Has DRG payment influenced the technical efficiency and productivity of diagnostic technologies in Portuguese public hospitals? An empirical analysis using parametric and non‐parametric methods

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.

Evolution of competing strategies in a threshold model for task allocation

A nature inspired decentralised multi-agent algorithm is proposed to solve a problem of distributed task allocation in which cities produce and store batches of different mail types. Agents must collect and process the mail batches, without global knowledge of their environment or communication between agents. The problem is constrained so that agents are penalised for switching mail types. When an agent process a mail batch of different type to the previous one, it must undergo a change-over, with repeated change-overs rendering the agent inactive. The efficiency (average amount of mail retrieved), and the flexibility (ability of the agents to react to changes in the environment) are investigated both in static and dynamic environments and with respect to sudden changes. New rules for mail selection and specialisation are proposed and are shown to exhibit improved efficiency and flexibility compared to existing ones. We employ a evolutionary algorithm which allows the various rules to evolve and compete. Apart from obtaining optimised parameters for the various rules for any environment, we also observe extinction and speciation.

The effect of load on agent-based algorithms for distributed task allocation

Multi-agent algorithms inspired by the division of labour in social insects and by markets, are applied to a constrained problem of distributed task allocation. The efficiency (average number of tasks performed), the flexibility (ability to react to changes in the environment), and the sensitivity to load (ability to cope with differing demands) are investigated in both static and dynamic environments. A hybrid algorithm combining both approaches, is shown to exhibit improved efficiency and robustness. We employ nature inspired particle swarm optimisation to obtain optimised parameters for all algorithms in a range of representative environments. Although results are obtained for large population sizes to avoid finite size effects, the influence of population size on the performance is also analysed. From a theoretical point of view, we analyse the causes of efficiency loss, derive theoretical upper bounds for the efficiency, and compare these with the experimental results.

Impact of power allocation strategies in long-haul few-mode fiber transmission systems

We report for the first time on the limitations in the operational power range of few-mode fiber based transmission systems, employing 28Gbaud quadrature phase shift keying transponders, over 1,600km. It is demonstrated that if an additional mode is used on a preexisting few-mode transmission link, and allowed to optimize its performance, it will have a significant impact on the pre-existing mode. In particular, we show that for low mode coupling strengths (weak coupling regime), the newly added variable power mode does not considerably impact the fixed power existing mode, with performance penalties less than 2dB (in Q-factor). On the other hand, as mode coupling strength is increased (strong coupling regime), the individual launch power optimization significantly degrades the system performance, with penalties up to ∼6dB. Our results further suggest that mutual power optimization, of both fixed power and variable power modes, reduces power allocation related penalties to less than 3dB, for any given coupling strength, for both high and low differential mode delays. © 2013 Optical Society of America.

Adaptive resource allocation for multicast orthogonal frequency division multiple access systems with guaranteed BER and rate

In this paper, we propose a resource allocation scheme to minimize transmit power for multicast orthogonal frequency division multiple access systems. The proposed scheme allows users to have different symbol error rate (SER) across subcarriers and guarantees an average bit error rate and transmission rate for all users. We first provide an algorithm to determine the optimal bits and target SER on subcarriers. Because the worst-case complexity of the optimal algorithm is exponential, we further propose a suboptimal algorithm that separately assigns bit and adjusts SER with a lower complexity. Numerical results show that the proposed algorithm can effectively improve the performance of multicast orthogonal frequency division multiple access systems and that the performance of the suboptimal algorithm is close to that of the optimal one. Copyright © 2012 John Wiley & Sons, Ltd. This paper proposes optimal and suboptimal algorithms for minimizing transmitting power of multicast orthogonal frequency division multiple access systems with guaranteed average bit error rate and data rate requirement. The proposed scheme allows users to have different symbol error rate across subcarriers and guarantees an average bit error rate and transmission rate for all users. Copyright © 2012 John Wiley & Sons, Ltd.

Resource allocation in decentralised computational systems:an evolutionary market-based approach

We present a novel market-based method, inspired by retail markets, for resource allocation in fully decentralised systems where agents are self-interested. Our market mechanism requires no coordinating node or complex negotiation. The stability of outcome allocations, those at equilibrium, is analysed and compared for three buyer behaviour models. In order to capture the interaction between self-interested agents, we propose the use of competitive coevolution. Our approach is both highly scalable and may be tuned to achieve specified outcome resource allocations. We demonstrate the behaviour of our approach in simulation, where evolutionary market agents act on behalf of service providing nodes to adaptively price their resources over time, in response to market conditions. We show that this leads the system to the predicted outcome resource allocation. Furthermore, the system remains stable in the presence of small changes in price, when buyers' decision functions degrade gracefully. © 2009 The Author(s).

An adaptive scheduling scheme for fair bandwidth allocation

Class-based service differentiation is provided in DiffServ networks. However, this differentiation will be disordered under dynamic traffic loads due to the fixed weighted scheduling. An adaptive weighted scheduling scheme is proposed in this paper to achieve fair bandwidth allocation among different service classes. In this scheme, the number of active flows and the subscribed bandwidth are estimated based on the measurement of local queue metrics, then the scheduling weights of each service class are adjusted for the per-flow fairness of excess bandwidth allocation. This adaptive scheme can be combined with any weighted scheduling algorithm. Simulation results show that, comparing with fixed weighted scheduling, it effectively improve the fairness of excess bandwidth allocation.

Multiple criteria decision-making techniques in higher education

Purpose: The purpose of this paper is to review the literature which focuses on four major higher education decision problems. These are: resource allocation; performance measurement; budgeting; and scheduling. Design/methodology/approach: Related articles appearing in the international journals from 1996 to 2005 are gathered and analyzed so that the following three questions can be answered: "What kind of decision problems were paid most attention to?"; "Were the multiple criteria decision-making techniques prevalently adopted?"; and "What are the inadequacies of these approaches?" Findings: Based on the inadequacies, some improvements and possible future work are recommended, and a comprehensive resource allocation model is developed taking account of these factors. Finally, a new knowledge-based goal programming technique which integrates some operations of analytic hierarchy process is proposed to tackle the model intelligently. Originality/value: Higher education has faced the problem of budget cuts or constrained budgets for the past 30 years. Managing the process of the higher education system is, therefore, a crucial and urgent task for the decision makers of universities in order to improve their performance or competitiveness. © Emerald Group Publishing Limited.

Research allocation on sparse graphs

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Human resource allocation in a call centre

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Wealth shocks, credit-supply shocks, and asset allocation:evidence from household and firm portfolios

We use a unique dataset with bank clients’ security holdings for all German banks to examine how macroeconomic shocks affect asset allocation preferences of households and non-financial firms. Our analysis focuses on two alternative mechanisms which can influence portfolio choice: wealth shocks, which are represented by the sovereign debt crisis in the Euro area, and credit-supply shocks which arise from reductions in borrowing abilities during bank distress. While households with large holdings of securities from stressed Euro area countries (Greece, Ireland, Italy, Portugal, and Spain) de-crease the degree of concentration in their security portfolio as a result of the Euro area crisis, non-financial firms with similar levels of holdings from stressed Euro area countries do not. Credit-supply shocks at the bank level result in lower concentration, for both households and non-financial corporations. Only shocks to corporate credit bear ramifications on bank clients’ portfolio concentration. Our results are robust to falsification tests, and instrumental variables estimation.

Distributed sequential task allocation in foraging swarms

When designing a practical swarm robotics system, self-organized task allocation is key to make best use of resources. Current research in this area focuses on task allocation which is either distributed (tasks must be performed at different locations) or sequential (tasks are complex and must be split into simpler sub-tasks and processed in order). In practice, however, swarms will need to deal with tasks which are both distributed and sequential. In this paper, a classic foraging problem is extended to incorporate both distributed and sequential tasks. The problem is analysed theoretically, absolute limits on performance are derived, and a set of conditions for a successful algorithm are established. It is shown empirically that an algorithm which meets these conditions, by causing emergent cooperation between robots can achieve consistently high performance under a wide range of settings without the need for communication. © 2013 IEEE.