Dynamic network data envelopment analysis for university hospitals evaluation

ABSTRACT OBJECTIVE To develop an assessment tool to evaluate the efficiency of federal university general hospitals. METHODS Data envelopment analysis, a linear programming technique, creates a best practice frontier by comparing observed production given the amount of resources used. The model is output-oriented and considers variable returns to scale. Network data envelopment analysis considers link variables belonging to more than one dimension (in the model, medical residents, adjusted admissions, and research projects). Dynamic network data envelopment analysis uses carry-over variables (in the model, financing budget) to analyze frontier shift in subsequent years. Data were gathered from the information system of the Brazilian Ministry of Education (MEC), 2010-2013. RESULTS The mean scores for health care, teaching and research over the period were 58.0%, 86.0%, and 61.0%, respectively. In 2012, the best performance year, for all units to reach the frontier it would be necessary to have a mean increase of 65.0% in outpatient visits; 34.0% in admissions; 12.0% in undergraduate students; 13.0% in multi-professional residents; 48.0% in graduate students; 7.0% in research projects; besides a decrease of 9.0% in medical residents. In the same year, an increase of 0.9% in financing budget would be necessary to improve the care output frontier. In the dynamic evaluation, there was progress in teaching efficiency, oscillation in medical care and no variation in research. CONCLUSIONS The proposed model generates public health planning and programming parameters by estimating efficiency scores and making projections to reach the best practice frontier.

EVALUATING THE EFFICIENCY PROGRESS WITH TECHNOLOGY IN A SPANISH HOTEL CHAIN

ABSTRACTThis paper analyzes the changes in the total factor productivity index of a Spanish hotel chain in the period from 2007 to 2010 with the purpose of identifying efficiency patterns for the chain in a period of financial crisis. The data envelopment analysis (DEA) Malmquist productivity index was used to estimate productivity change in 38 hotels of the AC chain. Results reveal AC hotels' efficiency trends and, therefore, their competitiveness in the recession period; they also show the changes experienced in these hotels' total productivity and its components: technological and efficiency changes. Positive efficiency changes were due to positive technical efficiency rather than technological efficiency. The recession period certainly influenced the performance of AC Hotels, which focused on organizational changes rather than investing in technology.

Avalia����o de desempenho e integra����o docente-assistencial nos hospitais universit��rios

OBJETIVO: Avaliar o desempenho e a integra����o entre as dimens��es de assist��ncia e de ensino dos hospitais universit��rios brasileiros. M��TODOS: Um modelo de data envelopment analysis em redes (network DEA) foi elaborado para aferir o desempenho de hospitais universit��rios federais, o qual permite considerar a rela����o entre as dimens��es de ensino e de assist��ncia, simultaneamente. Foram utilizados os dados do Sistema de Informa����o dos Hospitais Universit��rios do Minist��rio da Educa����o, referentes ao segundo semestre de 2003, e os resultados do modelo network foram comparados ��queles dos modelos DEA tradicionais para avalia����o das vantagens da nova proposta metodol��gica. RESULTADOS: A efici��ncia dos hospitais avaliados variou entre 0,19 e 1,00 (m��dia = 0,54). O escore dimensional mostrou que os hospitais priorizam o ganho de efici��ncia assistencial. Observou-se que h�� necessidade de dobrar o n��mero de alunos de medicina e de aumentar os residentes em 14% para que se tornem eficientes na dimens��o de ensino. CONCLUS��ES: O modelo mostrou utilidade de aplica����o tanto para os gestores das unidades, visando �� integra����o docente-assistencial, como para os ��rg��os reguladores, na defini����o de pol��ticas e incentivos.

Desempenho dos munic��pios paulistas: uma avalia����o de efici��ncia da aten����o b��sica �� sa��de

Neste trabalho, teve-se por objetivo construir uma metodologia de avalia����o de desempenho dos munic��pios paulistas quanto �� efici��ncia t��cnica na aplica����o de recursos p��blicos nas a����es de aten����o b��sica �� sa��de e analisar a influ��ncia de vari��veis n��o control��veis no processo de produ����o em tal ��rea. A efici��ncia t��cnica �� um dos par��metros de avalia����o de desempenho dos gestores p��blicos, refletindo a capacidade de uma entidade obter m��ximos outputs com o menor consumo de inputs. O alcance de tal m��trica pode ser prejudicado ou favorecido pelas vari��veis ambientais ou n��o control��veis que, se n��o forem consideradas na avalia����o de desempenho, podem gerar vieses. Nesse sentido, por meio da metodologia Data Envelopment Analysis (DEA) em dois est��gios, os escores de efici��ncia dos munic��pios foram estimados e depois ajustados com o uso da an��lise de regress��o. Os resultados indicaram que seria poss��vel aumentar, consideravelmente, a quantidade de servi��os prestados �� popula����o sem a necessidade de novas dota����es or��ament��rias na maioria dos munic��pios. Al��m disso, verificou-se que a maior propor����o de idosos em uma jurisdi����o torna a presta����o de servi��os mais cara; por sua vez, maiores densidade populacional, grau de urbaniza����o e escala dos estabelecimentos de sa��de favorecem o gasto p��blico com efici��ncia. Os cinco munic��pios paulistas considerados mais eficientes foram Tuiuti, Nova Guataporanga, Sabino, Lins e Santos.

Impacto de las inversiones en TI en la eficiencia de los bancos argentinos

Las tecnolog��as de informaci��n (TI) constituyen en la actualidad una herramienta fundamental para el logro de ventajas competitivas en un contexto sumamente cambiante. Resulta relevante conocer el impacto de su utilizaci��n sobre el desempe��o de las organizaciones, en particular en sectores como el bancario, que realizan un uso intensivo de informaci��n. En el presente trabajo se desarrolla un modelo que posibilita evaluar el impacto de las inversiones en TI sobre la eficiencia de las entidades bancarias. Se utiliz�� la t��cnica Data Envelopment Analysis (DEA) como herramienta de medici��n de la eficiencia de acuerdo al modelo elaborado sobre la informaci��n obtenida de los estados contables de entidades bancarias de la Rep��blica Argentina. Los resultados obtenidos demostraron que los bancos alcanzaron un buen nivel de eficiencia global. Se encontr�� que los m��s eficientes son las sucursales de entidades financieras del exterior y los bancos locales de capital extranjero.

Sensitivity analysis for unmeasured confounders using an electronic spreadsheet

In studies assessing the effects of a given exposure variable and a specific outcome of interest, confusion may arise from the mistaken impression that the exposure variable is producing the outcome of interest, when in fact the observed effect is due to an existing confounder. However, quantitative techniques are rarely used to determine the potential influence of unmeasured confounders. Sensitivity analysis is a statistical technique that allows to quantitatively measuring the impact of an unmeasured confounding variable on the association of interest that is being assessed. The purpose of this study was to make it feasible to apply two sensitivity analysis methods available in the literature, developed by Rosenbaum and Greenland, using an electronic spreadsheet. Thus, it can be easier for researchers to include this quantitative tool in the set of procedures that have been commonly used in the stage of result validation.

Oligochaeta (Annelida, Clitellata) in lotic environments in the state of S��o Paulo, Brazil

Despite the importance of Oligochaeta to the dynamics of aquatic ecosystems and to studies of the biology of pollution, there is currently a dearth of information on this group's ecology in Brazil. The aim of this study was to describe the Oligochaeta fauna in four watercourses - three urban and one rural - in the state of S��o Paulo: the Pinheirinho stream, the ��gua Branca stream, the Monjolinho River and the Gouveia stream, respectively. Sediment samples were taken with a Van Veen grab in two areas from each watercourse, during the summer and winter of 2001. In all collection areas, measurements of the pH, electrical conductivity, dissolved oxygen and turbidity of the water were made with a Horiba U-10 device. Principal component analysis showed that axes 1 and 2 explained 68.18% of the results' variability, with the first axis predominantly associated with the granulometric data and the second one with the limnological data. Cluster analysis indicated that area II of the Monjolinho River differed from the other collection sites. In the present study, the Oligochaeta group was represented by Tubificidae, Naididae, Alluroididae, Narapidae and Enchytraeidae. Among the three species of Tubificidae, Limnodrilus hoffmeisteri Claparede, 1862, was the most abundant and most frequent species. The results provided important information on the ecology and distribution of limnic Oligochaeta.

Indicadores bibliom��tricos e econom��tricos para a avalia����o de institui����es cient��ficas

O artigo �� dividido em duas partes. A primeira descreve a avalia����o de uma pequena universidade, baseada em dados cienciom��tricos tendo por principal objetivo avaliar a pesquisa com visibilidade internacional. A segunda parte mostra como um m��todo econom��trico (DEA: data enveloping analysis) pode ser usado para incluir na avalia����o o ensino e o levantamento de recursos, entre outros aspectos. As duas abordagens mostram como um corpo te��rico combinando bibliometria, cienciometria e econometria pode ser aplicado a problemas concretos.

Separa����o de espectros simulados e de luminesc��ncia total atrav��s do m��todo generalizado de anula����o do posto (GRAM)

A multivariate curve resolution method, "GENERALIZED RANK ANNIHILATION METHOD (GRAM)", is discussed and tested with simulated and experimental data. The analysis of simulated data provides general guidelines concerning the condition for uniqueness of a solution for a given problem. The second-order emission-excitation spectra of human and animal dental calculus deposits were used as an experimental data to estimate the performance of the above method. Three porphyrinic spectral profiles, for both human and cat, were obtained by the use of GRAM.

Propriedades estruturais e microestruturais de manganitas dopadas com cobre

We report a structural study on polycrystalline La0.86Sr0.14Mn1-y Cu yO3+delta samples (y = 0, 0.05, 0.10, 0.15, 0.20) using refinement of powder X-ray diffraction data and analysis of scanning electron microscopy images. It is found that the structure remains rhombohedral through the whole series, with a decrease in the average Mn-Mn bond distances, slight variations in Mn-O-Mn angle and reduction in the unit cell volume with increasing Cu amounts. The values of Mn-Mn distances suggest compact structures with d within ±1%. Scanning electron microscopy images reveal homogeneous microstructure in all samples, besides a trend for smaller grains and larger porosity with increasing Cu content.

Flavonoides de Lonchocarpus araripensis (Leguminoseae) - isolamento, atribui����o inequ��voca dos sinais de RMN ��H e 13C e an��lise conformacional

In a continuing investigation for potentially bioactive natural products, flavonoids were isolated from Lonchocarpus araripensis (Leguminoseae) and identified as 3-methoxy-6-O-prenyl-6'',6''-dimethylchromene-[7,8,2'',3'']-flavone (1), 3,6-dimethoxy-6'',6''-dimethylchromene-[7,8,2'',3'']-flavone (2) and 3,5,8-trimethoxy-[6,7,2",3"]-furanoflavone (3). This is the first time compound 3 has been described. Compound 2 has been previously isolated from roots while this is the first time 1 is reported in this species. Complete NMR assignments are given for1 ,2 and 3 together with the determination of conformation for 1.

Spatial analysis of urban violence based on emergency room data

OBJECTIVE: To estimate the spatial intensity of urban violence events using wavelet-based methods and emergency room data. METHODS: Information on victims attended at the emergency room of a public hospital in the city of S��o Paulo, Southeastern Brazil, from January 1, 2002 to January 11, 2003 were obtained from hospital records. The spatial distribution of 3,540 events was recorded and a uniform random procedure was used to allocate records with incomplete addresses. Point processes and wavelet analysis technique were used to estimate the spatial intensity, defined as the expected number of events by unit area. RESULTS: Of all georeferenced points, 59% were accidents and 40% were assaults. There is a non-homogeneous spatial distribution of the events with high concentration in two districts and three large avenues in the southern area of the city of S��o Paulo. CONCLUSIONS: Hospital records combined with methodological tools to estimate intensity of events are useful to study urban violence. The wavelet analysis is useful in the computation of the expected number of events and their respective confidence bands for any sub-region and, consequently, in the specification of risk estimates that could be used in decision-making processes for public policies.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

AbstractINTRODUCTION:We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informa����o de Agravos de Notifica����o (SINAN)] database.METHODS:A descriptive and retrospective epidemiological study was conducted from 2007 to 2013.RESULTS:A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases).CONCLUSIONS:Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Analysis and estimative of schistosomiasis prevalence for the state of Minas Gerais, Brazil, using multiple regression with social and environmental spatial data

The aim of this work is to establish a relationship between schistosomiasis prevalence and social-environmental variables, in the state of Minas Gerais, Brazil, through multiple linear regression. The final regression model was established, after a variables selection phase, with a set of spatial variables which contains the summer minimum temperature, human development index, and vegetation type variables. Based on this model, a schistosomiasis risk map was built for Minas Gerais.