943 resultados para resource-use efficiency


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Federal Highway Administration, Office of Safety and Traffic Operations Research and Development, Washington, D.C.

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Transportation Department, Office of Systems Engineering, Washington, D.C.

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Shipping list no.: 85-1122-P.

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Includes bibliographical references.

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This paper reports on the evaluation of the implementation of the National Recommendations for the Clinical Management of Alcohol-Related Problems in Indigenous Primary Care Settings undertaken in 2001 through 74 standardized workshops, which sought to determine: ( 1) whether this approach to implementation influenced the likelihood that the National Recommendations would be used; ( 2) whether it influenced participants' willingness to engage with Indigenous patients regarding alcohol-related issues; and ( 3) whether the implementation as a whole influenced both practice and clinicians' willingness to engage. Evaluation included pre-/post-workshop and follow-up questionnaires and a focus group. The findings presented indicate that distribution of clinical resources alone is not sufficient to ensure use and that, particularly for medical practitioners, appropriate introduction not only increases use but also positively influences willingness to engage with alcohol-related problems as part of primary clinical care. Further, the enthusiasm for guideline production should be tempered by the need to develop effective implementation strategies.

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1. Many species of delphinids co-occur in space and time. However, little is known of their ecological interactions and the underlying mechanisms that mediate their coexistence. 2. Snubfin Orcaella heinsohni, and Indo-Pacific humpback dolphins Sousa chinensis, live in sympatry throughout most of their range in Australian waters. I conducted boat-based surveys in Cleveland Bay, north-east Queensland, to collect data on the space and habitat use of both species. Using Geographic Information Systems, kernel methods and Euclidean distances I investigated interspecific differences in their space use patterns, behaviour and habitat preferences. 3. Core areas of use (50% kernel range) for both species were located close to river mouths and modified habitat such as dredged channels and breakwaters close to the Port of Townsville. Foraging and travelling activities were the dominant behavioural activities of snubfin and humpback dolphins within and outside their core areas. 4. Their representative ranges (95% kernel range) overlapped considerably, with shared areas showing strong concordance in the space use by both species. Nevertheless, snubfin dolphins preferred slightly shallower (1-2 m) waters than humpback dolphins (2-5 m). Additionally, shallow areas with seagrass ranked high in the habitat preferences of snubfin dolphins, whereas humpback dolphins favoured dredged channels. 5. Slight differences in habitat preferences appear to be one of the principal factors maintaining the coexistence of snubfin and humpback dolphins. I suggest diet partitioning and interspecific aggression as the major forces determining habitat selection in these sympatric species.

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Data on the occurrence of species are widely used to inform the design of reserve networks. These data contain commission errors (when a species is mistakenly thought to be present) and omission errors (when a species is mistakenly thought to be absent), and the rates of the two types of error are inversely related. Point locality data can minimize commission errors, but those obtained from museum collections are generally sparse, suffer from substantial spatial bias and contain large omission errors. Geographic ranges generate large commission errors because they assume homogenous species distributions. Predicted distribution data make explicit inferences on species occurrence and their commission and omission errors depend on model structure, on the omission of variables that determine species distribution and on data resolution. Omission errors lead to identifying networks of areas for conservation action that are smaller than required and centred on known species occurrences, thus affecting the comprehensiveness, representativeness and efficiency of selected areas. Commission errors lead to selecting areas not relevant to conservation, thus affecting the representativeness and adequacy of reserve networks. Conservation plans should include an estimation of commission and omission errors in underlying species data and explicitly use this information to influence conservation planning outcomes.

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We propose a new mathematical model for efficiency analysis, which combines DEA methodology with an old idea-Ratio Analysis. Our model, called DEA-R, treats all possible ratios "output/input" as outputs within the standard DEA model. Although DEA and DEA-R generate different summary measures for efficiency, the two measures are comparable. Our mathematical and empirical comparisons establish the validity of DEA-R model in its own right. The key advantage of DEA-R over DEA is that it allows effective integration of the model with experts' opinions via flexible restrictive conditions on individual "output/input" pairs. © 2007 Springer Science+Business Media, LLC.

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The use of Diagnosis Related Groups (DRG) as a mechanism for hospital financing is a currently debated topic in Portugal. The DRG system was scheduled to be initiated by the Health Ministry of Portugal on January 1, 1990 as an instrument for the allocation of public hospital budgets funded by the National Health Service (NHS), and as a method of payment for other third party payers (e.g., Public Employees (ADSE), private insurers, etc.). Based on experience from other countries such as the United States, it was expected that implementation of this system would result in more efficient hospital resource utilisation and a more equitable distribution of hospital budgets. However, in order to minimise the potentially adverse financial impact on hospitals, the Portuguese Health Ministry decided to gradually phase in the use of the DRG system for budget allocation by using blended hospitalspecific and national DRG casemix rates. Since implementation in 1990, the percentage of each hospitals budget based on hospital specific costs was to decrease, while the percentage based on DRG casemix was to increase. This was scheduled to continue until 1995 when the plan called for allocating yearly budgets on a 50% national and 50% hospitalspecific cost basis. While all other nonNHS third party payers are currently paying based on DRGs, the adoption of DRG casemix as a National Health Service budget setting tool has been slower than anticipated. There is now some argument in both the political and academic communities as to the appropriateness of DRGs as a budget setting criterion as well as to their impact on hospital efficiency in Portugal. This paper uses a twostage procedure to assess the impact of actual DRG payment on the productivity (through its components, i.e., technological change and technical efficiency change) of diagnostic technology in Portuguese hospitals during the years 1992–1994, using both parametric and nonparametric frontier models. We find evidence that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portugal during this time span.