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At least 271 records · Page 15Linked to original sources
PubMed1989

Comparison of two scores for allocating resources to doctors in deprived areas.

Current proposals in the general practitioner contract include additional payments to doctors working among deprived populations. The underprivileged area score will be used to identify local authority wards with the greatest levels of deprivation, thus acting as the basis for distributing considerable resources. Two methods of identifying deprived populations--the underprivileged area score and the material deprivation score--were compared to determine whether they result in similar allocation of resources to regions. Financial allocations to regions based on figures derived from the contract differed considerably if the material deprivation score was used instead of the underprivileged area score: Northern and Mersey regions gained over 50% of their allocation whereas East Anglia, Oxford, and South West Thames regions lost more than 30% of theirs. Such differences have considerable implications for doctors working among deprived populations as up to 60m pounds each year might be distributed by these payments.

England↗
PubMed1987

Waiting for care. Queuing and resource allocation.

Queues arise in medical care and serve as allocators in the absence of an effective market and when resources become perceptibly constrained. This is essentially the case in all countries where money is not the means for gaining access to medical services. A study estimated that the total wait in England was 96 days for nonemergency care leading to hospitalization, including primary and specialty ambulatory care, for that one quarter of patients who had been placed on a waiting list. Of the remaining hospitalized population one half were admitted immediately and another one fourth were either booked or transferred from other hospitals. The widely accepted notion that a large majority of hospitalized patients wait a long time for care in Britain is mistaken. The emphasis on primary ambulatory care means that essentially no one has to wait for general practitioner care. The wait for elective ambulatory specialty care averaged approximately 8 weeks for all patients. Although mortality is rarely an issue for those who wait, an argument can be made that convenience and quality of life are importantly affected.

Ambulatory Care↗
PubMedDate not supplied

[Mechanisms for allocating financial resources after decentralization in the state of Jalisco].

OBJECTIVE: To analyze, from the decision maker's perspective, the financial resource allocation process of the health services of the state of Jalisco (SSJ, per its abbreviation in spanish), within the context of decentralization. MATERIAL AND METHODS: Through a qualitative approximation using semi-structured individual interviews of key personnel in managerial positions as the method for compiling information, the experience of the SSJ in financial resource allocation was documented. From September to November 2003, the perception of managers and administrators regarding their level of autonomy in decision-making was explored as well as the process they follow for the allocation of financial resources, in order to identify the criteria they use and their justifications. RESULTS: From the point of view of decision-makers, autonomy of the SSJ has increased considerably since decentralization was implemented, although the degree of decision-making freedom remains limited due mainly to high adminstrative costs associated with salaries. In this sense, the implications attributable to labor situations that are still centralized are evident. Some innovative systems for financial resource allocation have been established in the SSJ for the sanitary regions and hospitals based upon administrative-managerial and productivity incentives. Adjustments were also made for degree of marginalization and population lag, under the equity criterion. CONCLUSIONS: General work conditions and decision-making autonomy of the sanitary regions constitute outstanding aspects pending decentralization. Although decentralization has granted more autonomy to the SSJ, the level of decision-making freedom for allocating financial resources has been held within the highest hierarchical levels.

Delivery of Health Care↗
PubMed2006

Resource allocation to reproduction and soma in Drosophila: a stable isotope analysis of carbon from dietary sugar.

Metabolic resources in adults of holometabolous insects may derive either from larval or adult feeding. In Drosophila melanogaster, reproduction and lifespan are differently affected by larval vs. adult resource availability, and it is unknown how larval vs. adult acquired nutrients are differentially allocated to somatic and reproductive function. Here we describe the allocation of carbon derived from dietary sugar in aging female D. melanogaster. Larval and adult flies were fed diets contrasting in sucrose (13)C/(12)C, from which we determined the extent to which carbon acquired at each stage contributed to adult somatic tissue and to egg manufacture. Dietary sugar is very important in egg provisioning; at every age, roughly one half of the carbon in eggs was derived from sugar, which turned over from predominantly larval to entirely adult dietary sources. Sucrose provided approximately 40% of total somatic carbon, of which adult dietary sucrose came to supply approximately 75%. Unlike in eggs, however, adult acquired sucrose did not entirely replace the somatic carbon from larvally acquired sucrose. Because carbon from larval sucrose appears to be fairly "replaceable", larval sucrose cannot be a limiting substrate in resource allocation between reproduction and lifespan.

Animals↗
PubMed1992

Decisions near the end of life: resource allocation implications for hospitals.

CONCLUSION: At a time when hospitals are having predictable difficulty accommodating infinite expectations with finite resources, there are still some observers who abhor even the possibility that the cost and volume of hospital services to the terminally ill be scrutinized. However, more assertive attention is justified on the basis of qualitative as well as quantitative evidence. Neither unrestricted medical paternalism nor total patient autonomy should be unequivocally endorsed. Both the physician and the patient have a mutual obligation and incentive to achieve a proper balance. This balance is dynamic rather than static because attitudes and values change, and advance directives are not immutable documents. Hospitals have a moral imperative to create an organizational environment in which a genuine collaborative decision-making process will ultimately benefit all participants.

Administrative Personnel↗
PubMed2004

[Indices of public health services and resource allocation from the Health Ministry of Chile].

BACKGROUND: Chile has a National Health Services System, formed by 29 Health Services. An efficient resource distribution among this services is crucial for an efficient health care delivery. AIM: To obtain indices from the Chilean Public Health Services, that could improve allocation of resources. MATERIAL AND METHODS: Information from the Chilean Public Health Services, corresponding to activities during 2001 budgetary period, was collected. This is the latest complete and official information for the totality of Health Services in the country. Seventeen variables generated or monitored by the Instituto Nacional de Estadísticas (INE), the Ministerio de Salud (MINSAL), the Ministerio de Hacienda, the Ministerio de Planificación y Cooperación (MIDEPLAN) and the Fondo Nacional de Salud (FONASA) were studied. The Main Components Analysis (ACP) was used, obtained from the R correlation matrix. RESULTS: The first two main components were selected, with an accumulated percentage of explained variability of 63.05%. The first component is related to the population assigned to each Health Service. This corresponds to the number of people needed to treat in the hospitals of these Services and their answer to this demand, justified by the expenses in which each Health Service incurs. There is an inverse relation of the first component with health indicators, measured by burden of disease and death. The second main component would represent the social and economic characteristics of the population, poor and very poor populations and public health insurance beneficiaries, to take care of in each Health Service. CONCLUSIONS: Health indicators in each Health Service are not considered a priority for resource distribution among Health Services in the country. The transference is done considering the indices contained in the two main components defined.

Chile↗