101,918 research outputs found
Increasing public healthcare network performance by deî ̧hospitalization:A patient pathway perspective
No full textPurpose
– The aim of this paper is to support public decision‐makers in a local healthcare agency (LHA) in evaluating the effects of different de‐hospitalization strategies and the potential for outsourcing clinical services.
Design/methodology/approach
– The approach adopted is based on the “patient pathway” perspective. Starting from the identification of specific care pathways, all the feasible care paths in a given LHA in Italy are investigated in order to evaluate the practicability of the de‐hospitalization of some phases with a particular focus on co‐ordination of hospitals and territorial services. A heuristic approach based on discrete‐event simulation modelling is proposed. The methodology and the simulation model have been validated with reference to field data derived from a full‐scale case study carried out within a LHA in southern Italy.
Findings
– The results show where, in terms of care pathways, de‐hospitalization is practicable, valuable in terms of better resource utilization, and eligible for outsourcing. The outsourcing option appears to be more sustainable from a social point of view. It specifies that there would be no dismissal of employees, and that there would be recruitment of specialized workers such as nurses and doctors, employed under more flexible conditions. Savings in overheads would be achieved by means of patient de‐hospitalization.
Originality/value
– The existing scientific literature, to the best of the authors' knowledge, deals with patient flow management at the hospital level. However, in the European countries, the public healthcare system is generally organized in terms of the territorially based allocation of service centres. Given the scarcity of public resources, the main difficulty seems to be a mismatch among actions needed to improve territorial and residential care for outsourcing, and the interventions needed to contain hospital costs
Modeling And Simulation of A Territorial Health Care Service (Hcs): Patients Vs HCs Management Perspective
No full textNowadays the increase of healthcare costs leads to the need to control healthcare expenditure and to assure high service quality. Methods and techniques adopted in the industrial systems’ context can be adopted to develop innovative operational practices in management of Health-Care Systems (HCSs).
This paper is developed under the Research Project of National Interest (PRIN-2007) “Innovation of Healthcare Service Networks by using Supply Chain Management Techniques”. The aim of the project is to
support public decision makers to face with the main problems of health-social network coordination problems among various Local Healthcare Agency (LHA) structures.
This paper introduces a new approach based on a patient-center perspective aiming to model territorial
healthcare service networks in order to analyze their efficiency in term of resource allocation and usage. A model able to evaluate the interaction among different service units belonging to the same network is proposed in order to support public decision makers to face with the design of healthcare network. The paper focuses on three features: to define the burdens of a territorial network and its characteristics; to classify the services provided and the interactions among them; to define the performance indicators of each service based on the most critical resources usage and on the quality of the service provided. Finally, preliminary results concerning a first model application to the LHA of Brindisi (in the Apulia Region) are presented
Learning sustainability through competitive game: experiences from the Vinyl Chloride Monomer (VCM) case study
No full textThe change of current design perspective in the industrial context towards a more sustainable one is a complex and challenging problem. Experiential learning performed through a “sustainable” competitive game could help practitioners, engineers and master students in being aware of the problem complexity. The paper describes objectives, methods, expected results and evaluation criteria of a learning competitive game. The goal of the “sustainable” game is two-fold: to identify the optimal site location of a new Vinyl Chloride Monomer (VCM) production plant in a given regional supply-chain; to find the best Pollution Prevention Equipment (PPE) configuration allowing to meet both the required level of plant availability and the environmental regulation limit of the air emissions. In both cases the sustainable solution of the problem shall be consistent with economic, as well as environmental constraints. This “reality” experience on sustainable design has been tested during the XIV Summer School “Franceso Turco” – Sustainable Development: The Role of Industrial Engineering
Analysis of ghost cells in calcifying cystic odontogenic tumors by confocal laser scanning microscopy
No full textObjective. The confocal laser scanning microscope represents an effective tool for studying biological samples stained for fluorescence observation. In this study we have used the confocal microscope to analyze ghost cells in calcifying cystic odontogenic tumors.Study design. Specimens from 15 calcifying cystic odontogenic tumor cases were stained with hematoxylin and eosin, and scanned by a confocal laser scanning microscope to generate optically sectioned images.Results. All of the analyzed samples presented autofluorescent cells that were identified as ghost cells. The degree of autofluorescence intensity was variable and may be a result of the presence of hard keratin.Conclusion. The confocal laser scanning microscope may be of help in analyzing and defining the nature and extent of keratinization processes in calcifying cystic odontogenic tumor ghost cells
Traumatic ulcerative granuloma with stromal eosinophilia of the oral mucosa: histological and immunohistochemical analysis of three cases.
No full textTraumatic ulcerative granuloma with stromal eosinophilia is an ulcerated oral lesion which pathogenesis is still unclear. Clinically, this disease is characterized by the presence of chronic ulcerative lesions with elevated and indurated borders in the oral mucosa. It usually develops rapidly and persists for several weeks or months, it presents mainly on the tongue but other areas such as gingival, cheek and vestibular mucosa may also be involved. We report three cases showing their clinical, histological and immunohistochemical analysis. In this study the authors underline the importance of a correct differential diagnosis and monitoring of these patients in order to prevent the development of possible serious complications
New approach for static bone histomorphometry: confocal laser scanning microscopy of maxillo-facial normal bone
No full text
Optical sensor for nanoparticles
No full textIn this paper we investigate a method for the detection of nanoparticles in order to reduce the risk associated with their toxicity, by taking into account the electromagnetic characteristics and the chemical analysis of the surface of a hybrid silicon photonic microresonator. Device sensing capabilities, both optical and chemical, are optimized in order to detect and size the nanoparticle. Thus, a silicon on insulator whispering gallery mode hybrid microresonator having an outer radius of 5 mu m and features that are typical of both ring and disk resonators, has been modeled. Quantum electrodynamics principles have been exploited in order to derive the master equation associated with the nanoparticle-resonator interaction. To allow a complete modeling of the sensor attention has been paid to the nanoparticle treatment, with the result that tested nanoparticles need to be chemically stabilized, monodisperse and formed by noble metal nanocolloids, in which a metal core (e. g. Au, Pd, etc) is surrounded by a monolayer or sub-monolayer film of an organic capping agen
management in Local Healthcare Agencies: a patient-pathway oriented framework
No full textHealthcare (HC) is one of the largest and most complex industries. In the last years Local Healthcare Agencies (LHAs) have been experienced high increase in expenditure. New methodological approaches allowing to optimize their efficiency and effectiveness are needed. Hospital departments are the most expensive services provided by LHAs. In this paper, a framework to model LHAs and evaluate the effects of some strategic decisions on LHAs performances is proposed. The analysis focuses on hospital units treating heart failure diseases since they are one of the main hospital admissions causes. The “de- hospitalization” of heart failure care pathways is evaluated as a possible solution to the problem of reducing costs and improving quality of service such as the system capability to provide service without delays
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