on water balance approach for both lowland paddy and upland crops. Considering basic database of different crops water demands in the whole growth stages and irrigation system engineering information, the OIDSS can make efficient decision of water allocation with the help of real-time field water detection and weather forecast. This system uses technical methods to reduce requirements of user's specialized knowledge and can also take user's managerial experience into account. As the system is developed by the Browser/Server model, it is possible to make full use of the internet resources, to facilitate users at any place where internet exists. The OIDSS has been applied in Zhanghe Irrigation District (Center China) to manage the required irrigation deliveries. Two years' application indicates that the proposed OIDSS can achieve promising performance for surface irrigation. Historical data of rice growing period in 2014 has been applied to test the OIDSS: it gives out 3 irrigation decisions, which is consistent with actual irrigation times and the forecast irrigation dates are well fit with the actual situations; the corresponding amount of total irrigation decreases by 15.13% compared to those without using the OIDSS.

Water resources management in southern Europe: clues for a research and innovation based regional hypercluster.

PubMed

Martins, G; Brito, A G; Nogueira, R; Ureña, M; Fernández, D; Luque, F J; Alcácer, C

2013-04-15

European countries are facing increasing pressures on their water resources despite stringent regulations and systematic efforts on environmental protection. In this context, research and innovation play a strategic role reinforcing the efficiency of water policies. The present study provides a multilevel assessment of research and innovation practices in the field of water resource management in southern European countries and regions (more specifically; Cyprus, Albania, Poitou-Charentes in France, Andalusia in Spain and the North of Portugal). The analysis was based on a strategic framework aimed at gaining an insight of the current constraints, as well as of the existing and future technological solutions for a better water resource management. The triple helix model proved to be a useful analytical framework for assessing the efforts of different groups towards a common goal. The analysis proved the existence of a significant evolution in the use of technological tools to assist decision-making processes in integrated river basin management in all regions. Nevertheless, the absence of formal channels for knowledge and data exchange between researchers and water resource managers complicates the formers involvement in the decision-making process regarding water allocation. Both researchers and consultants emphasize the low availability of data, together with the need to advance on water resource economics as relevant constraints in the field. The SWOT analysis showed similar concerns among the participating regions and provided a battery of effective projects that resulted in the preparation of a Joint Action Plan. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Agent Allocation System for the West Virginia University Extension Service

ERIC Educational Resources Information Center

Dougherty, Michael John; Eades, Daniel

2015-01-01

Extension recognizes the importance of data in guiding programming decisions at the local level. However, allocating personnel resources and specializations at the state level is a more complex process. The West Virginia University Extension Service has adopted a data-driven process to determine the number, location, and specializations of county…

Economics of Obesity — Learning from the Past to Contribute to a Better Future

PubMed Central

Ananthapavan, Jaithri; Sacks, Gary; Moodie, Marj; Carter, Rob

2014-01-01

The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process. PMID:24736685

Estimation of potential maximum biomass of trout in Wyoming streams to assist management decisions

USGS Publications Warehouse

Hubert, W.A.; Marwitz, T.D.; Gerow, K.G.; Binns, N.A.; Wiley, R.W.

1996-01-01

Fishery managers can benefit from knowledge of the potential maximum biomass (PMB) of trout in streams when making decisions on the allocation of resources to improve fisheries. Resources are most likely to he expended on streams with high PMB and with large differences between PMB and currently measured biomass. We developed and tested a model that uses four easily measured habitat variables to estimate PMB (upper 90th percentile of predicted mean bid mass) of trout (Oncorhynchus spp., Salmo trutta, and Salvelinus fontinalis) in Wyoming streams. The habitat variables were proportion of cover, elevation, wetted width, and channel gradient. The PMB model was constructed from data on 166 stream reaches throughout Wyoming and validated on an independent data set of 50 stream reaches. Prediction of PMB in combination with estimation of current biomass and information on habitat quality can provide managers with insight into the extent to which management actions may enhance trout biomass.

Understanding what matters: An exploratory study to investigate the views of the general public for priority setting criteria in health care.

PubMed

Ratcliffe, Julie; Lancsar, Emily; Walker, Ruth; Gu, Yuanyuan

2017-06-01

Health care policy makers internationally are increasingly expressing commitment to consultation with, and incorporation of, the views of the general public into the formulation of health policy and the process of setting health care priorities. In practice, however, there are relatively few opportunities for the general public to be involved in health care decision-making. In making resource allocation decisions, funders, tasked with managing scarce health care resources, are often faced with difficult decisions in balancing efficiency with equity considerations. A mixed methods (qualitative and quantitative) approach incorporating focus group discussions and a ranking exercise was utilised to develop a comprehensive list of potential criteria for setting priorities in health care formulated from the perspective of members of the general public in Australia. A strong level of congruence was found in terms of the rankings of the key criteria with the size of the health gain, clinical effectiveness, and the ability to provide quality of life improvements identified consistently as the three most important criteria for prioritising the funding of an intervention. Findings from this study will be incorporated into a novel DCE framework to explore how decision makers and members of the general public prioritize and trade off different types of health gain and to quantify the weights attached to specific efficiency and equity criteria in the priority setting process. Copyright © 2017 Elsevier B.V. All rights reserved.

Utility functions and resource management in an oversubscribed heterogeneous computing environment

DOE PAGES

Khemka, Bhavesh; Friese, Ryan; Briceno, Luis Diego; ...

2014-09-26

We model an oversubscribed heterogeneous computing system where tasks arrive dynamically and a scheduler maps the tasks to machines for execution. The environment and workloads are based on those being investigated by the Extreme Scale Systems Center at Oak Ridge National Laboratory. Utility functions that are designed based on specifications from the system owner and users are used to create a metric for the performance of resource allocation heuristics. Each task has a time-varying utility (importance) that the enterprise will earn based on when the task successfully completes execution. We design multiple heuristics, which include a technique to drop lowmore » utility-earning tasks, to maximize the total utility that can be earned by completing tasks. The heuristics are evaluated using simulation experiments with two levels of oversubscription. The results show the benefit of having fast heuristics that account for the importance of a task and the heterogeneity of the environment when making allocation decisions in an oversubscribed environment. Furthermore, the ability to drop low utility-earning tasks allow the heuristics to tolerate the high oversubscription as well as earn significant utility.« less

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

Friese, Ryan; Khemka, Bhavesh; Maciejewski, Anthony A

Rising costs of energy consumption and an ongoing effort for increases in computing performance are leading to a significant need for energy-efficient computing. Before systems such as supercomputers, servers, and datacenters can begin operating in an energy-efficient manner, the energy consumption and performance characteristics of the system must be analyzed. In this paper, we provide an analysis framework that will allow a system administrator to investigate the tradeoffs between system energy consumption and utility earned by a system (as a measure of system performance). We model these trade-offs as a bi-objective resource allocation problem. We use a popular multi-objective geneticmore » algorithm to construct Pareto fronts to illustrate how different resource allocations can cause a system to consume significantly different amounts of energy and earn different amounts of utility. We demonstrate our analysis framework using real data collected from online benchmarks, and further provide a method to create larger data sets that exhibit similar heterogeneity characteristics to real data sets. This analysis framework can provide system administrators with insight to make intelligent scheduling decisions based on the energy and utility needs of their systems.« less

Sharing intelligence: Decision-making interactions between users and software in MAESTRO

NASA Technical Reports Server (NTRS)

Geoffroy, Amy L.; Gohring, John R.; Britt, Daniel L.

1991-01-01

By combining the best of automated and human decision-making in scheduling many advantages can accrue. The joint performance of the user and system is potentially much better than either alone. Features of the MAESTRO scheduling system serve to illustrate concepts of user/software cooperation. MAESTRO may be operated at a user-determinable and dynamic level of autonomy. Because the system allows so much flexibility in the allocation of decision-making responsibilities, and provides users with a wealth of information and other support for their own decision-making, better overall schedules may result.

You Are the Danger: Attenuated Insula Response in Methamphetamine Users During Aversive Interoceptive Decision-Making*

PubMed Central

Stewart, Jennifer L.; May, April C.; Poppa, Tasha; Davenport, Paul W.; Tapert, Susan F.; Paulus, Martin P.

2014-01-01

Background Drug dependent individuals often make drug-taking decisions when they do not feel well. Yet, few studies have examined the influence of an aversive state on decision-making related neural processing. Methods We investigate brain activation to decision-making during an aversive interoceptive challenge in methamphetamine users using functional magnetic resonance imaging (fMRI). Recently abstinent inpatients with methamphetamine use disorder (METH; n=20) and healthy comparison subjects (CTL; n=22) performed a two-choice prediction task at three fixed error rates (ER; 20%=reward, 50%=uncertainty, 80%=punishment) while anticipating and experiencing episodes of inspiratory breathing load during fMRI. Results METH exhibited higher trait anxiety in conjunction with lower anterior insula (AI) and inferior frontal gyrus (IFG) activation than CTL across trials. METH also showed lower posterior insula (PI) and anterior cingulate cortex (ACC) activation than CTL during breathing load independent of ER. For the crucial ER by interoception interaction, METH displayed lower ACC activation to punishment/loss than CTL during breathing load. Within METH, lower trait anxiety was linked to bilateral AI/IFG attenuation across trials. Conclusions AI/IFG attenuations in METH are suggestive of an executive functioning deficit, particularly in users with low anxiety, reflecting reduced resources allocated to choice selection. In contrast, PI/ACC reductions in METH appear specific to impairments in registering and evaluating interoceptive experiences. Taken together, inadequate activation of brain areas that are important for regulating when one does not feel well may be the neural basis for poor decision-making by METH. PMID:24993186

"Not clinically indicated": patients' interests or resource allocation?

PubMed Central

Hope, T; Sprigings, D; Crisp, R

1993-01-01

The decision that a particular intervention is not clinically indicated may conceal two quite different ethical assumptions. The first assumption is that the intervention is not of overall benefit to this patient. The second is that limited resources should not be used for this patient. These issues are discussed with reference to cardiac surgery in elderly patients with reference to the main theories of allocation: QALYs, needs theories, the sanctity of life theory, the lottery theory, and market forces. Images p380-a PMID:8461686

Social Area Indicators of Educational Need. A Study of the Use of Census Descriptions of School Neighbourhoods in Guiding Decisions Concerning the Allocation of Resources to Educationally Disadvantaged Schools in Australia. ACER Research Monograph No. 20.

ERIC Educational Resources Information Center

Ross, Kenneth N.

The purpose of this study was to develop, validate, and describe indicators of educational disadvantage to be used in Australia to identify schools and students most in need of assistance from the Disadvantaged Schools Program. Initially, a detailed review was prepared of the resource allocation responses which have been made in Australia to the…

Research versus Advocacy in the Allocation of Resources: Problems, Causes, Solutions.

ERIC Educational Resources Information Center

Menolascino, Frank J.; Stark, Jack A.

1990-01-01

This commentary on EC 231 901 discusses whether resource allocations and service policies for mentally retarded individuals should be based upon purported findings of scientific theory or the purported needs of service systems. The paper calls for improved research utilization and understanding of what makes a social movement work. (JDD)

Theory of Mind Is Related to Children's Resource Allocations in Gender Stereotypic Contexts

ERIC Educational Resources Information Center

Rizzo, Michael T.; Killen, Melanie

2018-01-01

The present study investigated the relations between 4- to 6-year-old children's (N = 67) gender stereotypes, resource allocations, and mental state knowledge in gender-stereotypic contexts. Participants were told vignettes about female and male characters completing gender-stereotyped activities (making dolls or trucks). Children held stereotypic…

Advanced Economic Analysis

NASA Technical Reports Server (NTRS)

Greenberg, Marc W.; Laing, William

2013-01-01

An Economic Analysis (EA) is a systematic approach to the problem of choosing the best method of allocating scarce resources to achieve a given objective. An EA helps guide decisions on the "worth" of pursuing an action that departs from status quo ... an EA is the crux of decision-support.