Impacto de la prestación de servicios de salud bajo el modelo de red en el municipio de Sogamoso

El presente estudio es de tipo analítico, cohorte retrospectiva, tiene como objeto estudiar un modelo de prestación de servicios de salud bajo el concepto de red integrada, conformada por las clínicas privadas de segundo y tercer nivel de complejidad del municipio de Sogamoso (Boyacá). Se analizó el período comprendido entre los años 2012 a 2014, donde se puede evidenciar la implementación y puesta en marcha del modelo. En el mes de agosto del año 2012, la estrategia de asociatividad la adelantaron las tres instituciones de manera libre y autónoma, utilizando como guía la metodología propuesta por la Cepal en el año 2010; las diferencias entre esta metodología y el modelo utilizado se deben a las particularidades de las clínicas y del contexto en el que se desarrolló. Este modelo de atención surgió de la necesidad de prestar los servicios de salud ofertados por las clínicas, acorde con su capacidad instalada, al total de la población de la Nueva EPS en Sogamoso, que en ese momento coyuntural no se estaba cumpliendo en el municipio, y ninguna de las instituciones tenía la infraestructura individual para atender a toda su población. El resultado de la asociación de las tres clínicas se logró gracias a un grado de confianza previo entre los directivos de las instituciones y posterior a varias reuniones, en las que se tomó la determinación de trabajar con el modelo de Unión Temporal, ya que no son una persona jurídica diferente a las que la conforman Se demuestra el impacto de este modelo asociativo de cada una de las organizaciones que la componen evaluando cuatro ámbitos como la capacidad de aprendizaje, capacidad de gestión estratégica, economía de escala y poder de negociación y externalidades. Para la recolección de la información se utilizaron las bases de datos de las instituciones hospitalarias con la información de los indicadores de oportunidad, así como el incremento de la facturación y del recaudo antes y después de la formación de la Unión Temporal; adicionalmente se realizaron encuestas a los directores de las clínicas como fuente de información para desarrollo de nuevos productos, reducción de costos, ampliación de la oferta hospitalaria, establecimientos de alianza, puesta en marcha de servicios comunes y apertura de nuevos mercados. Sumado a lo anterior, se realizó una encuesta adicional a los usuarios del nuevo producto desarrollado. Como resultado de este estudio se encuentra beneficio en todos los ámbitos evaluados para las instituciones que interactúan bajo este modelo y se espera que obtengan los mismos beneficios que los demás actores participantes en él, como las EAPB, los cuales no hacen parte del presente estudio. En Colombia no se observa la existencia de un modelo similar en sistema de salud, a pesar del leve intento de la Ley 1438 del 2011 por iniciar la conformación de redes; por esta razón se puede decir que este estudio marca un derrotero para que las organizaciones de salud tengan un modelo de articulación ante la falta de desarrollos de esquemas de red y por tratarse de un modelo con ausencia de reglamentación.

Bilateral Transport Cost, Infrastructure, Common Bilateral Ties and Political Stability.

Los costos de transporte son una de las más importantes fuentes de barreras al comercio. Inspirados por este aspecto, utilizamos un modelo empírico ad-hoc con el fin de examinar los posibles determinantes de los costos de transporte. Utilizando una base de datos de costos de transporte bilaterales para el año 1990, replicamos el trabajo de Limao y Venables (2001) y encontramos que el efecto de su ´índice de infraestructura sobre los costos de transporte no es robusto. Siguiendo a Micco (2004) y Micco y Serebrinzky (2005) calculamos dos ´índices alternativos de infraestructura. Utilizando estos ´índices encontramos que aparte de la distancia, la infraestructura, la estabilidad política, las relaciones bilaterales comunes y los acuerdos de cielos abiertos son otros importantes canales mediante los cuales los costos de transporte pueden reducirse.

Analysis of house prices to assess economic impacts of new public transport infrastructure: Madrid metro line 12.

Transportation infrastructure is known to affect the value of real estate property by virtue of changes in accessibility. The impact of transportation facilities is highly localized as well, and it is possible that spillover effects result from the capitalization of accessibility. The objective of this study was to review the theoretical background related to spatial hedonic models and the opportunities that they provided to evaluate the effect of new transportation infrastructure. An empirical case study is presented: the Madrid Metro Line 12, known as Metrosur, in the region of Madrid, Spain. The effect of proximity to metro stations on housing prices was evaluated. The analysis took into account a host of variables, including structure, location, and neighborhood and made use of three modeling approaches: linear regression estimation with ordinary least squares, spatial error, and spatial lag. The results indicated that better accessibility to Metrosur stations had a positive impact on real estate values and that the effect was marked in cases in which a house was for sale. The results also showed the presence of submarkets, which were well defined by geographic boundaries, and transport fares, which implied that the economic benefits differed across municipalities.

Dynamic Model-based Management of Service-Oriented Infrastructure.

Models are an effective tool for systems and software design. They allow software architects to abstract from the non-relevant details. Those qualities are also useful for the technical management of networks, systems and software, such as those that compose service oriented architectures. Models can provide a set of well-defined abstractions over the distributed heterogeneous service infrastructure that enable its automated management. We propose to use the managed system as a source of dynamically generated runtime models, and decompose management processes into a composition of model transformations. We have created an autonomic service deployment and configuration architecture that obtains, analyzes, and transforms system models to apply the required actions, while being oblivious to the low-level details. An instrumentation layer automatically builds these models and interprets the planned management actions to the system. We illustrate these concepts with a distributed service update operation.

A repository for integration of software artifacts with dependency resolution and federation support

While developing new IT products, reusability of existing components is a key aspect that can considerably improve the success rate. This fact has become even more important with the rise of the open source paradigm. However, integrating different products and technologies is not always an easy task. Different communities employ different standards and tools, and most times is not clear which dependencies a particular piece of software has. This is exacerbated by the transitive nature of these dependencies, making component integration a complicated affair. To help reducing this complexity we propose a model-based repository, capable of automatically resolve the required dependencies. This repository needs to be expandable, so new constraints can be analyzed, and also have federation support, for the integration with other sources of artifacts. The solution we propose achieves these working with OSGi components and using OSGi itself.

PEPSI: Privacy-Enhanced Participatory Sensing Infrastructure.

Participatory Sensing combines the ubiquity of mobile phones with sensing capabilities of Wireless Sensor Networks. It targets pervasive collection of information, e.g., temperature, traffic conditions, or health-related data. As users produce measurements from their mobile devices, voluntary participation becomes essential. However, a number of privacy concerns -- due to the personal information conveyed by data reports -- hinder large-scale deployment of participatory sensing applications. Prior work on privacy protection, for participatory sensing, has often relayed on unrealistic assumptions and with no provably-secure guarantees. The goal of this project is to introduce PEPSI: a Privacy-Enhanced Participatory Sensing Infrastructure. We explore realistic architectural assumptions and a minimal set of (formal) privacy requirements, aiming at protecting privacy of both data producers and consumers. We design a solution that attains privacy guarantees with provable security at very low additional computational cost and almost no extra communication overhead.

A Model-based Repository for Open Source Service and Component Integration.

Open source is a software development paradigm that has seen a huge rise in recent years. It reduces IT costs and time to market, while increasing security and reliability. However, the difficulty in integrating developments from different communities and stakeholders prevents this model from reaching its full potential. This is mainly due to the challenge of determining and locating the correct dependencies for a given software artifact. To solve this problem we propose the development of an extensible software component repository based upon models. This repository should be capable of solving the dependencies between several components and work with already existing repositories to access the needed artifacts transparently. This repository will also be easily expandable, enabling the creation of modules that support new kinds of dependencies or other existing repository technologies. The proposed solution will work with OSGi components and use OSGi itself.

Infrastructure and Workflow for the Formal Evaluation of Semantic Search Technologies

This paper describes an infrastructure for the automated evaluation of semantic technologies and, in particular, semantic search technologies. For this purpose, we present an evaluation framework which follows a service-oriented approach for evaluating semantic technologies and uses the Business Process Execution Language (BPEL) to define evaluation workflows that can be executed by process engines. This framework supports a variety of evaluations, from different semantic areas, including search, and is extendible to new evaluations. We show how BPEL addresses this diversity as well as how it is used to solve specific challenges such as heterogeneity, error handling and reuse

Infrastructure (Resilience-oriented) Modelling Language: I®ML A proposal for modelling infrastructures and their connections

The modelling of critical infrastructures (CIs) is an important issue that needs to be properly addressed, for several reasons. It is a basic support for making decisions about operation and risk reduction. It might help in understanding high-level states at the system-of-systems layer, which are not ready evident to the organisations that manage the lower level technical systems. Moreover, it is also indispensable for setting a common reference between operator and authorities, for agreeing on the incident scenarios that might affect those infrastructures. So far, critical infrastructures have been modelled ad-hoc, on the basis of knowledge and practice derived from less complex systems. As there is no theoretical framework, most of these efforts proceed without clear guides and goals and using informally defined schemas based mostly on boxes and arrows. Different CIs (electricity grid, telecommunications networks, emergency support, etc) have been modelled using particular schemas that were not directly translatable from one CI to another. If there is a desire to build a science of CIs it is because there are some observable commonalities that different CIs share. Up until now, however, those commonalities were not adequately compiled or categorized, so building models of CIs that are rooted on such commonalities was not possible. This report explores the issue of which elements underlie every CI and how those elements can be used to develop a modelling language that will enable CI modelling and, subsequently, analysis of CI interactions, with a special focus on resilience

Risk sharing with Multilateral Financial Institutions in infrastructure and energy project financing : effect on capital relief for commercial banks

(Matsukawa and Habeck, 2007) analyse the main instruments for risk mitigation in infrastructure financing with Multilateral Financial Institutions (MFIs). Their review coincided with the global financial crisis of 2007-08, and is highly relevant in current times considering the sovereign debt crisis, the lack of available capital and the increases in bank regulation in Western economies. The current macroeconomic environment has seen a slowdown in the level of finance for infrastructure projects, as they pose a higher credit risk given their requirements for long term investments. The rationale for this work is to look for innovative solutions that are focused on the credit risk mitigation of infrastructure and energy projects whilst optimizing the economic capital allocation for commercial banks. This objective is achieved through risk-sharing with MFIs and looking for capital relief in project finance transactions. This research finds out the answer to the main question: "What is the impact of risk-sharing with MFIs on project finance transactions to increase their efficiency and viability?", and is developed from the perspective of a commercial bank assessing the economic capital used and analysing the relevant variables for it: Probability of Default, Loss Given Default and Recovery Rates, (Altman, 2010). An overview of project finance for the infrastructure and energy sectors in terms of the volume of transactions worldwide is outlined, along with a summary of risk-sharing financing with MFIs. A review of the current regulatory framework beneath risk-sharing in structured finance with MFIs is also analysed. From here, the impact of risk-sharing and the diversification effect in infrastructure and energy projects is assessed, from the perspective of economic capital allocation for a commercial bank. CreditMetrics (J. P. Morgan, 1997) is applied over an existing well diversified portfolio of project finance infrastructure and energy investments, working with the main risk capital measures: economic capital, RAROC, and EVA. The conclusions of this research show that economic capital allocation on a portfolio of project finance along with risk-sharing with MFIs have a huge impact on capital relief whilst increasing performance profitability for commercial banks. There is an outstanding diversification effect due to the portfolio, which is combined with risk mitigation and an improvement in recovery rates through Partial Credit Guarantees issued by MFIs. A stress test scenario analysis is applied to the current assumptions and credit risk model, considering a downgrade in the rating for the commercial bank (lender) and an increase of default in emerging countries, presenting a direct impact on economic capital, through an increase in expected loss and a decrease in performance profitability. Getting capital relief through risk-sharing makes it more viable for commercial banks to finance infrastructure and energy projects, with the beneficial effect of a direct impact of these investments on GDP growth and employment. The main contribution of this work is to promote a strategic economic capital allocation in infrastructure and energy financing through innovative risk-sharing with MFIs and economic pricing to create economic value added for banks, and to allow the financing of more infrastructure and energy projects. This work suggests several topics for further research in relation to issues analysed. (Matsukawa and Habeck, 2007) analizan los principales instrumentos de mitigación de riesgos en las Instituciones Financieras Multilaterales (IFMs) para la financiación de infraestructuras. Su presentación coincidió con el inicio de la crisis financiera en Agosto de 2007, y sus consecuencias persisten en la actualidad, destacando la deuda soberana en economías desarrolladas y los problemas capitalización de los bancos. Este entorno macroeconómico ha ralentizado la financiación de proyectos de infraestructuras. El actual trabajo de investigación tiene su motivación en la búsqueda de soluciones para la financiación de proyectos de infraestructuras y de energía, mitigando los riesgos inherentes, con el objeto de reducir el consumo de capital económico en los bancos financiadores. Este objetivo se alcanza compartiendo el riesgo de la financiación con IFMs, a través de estructuras de risk-sharing. La investigación responde la pregunta: "Cuál es el impacto de risk-sharing con IFMs, en la financiación de proyectos para aumentar su eficiencia y viabilidad?". El trabajo se desarrolla desde el enfoque de un banco comercial, estimando el consumo de capital económico en la financiación de proyectos y analizando las principales variables del riesgo de crédito, Probability of Default, Loss Given Default and Recovery Rates, (Altman, 2010). La investigación presenta las cifras globales de Project Finance en los sectores de infraestructuras y de energía, y analiza el marco regulatorio internacional en relación al consumo de capital económico en la financiación de proyectos en los que participan IFMs. A continuación, el trabajo modeliza una cartera real, bien diversificada, de Project Finance de infraestructuras y de energía, aplicando la metodología CreditMet- rics (J. P. Morgan, 1997). Su objeto es estimar el consumo de capital económico y la rentabilidad de la cartera de proyectos a través del RAROC y EVA. La modelización permite estimar el efecto diversificación y la liberación de capital económico consecuencia del risk-sharing. Los resultados muestran el enorme impacto del efecto diversificación de la cartera, así como de las garantías parciales de las IFMs que mitigan riesgos, mejoran el recovery rate de los proyectos y reducen el consumo de capital económico para el banco comercial, mientras aumentan la rentabilidad, RAROC, y crean valor económico, EVA. En escenarios económicos de inestabilidad, empeoramiento del rating de los bancos, aumentos de default en los proyectos y de correlación en las carteras, hay un impacto directo en el capital económico y en la pérdida de rentabilidad. La liberación de capital económico, como se plantea en la presente investigación, permitirá financiar más proyectos de infraestructuras y de energía, lo que repercutirá en un mayor crecimiento económico y creación de empleo. La principal contribución de este trabajo es promover la gestión activa del capital económico en la financiación de infraestructuras y de proyectos energéticos, a través de estructuras innovadoras de risk-sharing con IFMs y de creación de valor económico en los bancos comerciales, lo que mejoraría su eficiencia y capitalización. La aportación metodológica del trabajo se convierte por su originalidad en una contribución, que sugiere y facilita nuevas líneas de investigación académica en las principales variables del riesgo de crédito que afectan al capital económico en la financiación de proyectos.

Transportation infrastructure impacts on firm location: the effect of a new metro line in the suburbs of Madrid

Firm location patterns emerge as a consequence of multiple factors, including firm considerations, labor force availability, market opportunities, and transportation costs. Many of these factors are influenced by changes in accessibility wrought by new transportation infrastructure. In this paper we use spatial statistical techniques and a micro-level data base to evaluate the effects of Madrid?s metro line 12 (known as Metrosur) expansion on business location patterns. The case study is the municipality of Alcorcon, which is served by the new metro line since 2003. Specifically, we explore the location patterns by different industry sectors, to evaluate if the new metro line has encouraged the emergence of a ?Metrosur spatial economy?. Our results indicate that the pattern of economic activity location is related to urban accessibility and that agglomeration, through economies of scale, also plays an important role. The results presented in this paper provide evidence useful to inform efficient transportation, urban, and regional economic planning.

Floating car data augmentation based on infrastructure sensors and neural networks

The development of new-generation intelligent vehicle technologies will lead to a better level of road safety and CO2 emission reductions. However, the weak point of all these systems is their need for comprehensive and reliable data. For traffic data acquisition, two sources are currently available: 1) infrastructure sensors and 2) floating vehicles. The former consists of a set of fixed point detectors installed in the roads, and the latter consists of the use of mobile probe vehicles as mobile sensors. However, both systems still have some deficiencies. The infrastructure sensors retrieve information fromstatic points of the road, which are spaced, in some cases, kilometers apart. This means that the picture of the actual traffic situation is not a real one. This deficiency is corrected by floating cars, which retrieve dynamic information on the traffic situation. Unfortunately, the number of floating data vehicles currently available is too small and insufficient to give a complete picture of the road traffic. In this paper, we present a floating car data (FCD) augmentation system that combines information fromfloating data vehicles and infrastructure sensors, and that, by using neural networks, is capable of incrementing the amount of FCD with virtual information. This system has been implemented and tested on actual roads, and the results show little difference between the data supplied by the floating vehicles and the virtual vehicles.

Quantity of CO2 Emissions in the Life Cycle of a Highway Infrastructure

There is strong evidence to indicate that carbon dioxide and other greenhouse gases are accumulating at unprecedented concentrations in out atmosphere contributing to global climate change. Evidence is equally strong that human activities, mainly the burning of fossil fuels, are driving force in this process (IPCC 2007). While different industries contribute varying amounts to total anthropogenic greenhouse gases, it is incumbent upon each to understand its contribution and search for sensible ways to reduce overall greenhouse gas production. The aim of this paper is the development of a methodology to determine the amount of CO2 emissions of a highway, allowing providing solutions that can improve the energy footprint and reduce its emissions

Infrastructure Finance in Developing Countries by State and Multilateral Development Banks

Infrastructure concession is an alternative widely used by governments to increase investment. In the case of the road sector, the main characteristics of the concessions are: long-term projects, high investments in the early years of the contract and high risks. A viability analysis must be carried out for each concession and consider the characteristics of the project. When the infrastructure is located in a developing country, political and market growth uncertainties should be add in the concession project analysis, as well as economic instability, because they present greater risks. This paper is an analysis of state bank participation in road infrastructure finance in developing countries. For this purpose, we studied road infrastructure financing and its associated risks, and also the features of developing countries. Furthermore, we considered the issue of state banks and multilateral development banks that perform an important role by offering better credit lines than the private banks, in terms of cost, interest and grace period. Based on this study, we analyzed the Brazilian Development Bank - BNDES – and their credit supply to road infrastructure concessions. The results show that BNDES is the main financing agent for long-term investment in the sector, offering loans with low interest rates in Brazilian currency. From this research we argue that a single state bank should not alone support the increasing demand for finance in Brazil. Therefore, we conclude that there is a need to expand the supply of credit in Brazil, by strengthening private banks in the long-term lending market.

Renewable energy infrastructure. A challenge for Venezuelan industrial construction

The relevance of renewable energy has grown significantly in our global society. Important efforts are oriented to sustain it. Renewable energy depends on different technical, financial environmental and social complex processes. From the point of view of industrial construction sector this research evaluates some of the current trends in energy generation and use in Venezuela as well as environmental consequences and risks that derive from these. Additionally, authors highlight the importance of infrastructure as key issue to sustain renewable energy generation and use. The study present references of some energy renewable projects in process in Venezuela and the main problems that constrain their performance. Conclusions evidence the complex nature of industrial construction and suggest the need to improve industrial construction competitivenes as a strategy oriented to enhance renewable energy offer in the country. Additionally it is proposed to all stakeholders to work toghether to correct the conditions that currently limit industrial construction development. This is part of ongoing research.