Dissertations / Theses on the topic 'Patient allocation'
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Walts, Lynn Maddox Walker George M. "Patient classification system : an integrated method for measuring nursing intensity and optimizing resource allocation /." See options below, 1992. http://proquest.umi.com/pqdweb?did=745208811&sid=2&Fmt=2&clientId=68716&RQT=309&VName=PQD.
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Lin, Di. "Wireless health monitoring: patient arrival models, resource allocation and decision support systems." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121438.
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Overcrowding in the emergency department is a worldwide problem impairing the ability of hospitals to offer emergency care within a reasonable time frame. Not merely a problem of patient satisfaction, the problem of overcrowding is leading to an increased number of waiting room death cases, which refer to the death of patients while staying in a hospital's waiting room due to a lack of sufficient medical care, and this problem underscores the significance of improving healthcare quality. As a potential way of improving healthcare quality, a wireless healthcare monitoring system (HMS) could help healthcare staff monitor the condition of patients by automatically sending alert messages to a doctor device (e.g. a smartphone, a personal digital assistant, or a laptop) once emergent conditions occur.From a network design perspective, a wireless HMS should be capable of supporting the number of patients that will be using the system; being able to assess the network's capability to serve a given number of patients (defined as network patient capacity) is a critical factor in promoting adoption of such systems. This thesis investigates schemes for enhancing the network patient capacity within a HMS. The major objective is to explore the tradeoff between the network patient capacity and the Quality-of-Service (QoS) requirements of each patient, so that a fairly good network capacity is achieved subject to the constraints of QoS requirements within real-world transmission scenarios.In the first part of this thesis, we develop novel methods to estimate the average waiting time of a patient to access the Emergency Department (ED) of a hospital, showing why developing a HMS and allocating its limited wireless resources are important to improve the quality of medical care. The following part of this thesis presents various schemes for resource allocation within a HMS, in view of several factors that need to be taken into account in a real scenario, including different QoS requirements, Electromagnetic Interference (EMI) on medical equipments, as well as imperfect channel state information. We propose three novel techniques for improving the network patient capacity within a HMS, including a statistical multiplexing scheme, a channel prediction based scheme, and a medical decision support based scheme. The last part of this thesis focuses on the performance evaluation of a decision support system, a result that is important to assess the validity and acceptability of the decision support based resource allocation scheme proposed above.La surpopulation dans les urgences est un problème très répandu qui peut incommoder les hôpitaux à promulguer des soins urgents dans des délais raisonnables. Au-delà de la satisfaction du patient, le problème de surpopulation entraine une augmentation du nombre de décès en salle d'attente, référant à la mort de patient durant l'attente d'une prise en charge, laquelle est causée par manque de soins médicaux. Ce problème met en évidence l'importance d'améliorer la qualité des soins médicaux, c'est pourquoi un système de surveillance médicale (SSM) pourrait aider le personnel médical à contrôler l'état des patients, en envoyant automatiquement des messages d'alerte aux appareils des médecins (ex. un téléphone intelligent, un assistant numérique personnel ou un ordinateur portable) dès qu'une condition médicale urgente se déclare. Dans une perspective de conception réseau, un SSM sans fil devrait être capable de supporter le nombre de patients qui utiliseront le système, et le fait de pouvoir évaluer l'aptitude du réseau à traiter un certain nombre de patients (défini comme la capacité en patients du réseau) est un facteur important dans la promotion de tels systèmes. Cette thèse étudie les procédés pour augmenter la capacité en patients du réseau dans un SSM. L'objectif principal est de trouver un compromis entre la capacité en patients du réseau et les exigences de la Qualité de Service (QdS) pour chaque patient, de sorte à avoir une capacité de réseau raisonnable en dépit des contraintes de la QdS dans des scénarios de transmissions réelles. Dans la première partie de cette thèse, nous développons de nouvelles méthodes pour estimer la durée moyenne d'attente d'un patient pour accéder au Département des Urgences (DU) d'un hôpital. Ainsi nous montrons pourquoi le développement d'un SSM et l'allocation de ses ressources sans fil limitées sont importants pour améliorer la qualité des soins médicaux. La suite de cette thèse présente plusieurs plans pour l'allocation de ressources dans un SSM, en considérant plusieurs facteurs qui ont besoin d'être pris en compte dans le cas d'un scénario réel, ce qui comprend les différentes exigences de la QdS, les interférences électromagnétiques (IEM) sur les équipements médicaux, ainsi que l'information imparfaite des états du canal. Nous proposons trois nouvelles techniques pour améliorer la capacité du réseau en patients dans un SSM, ce qui inclut une partie sur le multiplexage statistique, une partie basée sur la prédiction du canal et une partie basée sur la décision médical à l'appui.La dernière partie de cette thèse se concentre autour de l'évaluation des performances pour un système d'aide à la décision, qui est un résultat important pour évaluer la validité et l'acceptabilité de la décision d'aide basée sur le schéma d'allocation des ressources proposé précédemment.
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Burgwin, Drew H. "Comparison of dispatch call evaluation to patient acuity and the resulting resource allocation in emergency medical services." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ54581.pdf.
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Burbidge, Nancy M. "Organ allocation and patient responsibility, re-examining the concept of responsibility in light of the thought of Emmanuel Levinas." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ66129.pdf.
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Göransson, Katarina. "Registered nurse-led emergency department triage : organisation, allocation of acuity ratings and triage decision making." Doctoral thesis, Örebro University, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-732.
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Successful triage is the basis for sound emergency department (ED) care, whereas unsuccessful triage could result in adverse outcomes. ED triage is a rather unexplored area in the Swedish health care system. This thesis contributes to our understanding of this complex nursing task. The main focus of this study has been on the organisation, performance, and decision making in Swedish ED triage. Specific aims were to describe the Swedish ED triage context, describe and compare registered nurses’ (RNs) allocation of acuity ratings, use of thinking strategies and the way they structure the ED triage process.
In this descriptive, comparative, and correlative research project quantitative and qualitative data were collected using telephone interviews, patient scenarios and think aloud method. Both convenience and purposeful sampling were used when identifying the participating 69 nurse managers and 423 RNs from various types of hospital-based EDs throughout the country.
The results showed national variation, both in the way triage was organised and in the way it was conducted. From an organisational perspective, the variation emerged in several areas: the use of various triageurs, designated triage nurses, and triage scales. Variation was also noted in the accuracy and concordance of allocated acuity ratings. Statistical methods provided limited explanations for these variations, suggesting that RNs’ clinical experience might have some affect on the RNs’ triage accuracy. The project identified several thinking strategies used by the RNs, indicating that the RNs, amongst other things, searched for additional information, generated hypotheses about the fictitious patients and provided explanations for the interventions chosen. The RNs formed relationships between their interventions and the fictitious patients’ symptoms. The RNs structured the triage process in several ways, beginning the process by searching for information, generating hypotheses, or allocating acuity ratings. Comparison of RNs’ use of thinking strategies and the structure of the triage process based on triage accuracy revealed only slight differences.
The findings in this dissertation indicate that the way a patient is triaged, and by whom, depends upon the particular organisation of the ED. Moreover, the large variation in RNs triage accuracy and the inter-rater agreement and concordance of the allocated acuity ratings suggest that the acuity rating allocated to a patient may vary considerably, depending on who does the allocation. That neither clinical experience nor the RNs’ decision-making processes alone can explain the variations in the RNs triage accuracy indicates that accuracy might be influenced by individual and contextual factors. Future studies investigating triage accuracy are recommended to be carried out in natural settings.
In conclusion, Swedish ED triage is permeated by diversity, both in its organisation and in its performance. The reasons for these variations are not well understood.
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Martins, Sara Vanessa Teixeira. "Apuramento de custos por utente nos cuidados de saúde primários." Master's thesis, Universidade Nova de Lisboa. Escola Nacional de Saúde Pública, 2012. http://hdl.handle.net/10362/10192.
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RESUMO - Introdução: A ausência de um plano de contabilidade analítica para os Cuidados de Saúde Primários é um problema para a realização da contabilidade interna, fundamental para a gestão de qualquer instituição de saúde. Sem linhas orientadoras para a uniformização dos critérios de imputação e distribuição dos custos/proveitos, torna-se complicado obter dados analíticos para que haja um controlo de gestão mais eficaz, que permita a utilização dos recursos de uma forma eficiente e racional, melhorando a qualidade da prestação de cuidados aos utentes.
Objectivo: O presente projecto de investigação tem como principal objectivo apurar o custo por utente nos Cuidados de Saúde Primários.
Metodologia: Foi construída uma metodologia de apuramento de custos com base no método Time-Driven Activity-Based Costing. O custo foi imputado a cada utente utilizando os seguintes costs drivers: tempo de realização da consulta e a produção realizada para a imputação dos custos com o pessoal médico; produção realizada para a imputação dos outros custos com o pessoal e dos custos indirectos variáveis; número total de utentes inscritos para a imputação dos custos indirectos fixos.
Resultados: O custo total apurado foi 2.980.745,10€. O número médio de consultas é de 3,17 consultas por utente inscrito e de 4,72 consultas por utente utilizador. O custo médio por utente é de 195,76€. O custo médio por utente do género feminino é de 232,41€. O custo médio por utente do género masculino é de 154,80€. As rubricas com mais peso no custo total por utente são os medicamentos (40,32%), custo com pessoal médico (22,87%) e MCDT (17,18%).
Conclusão: Na implementação de um sistema de apuramentos de custos por utente, é fulcral que existam sistemas de informação eficientes que permitam o registo dos cuidados prestados ao utente pelos vários níveis de prestação de cuidados. É importante também que a gestão não utilize apenas os resultados apurados como uma ferramenta de controlo de custos, devendo ser potenciada a sua utilização para a criação de valor ao utente.ABSTRACT - Introduction: The lack of a cost accounting plan for the primary health care program is an issue for the implementation of internal accounting, which is fundamental to the management of any health care institution. Without guidelines to standardize the criteria for allocation and distribution of costs/income, it becomes difficult to obtain the necessary analytical data to a more effective management control, allowing the use of resources in an efficient and rational way and delivering an improved healthcare service to the patients. Objectives: The aim of this study is to determine the cost per patient in primary healthcare. Methods: The cost evaluation study was based on the Time-Driven Activity-Based Costing method. The cost was allocated to each patient using the following cost drivers: duration of the consultation and undertaken production for the allocation of costs with medical staff; undertaken production for the allocation of other costs concerning staff and indirect variables; total number of patients registered for the allocation of indirect fixed costs. Results: The total cost calculated was €2.980.745, 10. The average number of consultations is 3,17 per registered patient and 4,72 per user patient. The average cost per patient is €195,76. The female population has an average cost per patient of €232,41. As for the male population, the average cost per patient is €154,80. The main cost categories contributing to the total cost per patient are medications (40,32%), medical costs (22,87%) and both diagnostics and therapeutics (17,18%). Conclusion: Within the implementation of a cost allocation system per patient, it is crucial to have efficient information systems to record the several patient healthcare services provided through the different levels of care. In addition to using the results as a cost control tool, it is also important for managers to use it as an instrument to create value for patients.
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Pike, Kenneth Charles. "Allocating life : the selection of liver transplant patients /." Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/8917.
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GREGOIRE, YVES AMBROISE. "La place de l'allocation aux adultes handicapes dans la prise en charge psychiatrique : etude faite au sein d'une population de patients suivis par une meme equipe soignante." Aix-Marseille 2, 1988. http://www.theses.fr/1988AIX20093.
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Tsang, K., and 曾光. "Prioritization preferences for corneal transplantation allocation in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972226.
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Stocken, Deborah Dawn. "Statistical modelling for the prognostic classification of patients with pancreatic cancer for optimisation of treatment allocation." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/1303/.
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Pancreatic cancer is a common cause of cancer death and is difficult to diagnose and treat. A prognostic index can be used in clinical practice to predict survival. Thirty six prognostic factor studies were identified but size and statistical methods were inappropriate. Continuous variables are often simplified incorrectly i) assuming linear relationships between predictors and log-hazard or ii) using dichotomisation. Non-linearity is addressed for the first time in this disease site using restricted cubic spline and fractional polynomial functions. Multivariable models containing non-linear transformations gave a substantially better fit. Important effects of some covariates were unrecognised under simplistic assumptions. The fitted functions generated by the two methods were similar. A direct comparison of these strategies was based on assessing the difference in the AIC values by calculating a sampling distribution in multiple bootstrap resamples. Model validation is also addressed for the first time in this disease and suggested minimal over-fitting with reproducible prognostic information when fitted to external data. This thesis provides the first validated prognostic tool in advanced pancreatic cancer developed using appropriate statistical methodology. Risk-sets identified by the model could help clinicians target treatments to patients more appropriately and have an impact on future trial design and analysis.
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Pleijel, Birgitta. "Skattning av prognostiska faktorer för gradering av smärtans komplexitet hos patienter i behov av multimodal smärtrehabilitering inom två vårdnivåer." Thesis, Uppsala universitet, Sjukgymnastik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-161968.
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Abstract PURPOSE: The aim of this study was to describe and compare possible differences regarding selected prognostic factors for disability between patients with non-specific chronic pain who were about to start a multidisciplinary treatment program (MMR), either within primary care (MMR1) or hospital care (MMR2). METHODS: The study had a descriptive and comparative cross sectional design. Eighty-nine patients were recruited consecutively when they were about to start their team treatment (50 in MMR1,39 in MMR2). The measurements were; Evaluation of self-reported self-efficacy for eight daily activities (STIVA-8), The Pain Belief Screening Instrument (PBSI) and Hospital Anxiety and Depression Scale (HADS). RESULTS: The study found some significant differences between the answers from patients in MMR1 and those from patients in MMR2. For instance, patients in MMR2 estimated lower self-efficacy according to STIVA-8 than patients in MMR1. Also, there were fewer low risk patients and more high risk patients in MMR2 than in MMR1 regarding pain intensity according to PBSI. In addition to this, there were fewer patients without depression and more with moderate depression in MMR2 than in MMR1 according to HADS. No significant differences could be shown for either anxiety according to HADS or for low- and high risk regarding activity disability according to PBSI. No significant differences could be found when pain intensity was measured with mean values on a scale from 0-10. CONCLUSIONS: Patients in MMR2 experienced more negative consequences from their pain disease than patients in MMR1. Systematic use of standardized self-reported instruments for selected prognostic factors could be helpful when screening for complexity and make it easier to decide whether the rehabilitation should be within MMR1 or MMR2 for patients in need of MMR.Sammanfattning SYFTE: Syftet med denna studie var att beskriva och jämföra om patienter med långvarig smärtproblematik inom primärvård (MMR1) respektive specialiserad sjukhusvård (MMR2), som stod i begrepp att påbörja multimodal smärtrehabilitering (MMR), skattade olika avseende ett antal prognostiska faktorer för funktionsförmåga. METOD: Studien hade en deskriptiv och komparativ tvärsnittsdesign. Åttionio konsekutivt tillfrågade patienter deltog (50 i MMR1, 39 i MMR2). Datainsamlingen gjordes vid start av MMR med tre självskattningsformulär; Skattning av tilltro till sin förmåga att utföra åtta specificerade vardagsaktiviteter (STIVA-8), The Pain Belief Screening Instrument (PBSI) och Hospital Anxiety and Depression Scale (HADS). RESULTAT: Studien visade statistiskt signifikanta skillnader avseende att patienterna i MMR2 skattade lägre tilltro till sin förmåga enligt STIVA-8, det var färre andel lågriskpatienter och större andel högriskpatienter i MMR2 avseende smärtintensitet enligt PBSI samt färre andel patienter utan depression i MMR2 och fler med måttliga depressionsbesvär i MMR2 enligt HADS. Inga signifikanta skillnader kunde visas avseende låg- och högrisk för aktivitetsbegränsning enligt PBSI och inte heller för ångest enligt HADS. När smärtintensitet beräknades med medelvärde på skalan 0-10 fanns inga signifikanta skillnader. KONKLUSION: Patienterna i MMR2 skattade mer negativa konsekvenser av sin smärtsjukdom än i MMR1. Systematisk användning av skattningsformulär som ringar in olika prognostiska faktorer bör kunna underlätta selektion och sortering vid val av vårdnivå för patienter i behov av MMR.
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Kilonzo, Kajiru. "Characteristics and allocation outcomes of patients assessed for the renal replacement therapy at Groote Schuur Hospital (2008-2012)." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13287.
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Includes bibliographical references.End Stage Kidney Disease (ESKD) is a global public health problem with an enormous economic burden. In resource limited settings like South Africa management of End Stage Kidney Diseases is rationed to the most transplantable candidates. Racial and socio-economic inequalities in selecting candidates have been documented in a South Africa despite the availability of guidelines. No data is available on selection outcomes using the current 2010 prioritization guidelines of Western Cape. We audited the outcome of patients assessed for the renal replacement therapy at Groote Schuur hospital. A retrospective analytic study of patients presented to the renal replacement therapy committee was conducted in the renal unit of Groote Schuur Hospital. Outcome letters, proceedings from the committee meetings and the hospital database were sources of data used. All new patients presented between 2008 and 2012 were included in the study. Data entry and statistical analysis was done using SPSS v.22. A total of 734 ESKD patients were assessed for renal replacement therapy between January, 2008 and December, 2012. During that period, there were 564 new patients, of which more than half (53.9%) were not selected for the program. Following the introduction of the new prioritization criteria a trend towards increasing number of patients presented and accepted was noted. More males were presented (M: F = 1.3) and most patients were below the age of 50yrs (n=478, 84.8%). Half of the patients came from low socioeconomic areas. There were no significant differences in socio-demographic factors before and after introduction of the new guidelines. Clinically they had advanced disease with either uremic (n=181, 44.4%) or fluid overload (n=179, 43.9%) symptoms as their major presentation. The underlying causes were Hypertension (40.6%), Diabetes (14.4%) and chronic Glomerulonephritis (15.8%). Predictors of rejection from the program included age above 50 years, unemployment and a poor psychosocial assessment. Substance abuse and Diabetes also showed a statistical significant association with the likelihood of being rejected. Race and marital status were not predictors. Efforts to allocate more resources should continue in view of the loss of young and potential productive life. Advanced presentation of patients with ESRD represents challenges in early diagnosis and referral in the current system. Community screening programs and improved access to knowledgeable clinicians at the primary level is advocated. The use of new selection guidelines have not led to an increase in selection inequalities.
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Hedding, Kirsty. "A descriptive study of demographics, triage allocations and patient outcomes for a private emergency centre in Pretoria for 2018." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32761.
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Background Triage aims to detect critically ill patients and to prioritise those with time-sensitive needs. It also contributes to the overall efficiency of an emergency centre (EC). International systems have been relatively well researched; however, no data exists on the use of the SATS score in private healthcare settings in SA. Objectives This study aimed to describe the demographics, triage allocations, time spent in EC and disposition of all patients presenting to a private hospital EC in Pretoria, South Africa in 2018. Methods A retrospective descriptive study was undertaken. Data relating to demographics, triage, and hospital disposition were collected on all patients presenting to the EC during the 2018 calendar year. Descriptive data analyses were conducted in Microsoft Excel. Results A total of 29 055 patients were included in this study. More than half (57.6%) were adults aged 18 to 60 years and approximately one-fourth (27.5%) were paediatrics (<18 years). The majority of patients were triaged yellow (73.5%); 17.4% were triaged as red and orange. It took, on average, 28 minutes to be seen by a provider and patients spent an average of 2 hours and 20 minutes in the EC. Delays to be seen exceeded standards for red and orange patients at 8 and 18 minutes respectively, and the mean time these patients spent in the EC was higher (2h 51 minutes and 2h 47 minutes respectively). Most patients (76.1%) were discharged; 5.6% were admitted to ICU/high care, 14.4% to the general ward, and 3.9% either absconded or refused hospital treatment. Of patients triaged red and orange, 11.1% and 49.3% were discharged respectively, and these patients used the most resources . Conclusion This study found that most of the patients were triaged into low acuity categories (yellow and green) and discharged home. High acuity patients were usually admitted to ICU or high care; however, these patients experienced delays in being treated and admitted. Causes of these issues, and implications on patient outcomes remain unknown. Large numbers of high acuity patients were ultimately discharged home. Further studies are needed to understand the influence of triage accuracy on these patients' outcomes.
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Mendez, Mario Fernando. "The allocation of spatial attention in the visual field in young adults, normal elderly and demented patients: The scanning focus model." Case Western Reserve University School of Graduate Studies / OhioLINK, 1991. http://rave.ohiolink.edu/etdc/view?acc_num=case1055778554.
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Wu, Jeng Lin, and 吳振麟. "From the Service Level Viewpoint to Study a Patient Bed Quantity Planning and Patient Bed Allocation Problem." Thesis, 1993. http://ndltd.ncl.edu.tw/handle/95072989921867280404.
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碩士中原大學
工業工程研究所
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Recently,the participation of medical insurance is increased rapidly and current medical facilities cannot provid adequate service. Therefore, many new hospitals have been built and some existed hospitals have also been renovated. The hospital management as such become an attracting arena in Industrial Engineering. In hospital, the issues of the patient building design and the patient bed quantity planning will deeply affect the profit of the hospital and the quantity of the service to the patients. A proper building design and bed quantity planning not only can reduce the unnecessary cost but also can increase the level of service to patients. Determining the necessary patient bed quantity is a fundamented problem of the patient building design issue. Effectively planning the number of beds can save the holding cost of unoccupied beds and decrease the occurrence of bed shortage. In the last two decades, several papers were revealed in which patient beds were determinted by assuming unlimited patient building space [Maclean (1987),Hershey(1981),Hancock(19- 76), and Esobque(1976) ]. This assumption simplifies the patient beds planninng problem and makes this problem unreal.In reality, the patient beds planning issue should be considered based on the available space, which are also affected by the existing patient beds. In this thesis, we consider both the unlimited and the limited cases. In dealing with the patient bed planning problem,we propose a patient bed control system. By applying the service level concept from the Inventory Control,the patient service level and the bed service level are used as two indices in this control system.
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Lin, Chin-Yi, and 林靜宜. "Patient Transporter Allocation and Business Process Reengineering- A Case study of a Regional Teaching Hospital." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/90782113526340747207.
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碩士雲林科技大學
工業工程與管理研究所碩士班
97
Since provider payment in Taiwan’s National Health Insurance and Labor Pension Act changed medical institution’s competition environment, patients are free to choose among all providers for medical services. Physician’s skill and hospital scale and its facility are no longer the major concerns of patient visit. Total quality of comprehensive service including physician’s attitude becomes the main considerations of patient visit. Patient transporters consisting of the non-medical staff are in charge outsourcing business services in patient transport dispatching. The aim was strategically to reduce overhead and to improve the flexibility, quality, innovation and efficiency of the process output. Their job content includes transportation of patients, in-patient medicine, laboratory specimens, patient records, medical instruments and so on. Through Business Process Reengineering methodology, linear programming, and simulation with Simprocess 4.3, we have found that: (1) busy rate of clerk staff decreases from 100% to 80.52%, and (2) busy rate of standby dispatcher increases from 73.34% to 81.9%, which are both close to the suggested rate of 80%. Meanwhile, the average waiting time per case decreases from 24 minutes to 10 minutes, and the number of standby dispatchers was reduced by two. On the other hand, using the check list significantly decreases human errors.
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CUEVAS, BRUN EDGAR HERNAN, and 古文嘉. "Optimization of Patient Allocation During an Epidemic Dengue Fever Outbreak in Ciudad del Este, Paraguay." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/44m58w.
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碩士國立臺北科技大學
管理學院外國學生專班
107
Dengue fever is a mosquito-borne disease that has rapidly spread throughout the past century. Initially only seen in tropical and subtropical areas, today it can also be encountered across temperate regions. In the past few decades, several dengue fever epidemics have taken place in numerous countries, some of which have been declared as endemoepidemic areas due to the constant recurrence of the disease. Most preventive mechanisms to deal with the disease focus on the eradication of the vector mosquito and vaccination campaigns; however, once an outbreak takes place, counting with the appropriate infrastructure, resources and mechanisms of response is indispensable to face the consequent events. This study presents single and multiple objective linear programming models that aim to optimize the allocation of patients and additional resources during an epidemic dengue fever outbreak, minimizing the summation of the distances traveled by all patients, while also minimizing individual journeys. By these means, the cost implied in transportation could be reduced. The case study was set in Ciudad del Este, Paraguay, nation that became an endemic area in 2002. Data provided by a privately-owned health insurance cooperative was used to test the three models presented in the study. Moreover, the results were computed and analyzed based on the algorithms that displayed the capabilities of their features, and the ε-constraint method was applied to solve multiple objective problems. Allocation of patients, resource shortage, and allocation of additional resources are shown in the results to highlight the advantages generated by the models, providing intrinsic information to both analysts and decision makers. Suggestions about expansions and improvements of the models are also mentioned, taking into consideration multiple scenarios where the models could be tested.
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King, Allana Sheree. "The effectiveness of a team nursing model compared with a total patient care model on staff wellbeing when organizing nursing work in acute care wards." Thesis, 2016. http://hdl.handle.net/2440/114479.
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Background The organization of the work of nurses, according to recognized models of care, can have a significant impact on the wellbeing and performance of nurses and nursing teams. This thesis focuses on two models of nursing care delivery, namely, team and total patient care, and their effect on nurses’ wellbeing. Objectives To examine the effectiveness of a team nursing model compared with a total patient care model on staff wellbeing when organizing nursing work in acute care wards. Inclusion criteria Types of participants Participants were nurses working on wards in acute care hospitals. Types of intervention The intervention was the use of a team nursing model when organizing nursing work. The comparator was the use of a total patient care model. Types of studies This review considered quantitative study designs for inclusion in the review. Types of outcomes The outcome of interest was staff wellbeing which was measured by staff outcomes in relation to job satisfaction, turnover, absenteeism, stress levels and burnout. Search strategy The search strategy aimed to find both published and unpublished studies from 1995 to April 21, 2014. Methodological quality Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data collection Data was extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the interventions, populations, study methods and outcomes of significance to the review question and its specific objectives. Data synthesis Due to the heterogeneity of the included quantitative studies, meta-analysis was not possible thus results have been presented in a narrative form. Results The database search returned 10,067 records. Forty-three full text titles were assessed, and of these 40 were excluded, resulting in three studies being included in the review. Two of the studies were quasi experimental designs and the other was considered an uncontrolled before and after experimental study. There were no statistically significant differences observed in any study in the overall job satisfaction of nurses using a team nursing model compared with a total patient care model. Some differences in job satisfaction were however observed within different subgroups of nurses. There were no statistically significant differences in either stress or job tension. Within the selected studies, the specific outcomes of absenteeism and burnout were not addressed. Conclusions Due to the limited number of quantitative studies identified for inclusion it was not possible to determine whether organizing nursing work in a team nursing model or a total patient care model is more effective in terms of staff wellbeing. Neither a team nursing model or a total patient care model had a significant influence on nurses’ overall job satisfaction, stress levels or staff turnover. There is an inability to ascertain if the type of model of care affects absenteeism or burnout as these outcomes were not addressed in any of the identified studies. Implications for practice Caution should be taken when evaluating which model of care is appropriate and the decision needs to incorporate staff experience levels and staff skill mix. There needs to be clear definition of nursing roles. Implications for research There is a need for further quantitative studies that are well designed with sufficient sample sizes to allow for attrition of participants, and that explore the impact each model has on nurse’s wellbeing, in particular, studies that address burnout and absenteeism. Consistent terminology is required to enable future comparison and research to occur at an international level. Future studies on models of care should include economic analysis to fully inform policy and practice.Thesis (M.Clin.Sc.) -- University of Adelaide, School of Public Health, 2016.
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Chang, Ya-Ting, and 張雅婷. "To Explore The Association Between Pharmacist Allocation And Patient Waiting Time In A Medical Center Outpatient Pharmacy." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/qh775e.
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碩士國立彰化師範大學
資訊管理學系
107
National Health Insurance has a great impact on the medical care in Taiwan. The medical resource will have redistribution by the policy. The hierarchical medical system will also affect patient behavior, and the quality of health care will affect condition of a medical organization. During treatment, a patient often complain about a large-scale hospital as follows: queuing for a long time to see a doctor and to pick up the medication. In order to provide demand between cost-effectiveness and service quality of the medical treatment in a hospital, this project will discuss the present situation of the pharmacy's workflow. This paper is base on the queuing theory to build a mathematical model and solve it by the exhausted method to find the suitable waiting time of peak time and off-peak hours. The executing result will be verified and analyzed to search the optimal solution.
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Inampudi, Venkata Srihari. "A Real Time Web Based Electronic Triage, Resource Allocation and Hospital Dispatch System for Emergency Response." 2011. https://scholarworks.umass.edu/theses/541.
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Disasters are characterized by large numbers of victims and required resources, overwhelming the available resources. Disaster response involves various entities like Incident Commanders, dispatch centers, emergency operations centers, area command and hospitals. An effective emergency response system should facilitate coordination between these various entities. Victim triage, emergency resource allocation and victim dispatch to hospitals form an important part of an emergency response system. In this present research effort, an emergency response system with the aforementioned components is developed.
Triage is the process of prioritizing mass casualty victims based on severity of injuries. The system presented in this thesis is a low-cost victim triage system with RFID tags that aggregate all victim information within a database. It will allow first responders' movements to be tracked using GPS. A web-based real time resource allocation tool that can assist the Incident Commanders in resource allocation and transportation for multiple simultaneous incidents has been developed. This tool ensures that high priority resources at emergency sites are received in least possible time. This web-based tool also computes the patient dispatch schedule from each disaster site to each hospital. Patients are allocated to nearest hospitals with available medical facilities. This tool can also assist resource managers in emergency resource planning by computing the time taken to receive required resources from the nearest depots using Google Maps. These web-based tools complements emergency response systems by providing decision-making capabilities.
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Gomes, Ana Beatriz Toscano Lourinho. "Hospital branding as a strategy for differentiation : does Hospital Branding Leverages Hospital Units in the Portuguese Market?" Master's thesis, 2018. http://hdl.handle.net/10400.14/25288.
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Hospital Branding has grown in the Portuguese healthcare market as a strategy to create a unified image to consumers, as well as executing common practices among hospitals to ensure a certain level of quality expected by patients.
This dissertation aimed to understand if Hospital Branding could be used as a differentiation strategy in a way that it could leverage the private hospitals’ performance in the Portuguese market. For this, tree research questions were developed by proposing that hospital branding provided private hospitals with better resource allocation skills, further tools to promote patient satisfaction and improved hospital positioning, when compared with unbranded hospitals. To analyze this, a 2-group sample was defined, with both branded and unbranded Portuguese private hospitals, and a set of hypotheses was created, supporting all research questions, and tested through association’s and differences’ tests. After analysis, not all hypotheses were accepted and, consequently, not all research questions were fully supported.
Evidence showed that hospital branding did provide private hospitals with a higher chance of offering more resources to patients, with a higher clinical excellence and safety than unbranded hospitals. Branded hospitals were expected to be more innovative regarding used technologies and more likely to present a transparent culture with patients.A presença de Marcas Hospitalares tem crescido no sector da saúde portuguesa sob forma de estratégia, capaz de proporcionar uma imagem unificada aos pacientes e de implementar práticas comuns entre hospitais, de modo a assegurar um nível de qualidade esperado pelos pacientes. Esta dissertação teve como objetivo compreender se o uso de marcas hospitalares poderia servir como estratégia de diferenciação no sector da saúde portuguesa, de tal forma que o seu uso seria capaz de promover o desempenho dos hospitais privados. Para tal, um total de três perguntas foram desenvolvidas, no qual foi proposto que o uso de marcas facultava aos hospitais privados uma melhor gestão de recursos, mais instrumentos para satisfação do paciente e um melhor posicionamento no mercado, quando comparados com outros hospitais. A metodologia incluiu a definição de uma amostra, dividida em dois grupos, constituída por hospitais privados associados, e não associados, a marcas hospitalares. Um conjunto de hipóteses foram criadas e testadas utilizando testes de associação e de diferenças. Após análise, nem todas as hipóteses foram aceites. Consequentemente, algumas suposições não foram apoiadas. Este estudo mostrou que o uso de marcas hospitalares proporcionou aos hospitais uma maior possibilidade de oferecer mais recursos aos pacientes, dotados de excelência clínica e segurança, quando comparados com outros hospitais. O uso de marcas hospitalares tornou os hospitais mais recetivos ao uso de inovações tecnológicas e à prática de uma cultura mais transparente com os pacientes.
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Lin, Pinhui, and 林品卉. "An On－line Allocation System for Emergent Patients." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/14408958054391704386.
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碩士大葉大學
工業工程與科技管理學系
100
In recent years, Because the global warming causes the climate to present the strange happening, Thailand flooding, In March northeast Japan has the large-scale earthquake and the Tsunami；Around natural disasters continue to occur, resulting in heavy casualties, broken homes, houses collapsed and major property damage, nowadays the condition is plans how the good urgent contingency plan and does pay great attention to prevent the disaster as well as the disaster, reconstructs the question. The present situation is to project emergency response plan and focus on disaster prevention and reconstruction, Know the contingency plan, but I don’t know the medical resources of the nearby hospitals, ambulance resources? Where? By now will on-the-spot direction personnel, how injury sickness designation to the most suitable healing institute will be the most important topics. This study injury patients five triage START and hospital information room FTP every 30 minutes to the local database to obtain the existing resources of each hospital through the ambulance side and the hospital side, the site operator can quickly and in the shortest time will hurt the patient classification to be sent to the most appropriate hospital. Policy-maker system of by this research development, provide the newest resources because of the immediate sick and wounded information's transmission as well as the hospital, Using Trauma login system and Affinity Set concept, plans the suitable designation model, will injury sickness to send fast to the most appropriate healing institute treatment, causes the shipping time to reduce, also causes the wound sickness survival time most to lengthen to a big way.
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Tsai, Yuen-Ching, and 蔡月卿. "A Study On Patients Satisfaction Of Hemodialysis Centers Space Allocation." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/35777801130818353917.
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碩士中華科技大學
建築工程與環境設計研究所
103
Currently the medical market, revenue hemodialysis centers in hospitals accounted for the bulk of health care revenue. However, fierce competition medical situations, how to create, maintain, and strengthen the relationship between hospital staff and patients from the user (patients and staff) satisfaction and thus enhance patient and employee satisfaction and loyalty of patients, in order to increase market share hospital hemodialysis centers, dialysis centers are today the establishment of its competitive advantage is an important factor in order to survive. Management of the hospital only to understand user behavior and improve hospital customer orientation, its quality of service possible upgrade. Due to the fierce competition between hemodialysis and operating environment changes, so medical institutions toward patient-centered care. Indeed a clear understanding of why patients want and demand, the voices and opinions of patients into the medical services provided, to the satisfaction, thereby improving the quality and achieve a win-win situation. In this study, a retrospective analysis archives for patient satisfaction questionnaire survey, based on questionnaires sent in matters other recommendations, the patient table described with words written opinion as to the qualitative and quantitative analytical methods are summarized Integration disease problems with their satisfaction recommendations integration patients. Then to the literature review, the status of investigation and analysis dialysis centers, for the results of the initial analysis, statistical analysis of patient satisfaction, showing that patients are not satisfied with the service currently provided in the security environment, instruments and facilities, and from hospital transportation convenience, patients did not achieve the desired focus to enhance patient satisfaction is concerned, there is considerable room for improvement, all must be improved. Most previous studies to investigate only set up to explore the environment to health care, and is based on the perspective of health care providers to raise the cover hospital dialysis center building, few joined the actual user experience. Many patients are exploring satisfaction from the services provided in terms, for example: the length of waiting time, courtesy or not, interpersonal relations and professional and the like; and less space by a medical environment, to explore patient satisfaction degrees. Expected results of this study to the concept of health as the main building to discuss issues of their patients of the hospital environment may occur crux and feelings, and finally to provide a reference health units and hospitals on the architectural design.
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Shiu, Ting wei, and 許庭瑋. "Multi-criteria Allocation Decision for Emergent Patients by Affinity Set." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/13828353267856854232.
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碩士大葉大學
工業工程與科技管理學系
99
Emergency medical and transferring is an important issue nowadays, it’s also the most important preprocess before patients arriving hospitals. A paramedic can find out patients' symptom by triage, then contact nearby hospitals to transferring. As the triage process is too complicated, although the studies about triage process are numerous, but it’s seldom using in information system developing. This study is trying to match demand side (patients) and supply side (hospitals) to make a decision about transferring patients. The patients attribute are: rank of patients, and urgency of patients. The hospitals attribute are: number of doctors on call, special life supports, number of available beds, rank of hospital, distance to hospital, and number of specialty doctor. These are measured by quantitative methods. The model objective is to match demand side and supply side, and find out the most suitable hospital. The traditional multi-criteria decision-making model can’t evaluate the sequence of multi-attribute. The last, we use a network model based on affinity set to represent the decision process of allocating patients.
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Santos, Verónica Sofia Alves. "Integração vertical de cuidados : o impacto nos custos do internamento hospitalar." Master's thesis, 2015. http://hdl.handle.net/10362/16308.
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RESUMO - Introdução: A integração vertical de cuidados surge em Portugal em 1999 com a criação da primeira Unidade Local de Saúde (ULS) em Matosinhos. Este modelo de gestão tem como principal objetivo reorganizar o sistema para responder de forma mais custo-efetiva às necessidades atuais.
Objetivo: Analisar o impacto da criação das ULS nos custos do internamento hospitalar português.
Metodologia: Para apurar o custo médio estimado por episódio de internamento hospitalar utilizou-se a metodologia dos Custos Estimados com base na Contabilidade Analítica. Contudo, não foram imputados custos por diária de internamento por centro de produção, mas apenas por doente saído em determinado hospital. Para efeitos de comparação dos modelos de gestão organizacionais consideraram-se variáveis demográficas e variáveis de produção.
Resultados: Da análise global, os hospitais integrados em ULS apresentam um custo médio estimado por episódio de internamento inferior quando comparados com os restantes. Em 2004 os hospitais sem modelo de integração vertical de cuidados apresentam uma diferença de custos de aproximadamente 714,00€. No ano 2009, último ano em análise, esta diferença é mais ténue situando-se nos 232,00€ quando comparados com hospitais integrados em ULS.
Discussão e Conclusão: Não existe uma tendência definida no que respeita à diferença de custos quando se comparam os diferentes modelos organizacionais. É importante que em estudos futuros se alargue a amostra ao total de prestadores e se aprofundem os fatores que influênciam os custos de internamento. A compreensão dos indicadores sociodemográficos, demora média, e produção realizada, numa ótica de custo efetividade e qualidade, permitirá resultados com menor grau de viés.Abstract Introduction: The vertical integration of care appeared in Portugal in 1999 with the creation of the first Unidade Local de Saúde (ULS) in Matosinhos. This management model has as main objective to reorganize the system to respond more cost-effective way to current needs. Objective: To analyze the impact of the creation of the ULS in Portuguese hospital costs. Methodology: To determine the average estimated cost per hospital inpatient episode used the methodology of Estimated Costs based on Cost Accounting. However, they were not charged for daily costs of hospitalization for production center, but only for sick out at one hospital. For comparison of organizational management models were considered demographic variables and output variables. Results: In the overall analysis, integrated hospitals on ULS have an average estimated cost per episode of lower admission when compared with the other. In 2004 hospitals without vertical integration of care model have a difference in costs of approximately 714,00€. In 2009, the last year under review, this difference is more tenuous being located in the 232,00€ when compared to integrated hospitals on ULS. Discussion and conclusion: There is no trend set in respect of the cost difference when comparing different organizational models. It is important that in future studies the sample combined to the total providers and understand the factors that influence the relocation costs. Understanding the socio-demographic indicators, average delays and production carried out in a perspective of cost effectiveness and quality will allow results with lesser degrees of bias.
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Chan, Caroline. "Allocating resources by modeling cardiac patient flow using a system dynamics approach." 2005. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=370369&T=F.
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Banjar, Haneen Reda. "Personalized Medicine Support System for Chronic Myeloid Leukemia Patients." Thesis, 2018. http://hdl.handle.net/2440/117837.
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Personalized medicine offers the most effective treatment protocols to the individual Chronic Myeloid Leukemia (CML) patients. Understanding the molecular biology that causes CML assists in providing efficient treatment. After the identification of an activated tyrosine kinase BCR-ABL1 as the causative lesion in CML, the first-generation Tyrosine Kinase inhibitors (TKI) imatinib (Glivec®), were developed to inhibit BCR-ABL1 activity and approved as a treatment for CML. Despite the remarkable increase in the survival rate of CML patients treated with imatinib, some patients discontinued imatinib therapy due to intolerance, resistance or progression. These patients may benefit from the use of secondgeneration TKIs, such as nilotinib (Tasigna®) and dasatinib (Sprycel®). All three of these TKIs are currently approved for use as frontline treatments. Prognostic scores and molecularbased predictive assays are used to personalize the care of CML patients by allocating risk groups and predicting responses to therapy. Although prognostic scores remain in use today, they are often inadequate for three main reasons. Firstly, since each prognostic score may generate conflicting prognoses for the risk index and it can be difficult to know how to treat patients with conflicting prognoses. Secondly, since prognostic score systems are developed over time, patients can benefit from newly developed systems and information. Finally, the earlier scores use mostly clinically oriented factors instead of those directly related to genetic or molecular indicators. As the current CML treatment guidelines recommend the use of TKI therapy, a new tool that combines the well-known, molecular-based predictive assays to predict molecular response to TKI has not been considered in previous research. Therefore, the main goal of this research is to improve the ability to manage CML disease in individual CML patients and support CML physicians in TKI therapy treatment selection by correctly allocating patients to risk groups and predicting their molecular response to the selected treatment. To achieve this objective, the research detailed here focuses on developing a prognostic model and a predictive model for use as a personalized medicine support system. The system will be considered a knowledge-based clinical decision support system that includes two models embedded in a decision tree. The main idea is to classify patients into risk groups using the prognostic model, while the patients identified as part of the high-risk group should be considered for more aggressive imatinib therapy or switched to secondgeneration TKI with close monitoring. For patients assigned to the low-risk group to imatinib should be predicted using the predictive model. The outcomes should be evaluated by comparing the results of these models with the actual responses to imatinib in patients from a previous medical trial and from patients admitted to hospitals. Validating such a predictive system could greatly assist clinicians in clinical decision-making geared toward individualized medicine. Our findings suggest that the system provides treatment recommendations that could help improve overall healthcare for CML patients. Study limitations included the impact of diversity on human expertise, changing predictive factors, population and prediction endpoints, the impact of time and patient personal issues. Further intensive research activities based on the development of a new predictive model and the method for selecting predictive factors and validation can be expanded to other health organizations and the development of models to predict responses to other TKIs.Thesis (Ph.D.) -- University of Adelaide, School of Computer Science, 2018
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Laliberté, Maude. "Exploration et analyse éthique des facteurs influençant la priorisation des patients, ainsi que la fréquence et la durée des traitements en physiothérapie musculosquelettique." Thèse, 2017. http://hdl.handle.net/1866/20256.
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Baller, Mary S. "Severity of illness among police-escorted psychiatric emergency room patients before and after the implementation of a regional, public-sector managed behavioral health care program." 2005. http://edissertations.library.swmed.edu/pdf/BallerM121905/BallerMary.pdf.
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Janvier, Annie. "The moral difference between premature infants and neonates compared to older patients." Thèse, 2007. http://hdl.handle.net/1866/6503.
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