PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Program Efficiency”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1989

Using mathematical programming to assess the relative performance of the health care industry.

Unlike conventional methods for evaluating program efficiency, a recently developed mathematical programming technique, Data Envelopment Analysis (DEA), is able to handle multiple inputs and outputs simultaneously without assigning arbitrary weights and does not require the use of homogeneous measurement units nor a prespecified functional relationship between inputs and outputs. Despite of its unfamiliarity to health care researchers and administrators, this technique is becoming increasingly popular as a means of evaluating relative performance in not-for-profit entities.

Decision Making, Organizational↗
PubMedDate not supplied

The impact of service delivery frequency on family planning program output and efficiency.

Operations research is the study of factors that can be controlled by program administrators. Among such factors is the frequency of performing program activities. The present experiment, conducted in Lima, Peru during 1985-86, tested the impact of holding family planning post sessions once per month, twice per month, and weekly. Frequency was shown to have a major impact on program outputs, costs, and cost-effectiveness. Depending on the indicator, sessions held twice per month produced between 1.5 and 2.1 times the output of those conducted once per month. Weekly sessions produced between 1.3 and 1.6 times the output of those held twice per month. At an output level of nearly 11,200 visits per year, twice-per-month sessions were estimated to be 7-38 percent more cost-effective, depending on the indicator, than once-per-month sessions, and 6-28 percent more cost-effective than weekly sessions.

Community Health Services↗
PubMed2002

Mediation designs for tobacco prevention research.

This paper describes research designs and statistical analyses to investigate how tobacco prevention programs achieve their effects on tobacco use. A theoretical approach to program development and evaluation useful for any prevention program guides the analysis. The theoretical approach focuses on action theory for how the program affects mediating variables and on conceptual theory for how mediating variables are related to tobacco use. Information on the mediating mechanisms by which tobacco prevention programs achieve effects is useful for the development of efficient programs and provides a test of the theoretical basis of prevention efforts. Examples of these potential mediating mechanisms are described including mediated effects through attitudes, social norms, beliefs about positive consequences, and accessibility to tobacco. Prior research provides evidence that changes in social norms are a critical mediating mechanism for successful tobacco prevention. Analysis of mediating variables in single group designs with multiple mediators are described as well as multiple group randomized designs which are the most likely to accurately uncover important mediating mechanisms. More complicated dismantling and constructive designs are described and illustrated based on current findings from tobacco research. Mediation analysis for categorical outcomes and more complicated statistical methods are outlined.

Adolescent↗
PubMed1999

Activation of caspases and p53 by bovine herpesvirus 1 infection results in programmed cell death and efficient virus release.

Programmed cell death (PCD), or apoptosis, is initiated in response to various stimuli, including virus infection. Bovine herpesvirus 1 (BHV-1) induces PCD in peripheral blood mononuclear cells at the G0/G1 phase of the cell cycle (E. Hanon, S. Hoornaert, F. Dequiedt, A. Vanderplasschen, J. Lyaku, L. Willems, and P.-P. Pastoret, Virology 232:351-358, 1997). However, penetration of virus particles is not required for PCD (E. Hanon, G. Meyer, A. Vanderplasschen, C. Dessy-Doize, E. Thiry, and P. P. Pastoret, J. Virol. 72:7638-7641, 1998). The mechanism by which BHV-1 induces PCD in peripheral blood mononuclear cells is not understood, nor is it clear whether nonlymphoid cells undergo PCD following infection. This study demonstrates that infection of bovine kidney (MDBK) cells with BHV-1 leads to PCD, as judged by terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling, DNA laddering, and chromatin condensation. p53 appears to be important in this process, because p53 levels and promoter activity increased after infection. Expression of proteins that are stimulated by p53 (p21(Waf1) and Bax) is also activated after infection. Cleavage of Bcl-xL, a protein that inhibits PCD, occurred after infection, suggesting that caspases (interleukin-1beta-converting enzyme-like proteases) were activated. Other caspase substrates [poly(ADP-ribose) polymerase and actin] are also cleaved during the late stages of infection. Inhibition of caspase activity delayed cytotoxic activity and virus release but increased the overall virus yield. Taken together, these results indicate that nonlymphoid cells undergo PCD near the end of productive infection and further suggest that caspases enhance virus release.

Animals↗
PubMed2002

Does the implementation of responsibility centers, total quality management, and physician fee programs improve hospital efficiency? Evidence from Taiwan hospitals.

OBJECTIVES: This study evaluates whether the implementation of various types of hospital-physician integration strategies, such as the responsibility centers system, total quality management, and physician fee programs, enhance efficiency for Taiwan hospitals. Because hospitals in Taiwan are structurally similar to staff-model HMOs, the study has implications beyond Taiwan. RESEARCH DESIGN: The Data Envelopment Analysis model is applied to measure hospital efficiency. Hospital efficiency refers to the ability to produce more outputs (eg, ambulatory and emergency visits, inpatient days, and inpatient visits) with the same inputs (eg, physicians, nurses, ancillary labor, and hospital beds). The sample consists of 90 general hospitals in Taiwan from 1994 to 1996. In addition, multitobit regression analysis is used to simultaneously estimate the effects of the hospital-physician integration strategies and provide better control for the effect of other factors (eg, size, degree of competition, ownership structure, teaching status, and the change in regulatory regime) that may also affect hospital efficiency. RESULTS: When evaluating the hospital-physician integration strategies individually, hospitals that implemented the responsibility centers system, total quality management, and physician fee programs were more efficient than hospitals that did not. Controlling for other factors using the multitobit model, hospitals that implemented physician fee programs remained significantly more efficient than others. In addition, hospitals that implemented total quality management were more efficient when they had implemented the strategy for at least 2 years. Hospitals that implemented the responsibility centers system were more efficient but only when integrating the system with formal incentive schemes. CONCLUSIONS: Physician fee programs seem to provide the most direct and robust incentives to enhance hospital efficiency under a fee-for-service regime like that in Taiwan. Because of time-lagged effects, hospitals that implemented the total quality management programs were more efficient but only when the programs had been implemented for at least 2 years. The responsibility centers system can also be effective when the system was associated with formal incentive schemes. The results indicate the importance of having both the individual-based and team-based incentives in place. Finally, the hospital-physician integration strategies appear to be effective individually, but the results change significantly when they are evaluated simultaneously, together with other control variables, in the tobit model. This indicates the importance of investigating hospital-physician integration strategies as a portfolio instead of a single tool.

Decision Making, Organizational↗
PubMed1982

Predictors of cancellation in an Oregon involuntary commitment program.

The problem of attrition from mental health care programs before such services begin is poorly understood. The present research has identified several variables which predict first appointment cancellations for Oregon involuntary commitment petitioners in behalf of potential clients. The value of such variables is discussed in terms of petitioner attrition from involuntary commitment programs, mental health needs of those petitioning for the involuntary commitment of "allegedly mentally ill" persons, increased mental health program efficiency, and economic benefits for underbudgeted and understaffed mental health care programs. Recommendations to improve community mental health programs in general, and involuntary commitment programs in particular are presented.

Adult↗
PubMedDate not supplied

A cost-effective competency program for a rehabilitation unit.

As competency evaluations become the standard for assessing proficient nursing practice, the need for validated, cost-effective, and efficient programs will increase. This article describes a competency assessment program that was implemented for a hospital-based, 15-bed acute rehabilitation unit in Chehalis, WA. The program, initiated and executed by the hospital's staff development department, was efficient in terms of financial costs to the unit and the time required for implementation for all participating staff. Appropriately selected psychomotor and cognitive skills were verified through return demonstration and written examination. The 14 members of the licensed staff successfully completed all aspects of the program.

Clinical Competence↗
PubMedDate not supplied

Program evaluation. Part 1: Four generations of theory.

Program evaluation is necessary for understanding and improving educational programs in nursing, but it is frequently surrounded by a climate of unease and perplexity. This first article in a two-part series reviews and evaluates extant models of program evaluation using Guba and Lincoln's four generations of evaluation as a theoretical framework. The second article (November/December 1990) examines the state-of-the-art of program evaluation in nursing education and proposes implementation of a responsive model of program evaluation in schools of nursing. The series aims to foster more dynamic, efficient program analysis, thereby enhancing the effectiveness of nursing's educational programs.

Humans↗
PubMed1989

Monitoring patient outcome following discharge: a computerized geriatric case-management system.

Many political, economic, and social factors are influencing health care providers to consider case-management programs. The authors describe a computer-supported, hospital-based case management program for elderly patients and report on the benefits and drawbacks of the program. Primary benefits include access to better client data, improved discharge planning capabilities, and greater program efficiency. Drawbacks chiefly are related to the difficulties inherent in introducing computerization into a human service setting. Overall, the program is a beneficial addition to patient care efforts and is a valuable tool for tracking high-risk patients in acute-care settings.

Aged↗
PubMed1999

Efficiency of fluoride programs in the light of reduced caries levels in young populations.

Since the late 1930s, when the efficacy of fluoride in caries prevention was first detected, various efficient methods for fluoride delivery have been developed. Nowadays, fluoride is used for caries prevention on a global scale, the most widely used methods being fluoridated toothpaste and water fluoridation. The latter is a typical community-based prevention method, whereas the former method relies on individual motivation. The goal of an efficient community-based fluoride program is to maintain a constant low level of fluoride in as many mouths as possible at as low a cost as possible. Initially, water fluoridation and other community-based programs were highly efficient, but nowadays in societies in which the major part of the population is using fluoride toothpaste and caries levels are low, population-based programs show a low efficiency. As an example, even though water fluoridation was withdrawn in Kuopio, there have been no dramatic effects on the dental health of children and youths. In societies with well-attended, community-based, free dental health care for children and youths, the dental motivation of individuals is, in general, very high and the use of fluoride for caries prevention may be taken care of at the individual level.

Cariostatic Agents↗
PubMed1995

The Carolina Children's Communicative Disorders Program. An opportunity for North Carolina's children.

The CCCDP provides devices and services to underprivileged children with communication disorders. Since its organization, the program has helped 197 children, including 21 given cochlear implants, and has disbursed 258 hearing aids or devices. It is cost-efficient program that has potential to help many of our state's needful children. We solicit referrals from all NC physicians, audiologists, speech pathologists, educators, and other professionals. Applications and financial forms will be furnished on request.

Adolescent↗
PubMedDate not supplied

Physician efficiency and reimbursement: a case study.

Joint ventures between hospitals and doctors are being widely developed and reported as the most promising mechanism for building alliances, providing financial rewards, and accessing new markets. However, joint ventures cannot be structured to involve an entire medical staff directly. Likewise, they cannot motivate a medical staff to change medical practice patterns in order to improve a hospital's reimbursement efficiency. This article describes a system of physician economic efficiency criteria that is being used by one hospital in making medical staff reappointment decisions and has the effect of placing all physicians at risk individually for the hospital's reimbursement performance. Although somewhat controversial, this economic efficiency program has proven a remarkably effective tool for change.

Documentation↗
PubMedDate not supplied

Program evaluation. Part 2: A responsive model proposal.

While program evaluation is necessary for understanding and improving educational programs in nursing, it is frequently surrounded by a climate of unease and perplexity. The first article (September/October 1990) in this two-part series reviewed models of program evaluation. This second article examines the state-of-the-art of program evaluation in nursing education and proposes implementation of a responsive model of evaluation in schools of nursing. The series aims to foster more dynamic, efficient program analysis, thereby enhancing the effectiveness of nursing education programs.

Education, Nursing↗
PubMed2002

Efficacy of preoperative donation of autologous blood in patients undergoing radical retropubic prostatectomy.

BACKGROUND: Radical retropubic prostatectomy (RRP) has resulted in substantial blood loss and the frequent need for homologous blood transfusion. In this study, the efficacy of autologous blood transfusion, from medical and financial perspectives, was evaluated in patients undergoing RRP. METHODS: Between 1994 and 2000, 80 patients with localized prostate cancer underwent RRP in our institute. Based on informed consent, preoperative donation of autologous blood (PDA) was performed in 65 out of 80 patienets. Four or six units were donated during the first 3 years; however, donation units were reduced to a maximum of 4 units since 1997 onwards. The discard rate of donated blood and frequency of homologous transfusion were examined. Changes of hematocrit (Ht) and hemoglobin (Hb) levels through donation and surgery and important factors that may affect postoperative levels of Ht and Hb were evaluated in 56 patients receiving 4-unit donations. RESULTS: Overall, 2 or 4 units of donated blood were discarded in four patients and homologous transfusion was required in two patients. In 56 patients receiving 4-unit donation, the mean Ht level at predonation was 43.3%. Following donation, this decreased to 35.7%. The administration of recombinant human erythropoietin (rHuEpo) relieved declining Ht levels following donation, but changes in Ht levels after surgery were minor. Important factors related to postoperative decline of Ht and Hb levels were operative time and blood loss. CONCLUSIONS: The program of 4-unit PDA can be performed safely without rHuEpo injection, and it is useful to reduce the risk of requiring homologous transfusion. However, more efficient programs to relieve patient burden and to reduce medical cost are needed.

Aged↗
PubMedDate not supplied

Fundamental elements of the quality of care: a simple framework.

This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.

Contraception↗
PubMed2026

Genome-wide association identifies and validates genomic region controlling grain yield and agronomic traits in extra-early orange maize inbred lines under drought.

In order to meet the expected maize yield by 2050, breeders must work to improve breeding program efficiency by intensifying the implementation of new and improved technologies such as marker-assisted selection (MAS). Dissecting the genomic regions associated with drought tolerance is the first step forward in MAS program deployment for maize improvement under drought stress. Genome-wide association studies (GWAS) were used to investigate and identify quantitative trait loci (QTLs) associated with six traits under drought stress. One hundred and eighty-seven extra-early orange maize inbred lines were evaluated under managed drought stress at Ikenne, in Nigeria, during the 2022 and 2023 dry seasons. The materials were also genotyped using 9355 DArTseq SNP markers and analyzed using the enriched compressed mixed linear model (ECMLM). Enriched compressed mixed linear model was used for association-trait analysis. The ECMLM-based GWAS identified 45 candidate genomic loci associated with the six traits, including five for grain yield, with R2 ranging from 8.79 to 25.3%. Independent validation using the multi-locus 3VmrMLM approach confirmed seven high-confidence genomic loci consistently detected by both methods across grain yield, anthesis-silking interval, ear aspect, and ears per plant, providing additional statistical support for these genomic regions. Candidate gene annotation identified biologically relevant genes underlying the validated loci, including Zm00001eb238250 (protein-serine/threonine phosphatase), Zm00001eb040940 (trehalose-phosphatase), Zm00001eb117820 (homeobox protein knotted-1-like 4), Zm00001eb145560 (zinc ion-binding protein), and Zm00001eb294180 (WRKY DNA-binding domain protein), suggesting their potential roles in drought adaptation and grain productivity. These findings improve our understanding of the genetic architecture of drought tolerance in extra-early orange maize and provide valuable genomic resources for accelerating drought-resilient maize breeding.

Zea mays↗