A válság hatása a termelési tevékenységre (The impact of crisis on operations strategy and practices)

A tanulmány fő célja a gazdasági világválság termelésre gyakorolt hatásainak bemutatása volt a versenyképesség-kutatás adatainak elemzésével. Mivel a vállalatokra a válság különbözőképpen hat, ezért érintettségük alapján a szerzők három csoportba sorolták őket. Az irodalom felhasználásával megfogalmazták a termelési stratégiára és a termelés működési következményeire vonatkozó hipotéziseiket. Eredményeik alapján a válsággal leginkább érintett vállalatok rendelkeznek a legstabilabb termelési stratégiával és gyakorlattal. Ugyanakkor a válság következtében az ár és a szolgáltatások stratégiai szerepe minden vállalatnál erősödött, az innovációé viszont visszaesett. A válság egyik vállalatcsoportnál sem eredményezte a megmaradó munkaerő fejlesztésének ugrásszerű növekedését. A folyamatfejlesztés erősödése, illetve a globális irányba mozdulás csak a legkevésbé érintett csoportnál volt jellemző. ___________________ The objective of this article is to describe the impact of the world economic crisis on operations using the data of the competitiveness survey. Since the crisis affects companies differently, the authors classified them into three groups: the most affected, the moderately affected and the least affected group, accordingly. Relying on the literature they formed hypotheses about the impact of crisis on operations strategy and its everyday operational consequences. Based on the authors’ results the most affected companies have the most stable operations strategy and practices. Nevertheless, due to the crisis the importance of prices and services increased, while the importance of innovation decreased in each group. At the level of everyday practice the crisis has not led to extraordinary increase in work force development. Process improvement and turning to globalization became stronger only in the least affected group.

A válság hatása a termelési tevékenységre – több nézőpontú közelítés = The impact of crisis on operations strategy and practices

Műhelytanulmányunk fő célja a gazdasági világválság termelésre gyakorolt hatásainak bemutatása a versenyképesség kutatás adatainak elemzésével. Mivel a vállalatokra a válság különbözőképpen hat, ezért érintettségük alapján három csoportba soroltuk őket. Az irodalom felhasználásával megfogalmaztuk a termelési stratégiára és a termelés működési következményeire vonatkozó hipotéziseinket. Eredményeink alapján a válsággal leginkább érintett vállalatok rendelkeznek a legstabilabb termelési stratégiával és gyakorlattal. Ugyanakkor a válság következtében az ár és a szolgáltatások stratégiai szerepe minden vállalatnál erősödött, az innovációé viszont visszaesett. A gyakorlatok szintjén a válság egyik vállalatcsoportnál sem eredményezte a megmaradó munkaerő fejlesztésének ugrásszerű növekedését. A folyamatfejlesztés erősödése, illetve a globális irányba mozdulás csak a legkevésbé érintett csoportnál volt jellemző. Eredményeink alapján a válság általi érintettség és a termelési stratégia, illetve gyakorlat területén bekövetkezett hangsúlyeltolódások között nem nagyon van összefüggés. ________ The objective of this study is to describe the impact of the world economic crisis on operations using the data of the competitiveness survey. Since the crisis affects companies differently, we classified them into three groups: the most affected, the moderately affected and the least affected group, accordingly. Relying on the literature we formed hypotheses about the impact of crisis on operations strategy and its everyday operational consequences. Based on our results the most affected companies have the most stable operations strategy and practices. Nevertheless, due to the crisis the importance of prices and services increased, while the importance of innovation decreased in each group. At the level of everyday practice the crisis has not led to extraordinary increase in work force development. Process improvement and turning to globalization became stronger only in the least affected group. According to our results, there is no direct link between the perceived impact of crisis and the changes in operations strategies and practices.

Facets of operational performance in an emergency room (ER)

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's operational performance in general and the trade-offs in flow times, inventory levels (that is the number of patients waiting in the system), and resource utilization; (3) the impacts of potential process and staffing changes to improve the ER's performance. Specifically, the paper discusses four proposals for streamlining the patient flow: establishing designated tracks (fast track, diagnostic track), creating a holding area for certain type of patients, introducing a protocol that would reduce the load on physicians by allowing a registered nurse to order testing and treatment for some patients, and potentially and in the longer term, moving from non-ER specialist physicians to ER specialists. The paper's findings are based on analyzing the paths and flow times of close to two thousand patients in the emergency room of the Medical Center of Leeuwarden (MCL), The Netherlands. Using exploratory data analysis the paper presents generalizable findings about the impacts of various factors on ER's lead-time performance and shows how the proposals fit with well-documented process improvement theories. © 2010 Elsevier B.V. All rights reserved.

A lean elvek alkalmazása az egészségügyi folyamatok fejlesztésében = Applying lean principles in healthcare process development

A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.

Cost-benefit analysis of climate change – A methodological overview of recent studies

Global warming16 has already begun. Climate change has become a self-propelling and self-reinforcing process as a result of the externality associated with greenhouse- gas (GHG) emissions. Although it is an externality related to humankind, according to a number of unique features we should distinguish it from other externalities. Climate change is a global phenomenon in its causes and consequences. The long-term and persistent impacts of climate change will likely continue over centuries without further anthropogenic mechanism. The preindustrial (equilibrium) level of GHG concentration in the atmosphere cannot be restored since it is irreversible, but if we do not stabilise the actual level of atmospheric concentration, the situation will become much worse than it is now. Assessing the impacts of climate change requires careful considerations because of the pervasive uncertainties and risks associated with it.

Systematic review and analysis of evidences on clinical efficacy and cost-effectiveness of biological drugs for the treatment of Ankylosing Spondylitis

Technology: Infliximab and comparator biological such as adalimumab, etanercept, golimumab. Conditions: Ankylosing spondylitis (AS) Issue: Infliximab is registered to be used in patients with AS. The aim of the Report is to evaluate the clinical efficacy and safety of infliximab and comparator biologicals for the treatment of adult AS. Methods: Systematic literature review and analysis as well as meta-analysis (direct and indirect comparison) of published randomised controlled clinical trials (RCT) were performed, all relevant health economics literature were identified ad analysed. Results: Clinical efficacy of biological therapies is based on good clinical evidences regarding to all clinical efficacy endpoints (ASAS20, ASAS40, ASAS 5/6, and BASDAI 50% response). Altogether, 22 trials are included in our meta-analysis, 12 infliximab, 3 adalimumab studies, 6 etanercept and 1 golimumab. Efficacy of biological treatments for the treatment of AS has been established by clinical scientific evidences, significant improvement at all outcomes considered was confirmed. According to the results of indirect comparison, there were no significant difference between biological treatments and placebo in terms of safety and tolerability endpoints. We found no significant difference between the clinical efficacy and safety of infliximab, adalimumab, etanercept and golimumab therapies. Cost-utility analysis of adalimumab and/or infliximab, etanercept and golimumab treatment for AS were performed in the UK, Canada, The Netherlands, Germany, Spain and France. There are no cost-utility studies from Eastern Central Europe. Implications for decision making: Efficacy of infliximab and comparator biologicals for the treatment of Ankylosing Spondylitis (AS) was proved by clinical evidence, significant improvement at all outcomes considered was confirmed. We found no significant differences in efficacy and safety of different biological treatments. Health economics results suggest that biological therapies are cost-effective alternatives for the treatment of AS in group of developed high income countries. There is a lack of health economics results in Central-Eastern European countries however these data are more and more required by governments and funders as part of the company economic dossiers.

Cost of illness in benign prostatic hyperplasia: A review

The paper provides a systematic review on the cost-of-illness studies in an age-associated condition with high prevalence, benign prostatic hyperplasia (BPH), published in Medline between 2005 and 2015. Overall 11 studies were included, which were conducted in 8 countries. In the US, the annual direct medical costs per patient ranged from $255 to $5,729, while in Europe from €253 to €1,251. In 2008, in the UK total annual direct medical costs of BPH were £180.8 million at national level. In the US, overall costs of BPH management in the private sector were estimated at $3.9 billion annually, of which $500 million was attributable to productivity loss (year 1999). Due to demographic factors and possible surgical innovations in the field of urology, the costs of BPH are likely to increase in the future. Over the next decade the age of retirement is projected to rise, consequently, the indirect costs related to aging-associated conditions such as BPH are expected to soar. To promote the transparent and cost-effective management of BPH, development of rational clinical guidelines would be essential that may lead to significant improvement in quality of care as well as reduction in healthcare expenditure.