La qualità erogata da un'azienda di trasporto collettivo in ambito urbano: calcolo del livello di servizio delle principali linee di ATC (BO)

Oggetto di questa tesi è lo studio della qualità del servizio di trasporto erogato che condiziona la qualità percepita dall’utente, poiché spesso proprio a causa di un errato processo di pianificazione e gestione della rete, molte aziende non sono in grado di consolidare un alto livello di efficienza che permetta loro di attrarre e servire la crescente domanda. Per questo motivo, si è deciso di indagare sugli aspetti che determinano la qualità erogata e sui fattori che la influenzano, anche attraverso la definizione di alcuni indicatori rappresentativi del servizio erogato. L’area di studio considerata è stata quella urbana di Bologna, e sono state prese in esame due linee di ATC, la 19 e la 27, caratterizzate entrambe da una domanda di trasporto molto elevata. L’interesse è ricaduto in modo particolare sugli aspetti legati alla regolarità del servizio, ovvero al rispetto della cadenza programmata delle corse e alla puntualità, ossia il rispetto dell’orario programmato delle stesse. Proprio da questi due aspetti, infatti, dipende in larga misura la percezione della qualità che gli utenti hanno del servizio di trasporto collettivo. Lo studio è stato condotto sulla base di dati raccolti attraverso due campagne di rilevamento, una effettuata nel mese di maggio dell’anno 2008 e l’altra nel mese di settembre dello stesso anno. La scelta del periodo, della zona e delle modalità di rilevamento è strettamente connessa all’obiettivo prefissato. Il servizio è influenzato dalle caratteristiche del sistema di trasporto: sia da quelle legate alla domanda che da quelle legate all’offerta. Nel caso della domanda di trasporto si considera l’influenza sul servizio del numero di passeggeri saliti e del tempo di sosta alle fermate. Nel caso dell’offerta di trasporto si osservano soprattutto gli aspetti legati alla rete di trasporto su cui si muovono gli autobus, analizzando quindi i tempi di movimento e le velocità dei mezzi, per vedere come le caratteristiche dell’infrastruttura possano condizionare il servizio. A tale proposito è opportuno dire che, mentre i dati della prima analisi ci sono utili per lo studio dell’influenza del tempo di sosta sull’intertempo, nella seconda analisi si vuole cercare di effettuare ulteriori osservazioni sull’influenza del tempo di movimento sulla cadenza, prendendo in esame altri elementi, come ad esempio tratti di linea differenti rispetto al caso precedente. Un’attenzione particolare, inoltre, verrà riservata alla verifica del rispetto della cadenza, dalla quale scaturisce la definizione del livello di servizio per ciò che riguarda la regolarità. Per quest’ultima verrà, inoltre, determinato anche il LOS relativo alla puntualità. Collegato al problema del rispetto della cadenza è il fenomeno dell’accodamento: questo si verifica quando i mezzi di una stessa linea arrivano contemporaneamente ad una fermata uno dietro l’altro. L’accodamento ha, infatti, origine dal mancato rispetto della cadenza programmata tra i mezzi ed è un’evidente manifestazione del mal funzionamento di un servizio di trasporto. Verrà infine condotta un’analisi dei fattori che possono influenzare le prestazioni del servizio di trasporto pubblico, così da collocare i dati ottenuti dalle operazioni di rilevamento in un quadro più preciso, capace di sottolineare alcuni elementi di criticità e possibili rapporti di causalità.

Equity in access to outpatient rehabilitation services for children with traumatic brain injury and public insurance

Thesis (Master's)--University of Washington, 2016-06

Better queue management in a busy public hospital of a developing country without appointment system::an application using data envelopment analysis

Queuing is a key efficiency criterion in any service industry, including Healthcare. Almost all queue management studies are dedicated to improving an existing Appointment System. In developing countries such as Pakistan, there are no Appointment Systems for outpatients, resulting in excessive wait times. Additionally, excessive overloading, limited resources and cumbersome procedures lead to over-whelming queues. Despite numerous Healthcare applications, Data Envelopment Analysis (DEA) has not been applied for queue assessment. The current study aims to extend DEA modelling and demonstrate its usefulness by evaluating the queue system of a busy public hospital in a developing country, Pakistan, where all outpatients are walk-in; along with construction of a dynamic framework dedicated towards the implementation of the model. The inadequate allocation of doctors/personnel was observed as the most critical issue for long queues. Hence, the Queuing-DEA model has been developed such that it determines the ‘required’ number of doctors/personnel. The results indicated that given extensive wait times or length of queue, or both, led to high target values for doctors/personnel. Hence, this crucial information allows the administrators to ensure optimal staff utilization and controlling the queue pre-emptively, minimizing wait times. The dynamic framework constructed, specifically targets practical implementation of the Queuing-DEA model in resource-poor public hospitals of developing countries such as Pakistan; to continuously monitor rapidly changing queue situation and display latest required personnel. Consequently, the wait times of subsequent patients can be minimized, along with dynamic staff scheduling in the absence of appointments. This dynamic framework has been designed in Excel, requiring minimal training and work for users and automatic update features, with complex technical aspects running in the background. The proposed model and the dynamic framework has the potential to be applied in similar public hospitals, even in other developing countries, where appointment systems for outpatients are non-existent.

The patient-provider relationship and antenatal care uptake at two referral hospitals in Malawi: A qualitative study

Background In post-stroke patients, impairment of quality of life (QOL) has been associated with functional impairment, age, anxiety, depression, and fatigue. Good social support, higher education, and better socioeconomic status are associated with better QOL among stroke survivors. In Africa, studies from Nigeria and Tanzania have reported on post-stroke QOL. Background Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization’s recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake. Methods A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites. Results Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed that, due to staff shortages, patients often do not receive the care they deserve. Conclusions The results of this study suggest that, in addition to other factors, healthcare provider attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.

Two-stage no-wait scheduling models with setup and removal times separated

This paper studies two models of two-stage processing with no-wait in process. The first model is the two-machine flow shop, and the other is the assembly model. For both models we consider the problem of minimizing the makespan, provided that the setup and removal times are separated from the processing times. Each of these scheduling problems is reduced to the Traveling Salesman Problem (TSP). We show that, in general, the assembly problem is NP-hard in the strong sense. On the other hand, the two-machine flow shop problem reduces to the Gilmore-Gomory TSP, and is solvable in polynomial time. The same holds for the assembly problem under some reasonable assumptions. Using these and existing results, we provide a complete complexity classification of the relevant two-stage no-wait scheduling models.

A new evolutionary clustering search for a no-wait flow shop problem with set-up times

This paper addresses the m-machine no-wait flow shop problem where the set-up time of a job is separated from its processing time. The performance measure considered is the total flowtime. A new hybrid metaheuristic Genetic Algorithm-Cluster Search is proposed to solve the scheduling problem. The performance of the proposed method is evaluated and the results are compared with the best method reported in the literature. Experimental tests show superiority of the new method for the test problems set, regarding the solution quality. (c) 2012 Elsevier Ltd. All rights reserved.

Stochastic scheduling - A flow shop no wait application and solutions

Minimizing the makespan of a flow-shop no-wait (FSNW) schedule where the processing times are randomly distributed is an important NP-Complete Combinatorial Optimization Problem. In spite of this, it can be found only in very few papers in the literature. By considering the Start Interval Concept, this problem can be formulated, in a practical way, in function of the probability of the success in preserve FSNW constraints for all tasks execution. With this formulation, for the particular case with 3 machines, this paper presents different heuristics solutions: by integrating local optimization steps with insertion procedures and by using genetic algorithms for search the solution space. Computational results and performance evaluations are commented. Copyright (C) 1998 IFAC.

Waiting times for cataract surgery in ten European countries: an analysis using data from the SHARE survey

AIMS: To assess waiting times for cataract surgery and their acceptance in European countries, and to find explanatory, country-specific health indicators. METHODS: Using data from the survey of health, ageing and retirement in Europe (SHARE), waiting times for cataract surgery of 245 respondents in ten countries were analysed with the help of linear regression. The influence of four country specific health indicators on waiting times was studied by multiple linear regression. The influence of waiting time and country on the wish to have surgery performed earlier was determined through logistic regression. Additional information was obtained for each country from opinion leaders in the field of cataract surgery. RESULTS: Waiting times differed significantly (p<0.001) between the ten analysed European countries. The length of wait was significantly influenced by the total expenditure on health (p<0.01) but not by the other country specific health indicators. The wish to have surgery performed earlier was determined by the length of wait (p<0.001) but not by the country where surgery was performed. CONCLUSION: The length of wait is influenced by the total expenditure on health, but not by the rate of public expenditure on health, by the physician density or by the acute bed density. The wish to have surgery performed earlier depends on the length of wait for surgery and is not influenced by the country.

They also serve who only stand and wait

Purpose Waiting for service by customers is an important problem for many financial service marketers. Two new approaches are proposed. First, customer evaluation of the service is increased with an ambient scent. Second a cognitive variable is identified which different iates customers by the way they value time so that they can be segmented. Methodology Pretests included focus groups which highlighted financial services and a pilot test were foll owed by a main sample of 607 subjects. Structural equation modelling and multivariate analysis of covariance were used for analysis. Findings A cognitive variable, the need for time management can be used, together with demographic and customer net worth data, to segment a customer base. Two environmental interventions, music and scent, can increase customer satisfaction among customers kept waiting in a line. Research implications Two original approaches to a rapidly growing service marketing problem are identified. Practical implications Service contact points can reduce incidence of "queue rage" and enhance customer satisfaction by either or both of two simple modifications to the service environment or a preventive strategy of offering targeted customers an alternative. Originality A new method of segmentation and a new environmental intervention are proposed .

Good times and philanthropy : giving by Australia's affluent

This report draws upon the latest research to examine giving trends by affluent individuals in Australia and how these compare with overseas counterparts. It is driven by several factors. Giving by individuals matters enormously to the nonprofit sector, far exceeding business donations. Whether the richest of the population gives commensurate with their wealth is a question worth asking.