Search results for "Rationing"
showing 10 items of 33 documents
The European COVID-19 drugs calculation tool: an aid for the estimation of the drugs needed during the SARS-CoV 2 pandemic
2021
Objective To create an informatics supportive tool, which can assist healthcare professionals in estimating potential requirements for essential drug supplies to respond to the current SARS-CoV-2 pandemic based on epidemiological forecasting. Methods The tool was based on a Susceptible-Infected-Removed (SIR) epidemiological model in which the population is divided into three compartments and transmission parameters are specified to define the rate at which people move between stages. Appropriate data entry was guaranteed by the creation of structured guided paths. The drugs needed for the forecasted patients were estimated according to a list of critical care drugs compiled by consulting pr…
Learning from the past in the COVID-19 era: rediscovery of quarantine, previous pandemics, origin of hospitals and national healthcare systems, and e…
2020
Abstract After the dramatic coronavirus outbreak at the end of 2019 in Wuhan, Hubei province, China, on 11 March 2020, a pandemic was declared by the WHO. Most countries worldwide imposed a quarantine or lockdown to their citizens, in an attempt to prevent uncontrolled infection from spreading. Historically, quarantine is the 40-day period of forced isolation to prevent the spread of an infectious disease. In this educational paper, a historical overview from the sacred temples of ancient Greece—the cradle of medicine—to modern hospitals, along with the conceive of healthcare systems, is provided. A few foods for thought as to the conflict between ethics in medicine and shortage of personne…
Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): A case-series report
2020
Abstract Objective The impact of coronavirus disease 2019 (COVID-19) on the postoperative course of patients after cardiac surgery is unknown. We experienced a major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in our cardiac surgery unit, with several patients who tested positive early after surgery. Here we describe the characteristics, postoperative course, and laboratory findings of these patients, along with the fate of the health care workers. We also discuss how we reorganize and reallocate hospital resources to resume the surgical activity without further positive patients. Methods After diagnosis of the first symptomatic patient, surgery was suspended. Naso…
Multicentric evaluation of model for end-stage liver disease-based allocation and survival after liver transplantation in Germany - Limitations of th…
2010
Summary Since the introduction of model for end-stage liver disease (MELD) in 2006, post-orthotopic liver transplantation (OLT) survival in Germany has declined. The aim of this study was to evaluate risk factors and prognostic scores for outcome. All adult OLT recipients in seven German transplant centers after MELD implementation (December 2006–December 2007) were included. Recipient data were analyzed for their influence on 1-year outcome. A total of 462 patients (mean calculated MELD = 20.5, follow-up: 1 year) were transplanted for alcoholic cirrhosis (33.1%), hepatocellular carcinoma (26.6%), Hepatitis-C (17.1%), Hepatitis-B (9.5%), primary sclerosing cholangitis (5.6%) and late graft-…
The shaping of public economic discourse in postwar America: the 1947 meat shortage and Franco Modigliani's meat plan
2015
This paper discusses the American debate over price controls and economic stabilization after World War II, when the transition from a war economy to a peace economy was characterized by bottlenecks in the productive system and shortages of food and other basic consumer goods, directly affecting the living standard of the population, the public opinion, and political discourse. Specifically, we will focus on the economist Franco Modigliani and his proposal for a "Plan to meet the problem of rising meat and other food prices without bureaucratic controls." The plan prepared by Modigliani in October 1947 was based on a system of taxes and subsidies to foster a proper distribution of disposabl…
La diversificación y consolidación de los servicios sociales para las personas mayores en España y Suecia
2011
La información sobre los servicios públicos para las personas mayores a menudo se limita a la atención residencial y a la ayuda a domicilio. Sin embargo, estos servicios básicos son en muchos países complementados o sustituidos por otros servicios de menor envergadura, como el transporte, comidas a domicilio, teleasistencia y centros de día. Esta diversificación partió de un racionamiento de los servicios para lograr una asignación más racional de los recursos y, si se podía, un menor gasto. En este trabajo se utilizan diversos datos sobre estos servicios en España y Suecia. Cuando se consideran todos los cuidados, la cobertura de atención es mucho mayor que si sólo se contemplan los servic…
Value congruence in health care priority setting: social values, institutions and decisions in three countries
2014
AbstractMost developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at lar…
An ethical algorithm for rationing life sustaining treatment during the COVID-19 pandemic
2020
The burning ethical question raised by the COVID-19 pandemic is how to deal fairly and ethically with a large number of patients simultaneously becoming critically unwell. Across the world, in both developed and developing countries, health systems are grappling with the possibility or the reality that the demand for intensive medical care will outstrip availability. There is a need for ethical guidelines on how to allocate treatment, but such guidelines are potentially highly controversial.1 In this commentary, we set out a simple algorithm (Figure 1), including what we take to be the essential ethical principles that ought to guide resource allocation in any country or setting as well as …
Frictional and Non-Frictional Unemployment in a Labor Market with Matching Frictions
2016
Using the Mortensen and Pissarides model of a labor market with frictions, this paper proposes a new method, simpler than the one presented in Michaillat (2012), for decomposing unemployment into frictional and non-frictional (rationing) unemployment for a derived rigid wage-setting rule. We use it to compute the frictional and non frictional unemployment rate for two economies characterized by different labor market institutions, namely the US and the Spanish economy. For the entire period under study, the US frictional unemployment rate is around 36 per cent of total unemployment, whereas for Spain, approximately 20 per cent of all unemployment is due to frictions. This outcome may be exp…
The role of «perceived loss» aversion on credit screening: an experiment
2013
A major characteristic of credit markets is information asymmetry.To combat its problems, as credit rationing, principals can use a menu of contracts to screen clients with different risk level. We conduct a laboratory experiment to address an important question for such settings —does the framing of the offered menu of contracts interfere with the self-selection mechanism? The answer is yes. We find subjects' choices shift when the same (positive) outcomes of the same menu of contracts are presented in two different frames. Subjects exhibit loss aversion in their perception of the positive outcomes below the reference point, and self-selection fails to occur. Uno de los mayores problemas a…