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排序方式: 共有209条查询结果,搜索用时 15 毫秒
1.
This paper describes a methodology for allocating resources in hospitals. The methodology uses two linear goal-programming models. One model sets case mix and volume for physicians, while holding service costs fixed; the other translates case mix decisions into a commensurate set of practice changes for physicians. The models allow decision makers to set case mix and case costs in such a way that the institution is able to break even, while preserving physician income and minimizing disturbance to practice. The models also permit investigation of trade-offs between case mix and physician practice parameters. Results are presented from a decision-making scenario facing the surgical division of Toronto's Mount Sinai Hospital after the announcement of a 3-year, 18% reduction in funding. 相似文献
2.
节能服务企业效率对于推动节能服务产业发展和确保国家“双碳”目标实现具有重要意义。运用三阶段SBM模型,对2020年60家中国节能服务上市企业的综合效率进行实证研究,并分析效率的影响因素。研究结果表明,经济发展水平对综合效率具有双重影响,合适的产业结构和较高的投入资本回报率有利于综合效率提升,而政府补贴与企业存续时间制约了综合效率改进;剔除环境因素与随机误差影响后,多数企业综合效率下降,整体效率偏低;提高规模效率是提升综合效率的关键,且绝大部分企业处于规模收益递增状态。研究最后提出创新补贴方式、建立企业认证制度、开展综合能源服务和推动企业间兼并重组等可行建议,以提升节能服务企业的综合效率。 相似文献
3.
D. Joe Boone 《Accreditation and quality assurance》2004,10(1-2):5-9
A recent US Institute of Medicine report indicated that up to 98,000 deaths and more than 1 million injuries occur each year in the United States due to medical errors. These include diagnostic errors, such as an error or delay in diagnosis, failure to employ indicated tests and the use of outmoded tests. Laboratory tests provide up to 80% of the information used by physicians to make important medical decisions, therefore it is important to determine how often laboratory testing mistakes occur, whether they cause patient harm, where they are most likely to occur in the testing process, and how to prevent them from occurring. A review of the literature and a US Quality Institute Conference in 2003 indicates that errors in laboratory medicine occur most often in the pre-analytical and post-analytical steps in the testing process, but most of the quality improvement efforts focus on improving the analytical process. Measures must be developed and employed to reduce the potential for mistakes in laboratory medicine, including better indicators for the quality of laboratory service. Users of laboratory services must be linked with the laboratorys information system to assist them with decisions about test ordering, patient preparation, and test interpretation. Quality assessment efforts need to be expanded beyond external quality assessment programs to encompass the detection of non-analytical mistakes and improving communication between the users of and providers of laboratory services. The actual number of mistakes in laboratory testing is not fully recognized, because no widespread process is in place to either determine how often mistakes occur or to systematically eliminate sources of error. We also tend to focus on mistakes that result in adverse events, not the near misses that cause no observable harm. The users of laboratory services must become aware of where testing mistakes can occur and actively participate in designing processes to prevent mistakes. Most importantly, healthcare institutions need to adopt a culture of safety, which is implemented at all levels of the organization. This includes establishing closer links between providers of laboratory services and others in the healthcare delivery system. This was the theme of a 2003 Quality Institute Conference aimed at making the laboratory a key partner in patient safety. Plans to create a permanent public–private partnership, called the Institute for Quality in Laboratory Medicine, whose mission is to promote improvements in the use of laboratory tests and laboratory services are underway.Presented at the 9th Conference on Quality in the Spotlight, 18–19 March 2004, Antwerp, Belgium. 相似文献
4.
东海区海岸带景观格局变化对生态系统服务价值的影响 总被引:2,自引:0,他引:2
对大尺度、长时序的海岸带景观格局和生态系统服务价值(ecosystem services value,ESV)的研究,有利于更好地促进区域生态系统保护工作的开展。以1990,1995,2000,2005,2010,2015年6期遥感影像解译结果为基础,对东海区海岸带景观格局变化特征和ESV时空演变进行了分析,并探讨了ESV与景观格局变化二者间的关系。结果表明,1990—2015年的25 a间,受人类活动的影响,东海区海岸带农田和海域面积大量减少,建设用地面积大幅增加;在所研究的5类地貌类型中,除中起伏山地外,其余地貌类型景观面积转移都较为剧烈。25 a间东海区海岸带斑块数量、斑块密度、边界密度、shannon多样性指数等不断增加,景观破碎化、复杂化、多样化增强。农田景观的最大斑块指数、形态指数、边界密度等变化均较大。东海区海岸带ESV呈先增加后减小的趋势,其中森林景观对ESV总量贡献最大;水文调节、生物多样性维持、气候调节、土壤保持、废物处理和气体调节是东海区海岸带主要的生态系统服务功能;在空间上表现出以单位面积中、低ESV为主导的空间分布,高、极高和极低ESV分布较少。研究区ESV总量与农田和海域以及水域和建设用地面积显著相关;与斑块密度、边界密度和形态指数呈显著负相关。同时,食物生产、气体调节、气候调节、土壤保持和生物多样性维持的服务价值与景观指数间均显著相关。 相似文献
5.
6.
Land exhibits diverse functions under the combined influence of natural and human forces. A production–living–ecology functional classification system was constructed by integrating land, ecosystem, and landscape functions. The land functional value was calculated by systematically integrating ecosystem service value assessments. The primary and secondary functions, as well as combinations of different land‐use types, were determined using vertical and horizontal comparison methods. The production–living–ecology ranges were then delineated in Puge County, which is a typical mountain county in China. The production–living–ecology functions identified were well connected with the current land‐use types. The “production–living–ecology” space in Puge County showed obvious multifunctionality and agglomeration. The function identification system proposed in this paper integrated multiple methods, overcame the difficulty of direct quantitative identification of land functions. The methods used to map and quantify land function will enhance our ability to understand and model land system changes and adequately inform policies and planning. Summary for Managers
- The function valuation method constructed in this paper could be used to reflect the multifunctionality and importance of land use and provide guidance and a quantitative basis for regional development planning.
- The spatial classification results provided in this paper could offer a valuable reference for the land management department to scientifically formulate land use planning.
- Under the goal of creating a group‐type urban development pattern and constructing an ecological protection pattern in Puge County, the hotspot analysis results of this paper can provide decision‐making tools and alternative spatial plans.
7.
José Manuel Cordero Edurne Alonso-Morán Roberto Nuño-Solinis Juan F. Orueta Regina Sauto Arce 《European Journal of Operational Research》2015
This paper uses a fully nonparametric approach to estimate efficiency measures for primary care units incorporating the effect of (exogenous) environmental factors. This methodology allows us to account for different types of variables (continuous and discrete) describing the main characteristics of patients served by those providers. In addition, we use an extension of this nonparametric approach to deal with the presence of undesirable outputs in data, represented by the rates of hospitalization for ambulatory care sensitive condition (ACSC). The empirical results show that all the exogenous variables considered have a significant and negative effect on efficiency estimates. 相似文献
8.
从地理学与海洋学视域出发, 在阐述舟山海岛独特性和研究价值的基础上, 通过文献计量分析梳理以舟山海岛为研究对象的相关研究脉络, 提出了未来舟山研究值得关注的重点, 即着眼最基本的生产、生活、生态问题研究舟山地区海洋生态环境变化和工农业技术水平的互馈机制, 模拟自然与人文要素的耦合格局、尺度与机理, 为海岛可持续发展决策和社会提供动态信息. 相似文献
9.
具有第二次多选择服务的M[X]/G/1排队系统 总被引:9,自引:0,他引:9
本文研究成批到达的具有第二次多选择服务的单服务员排队系统.顾客的到达形成一广义泊松过程,不同批的顾客按先到先服务的规则,而同一批的顾客按随机次序接受服务.两次服务的服务时间都是一般分布且相互独立.本文采用补充变量法,求得在瞬态和稳态情况下系统队长的概率母函数,然后又计算出顾客的平均队长和平均等待时间. 相似文献
10.
We study the sojourn times of customers in an M/M/1 queue with the processor sharing service discipline and a server that is subject to breakdowns. The lengths of the breakdowns have a general distribution, whereas the on-periods are exponentially distributed. A branching process approach leads to a decomposition of the sojourn time, in which the components are independent of each other and can be investigated separately. We derive the Laplace–Stieltjes transform of the sojourn-time distribution in steady state, and show that the expected sojourn time is not proportional to the service requirement. In the heavy-traffic limit, the sojourn time conditioned on the service requirement and scaled by the traffic load is shown to be exponentially distributed. The results can be used for the performance analysis of elastic traffic in communication networks, in particular, the ABR service class in ATM networks, and best-effort services in IP networks. 相似文献