Measure Of Effectiveness Research Articles

Analysis Of The Application Of Electronic Medical Record In RUMKITAL Dr. Mintohardjo With The Measures Of Effectiveness Method

The phenomenon of the industrial revolution 4.0 accompanied by the rapid development of information technology has had a positive impact on the development of hospital management information systems. Currently, manual medical records are deemed no longer effective in relation to the community's need for quality, fast, precise, accurate and complete health services. Electronic Medical Record enables service providers to track patient data more quickly, identify visits, prevent and screen, help diagnose and manage disease so as to improve the quality of health services. This research was conducted to measure the effectiveness of the application of the Electronic Medical Record in Rumkital Dr. Mintohardjo by measuring the data input component, data integration and data security is assessed from the Usability, Flexibility and Efficiency of each component. Data collection was obtained from interviews and questionnaires from informants and respondents, namely officials and health workers at Dr. Rumkital. Mintohardjo regarding the application of Electronic Medical Records. The data obtained were then processed using the Measures of Effectiveness (MoE) method to measure the effectiveness of the application of the Electronic Medical Record. The hypothesis of this research is that the more effective the application of the Electronic Medical Record, the higher the quality of health services at Dr. Hospital. Mintohardjo and proven through data processing using the Measures of Effectiveness method. This study found the results that the effectiveness of the application of the Electronic Medical Record in Rumkital Dr. Mintohardjo has an MoE value of 0.676, it is included in the effective category.
 
 Keywords Electronic Medical Record, Measures Of Effectiveness, Rumkital Dr Mintoharjo

(268) Intracavernous Prostaglandin Injection as a Predictor and Effectiveness Measure for LISWT Sessions in ED Patients: A Single Urologist's Experience

Abstract Introduction In recent years, therapeutic approaches for treating vasculogenic Erectile Dysfunction (ED) have evolved, with Low Intensity Shock Wave Therapy (LISWT) emerging as a promising modality. Objective To objectively evaluate the efficacy of LISWT for ED patients and to predict the required number of sessions, we examined the effects of administering up to 10 mcg of intracavernous alprostadil injections both before and after treatment Methods 85 vasculogenic ED patients (Average age: 57); 33 with mild to moderate ED and 52 with moderate or severe ED. Intracavernous injection (ICI) of ≤10 mcg of alprostadil was given before LISWT and one month post-treatment. Depending on ICI response, patients underwent either six (Erection Hardness Score (EHS) ≤3) or four (EHS=4) weekly LISWT sessions using PiezoWave2 from Richard WOLF. LISWT Parameters: 0.16mj/mm2 energy flux density, 8 Hz frequency, 10mm wave focus penetration depth, and 6000 shocks per session distributed among the two crura of the penis (2000 shocks), dorsum penis (2000 shocks), and lateral penis (2000 shocks). Results 33 patients showed a robust response to the 10mcg ICI and were treated with four LISWT sessions. 52 patients exhibited a partial response to the 10mcg ICI, necessitating six LISWT sessions. 78.6% (26 out of 33) of the patients who initially responded well to 10 mcg ICI had a consistent response to 8 mcg ICI; 63.6% (33 out of 52) of those with a partial initial response to 10 mcg ICI demonstrated an improved reaction to the same dosage post-treatment (table 1) (fig. 1). No complications were reported from the ICI. Conclusions Intracavernous prostaglandin injection can serve as a predictor for the required number of LISWT sessions and can objectively gauge the treatment's effectiveness in ED patients. Further randomized studies, incorporating parameters such as EHS, IIEF, and the ICI dosage, are recommended to validate this method's feasibility Disclosure No.

Examining the influence of item exposure and retrieval practice effects on test performance in a large‐scale workforce development training programme

AbstractMany workforce development training programmes use learning gains as a measure of programme effectiveness. However, research on K‐12 education suggests that posttest scores may be influenced by pretesting effects. Pretesting may improve posttest performance by giving learners preknowledge of posttest content. Alternatively, pretesting may enhance learning via the retrieval practice effect. Cross‐classified analysis was used to detect pretesting effects in archival data from a large‐scale agriculture workforce development programme. Data included scores from 14,302 learners, 352 trainers and 261 training centres. Results indicated that pretesting led to higher scores on posttests. Follow‐up logistic regression analyses found no effect for time lag between pretest and posttest. In addition, pretested learners did not perform better on items that were included on both forms, suggesting that score differences were due to retrieval practice effects rather than preknowledge of posttest content. These results provide evidence that pretesting may enhance learning in large‐scale workforce development training courses.

From text to effectiveness: Quantifying green industrial policies in China

The evolution of green industrial policy in China is deeply embedded within a unique political, economic, cultural, and social milieu. The intricacies and complexities inherent in this context present challenges for quantitative policy research. In the existing literature, the study of thematic clustering of green industry policy instruments and their effectiveness measures in large-scale policy text repositories remains a relatively unexplored area. To fill this research gap, this study provides an analysis of China's green industrial policies from 1994 to 2022. By adopting the Latent Dirichlet Allocation (LDA) topic model, implicit and optimal themes are identified, and key policy instruments are systematically and comprehensively parsed. Based on this, the cutting-edge Policy Modeling Consistency-Text Encoder (PMC-TE) index model was used to conduct an in-depth quantitative evaluation of various policy tools. The findings reveal 15 policy instruments from 7891 Chinese green industry policy documents. Notably, technical support, information resource demonstration project policies emerged as the most frequently deployed and efficacious. Conversely, government procurement and service outsourcing policies, while showing incremental growth year-on-year, lagged in utilization and effectiveness. These policy instruments can be broadly categorized into three primary archetypes: supply-type, demand-type, and environment-type. The supply-type instruments dominate, while environment-type instruments remain underutilized. Additionally, this study delineates the four chronological phases of China's green industrial policy evolution, illuminating China's strategic pivots-transitioning from resource allocation, to market dynamics, and ultimately to environmental governance trajectories.

Cost-effectiveness analysis of margin-controlled surgery for vulvar Paget’s disease

ObjectivesTo determine the cost of two surgical treatment approaches for vulvar Paget’s disease and model the cost-effectiveness considering differences in recurrence and reoperation over time. MethodsWe assessed cost-effectiveness between excision guided by Mohs micrographic surgery (MMS-E) and traditional wide local excision (WLE). We examined billing data from patients with vulvar Paget’s disease who underwent MMS-E (cases, n = 24, 2018–2022) or WLE (controls, n = 64, 1990–2020). We created typical treatment bundles incorporating physician-administered services and facility costs standardized to Medicare reimbursements in 2022 United States Dollars (USD). The primary measure of effectiveness was disease-free years of life. A secondary analysis estimated quality-adjusted life years (QALY). A Markov model simulated treatment pathways over a 10-year time horizon. Transition probabilities were based on institutional recurrence rates (3-year RR 6.7 % for MMS-E vs 34.1 % for WLE). We used a willingness-to-pay threshold of 100,000 USD per QALY. ResultsThe cost of a single surgical episode was 34,664 USD for MMS-E and 14,969 USD for WLE. In the setting of lower recurrence rates with MMS-E, the incremental cost was 12,789 USD per disease-free year gained. A secondary analysis incorporating QALY showed an incremental cost of 72,820 USD per QALY. ConclusionsMMS-E appears to be a cost-effective treatment for vulvar Paget’s disease compared to historic standard of care. Our ability to estimate quality of life gained by avoiding disease recurrence was limited by scant data for this rare condition; thus, future studies incorporating health utility values are needed to facilitate a more comprehensive analysis.

Verification of the Applicability of Obstacle Recognition Distance as a Measure of Effectiveness of Road Lighting on Rainy and Foggy Roads

Adverse weather conditions at night are very fatal to drivers, causing serious traffic accidents. Road lighting is a facility that can alleviate these dangerous situations. Nevertheless, road lighting has only rarely been studied during adverse weather. The reason is that the current road lighting performance evaluation method is presented based on normal weather. The current road lighting performance evaluation method uses a luminance meter to measure the road surface, which is not suitable due to scattering during adverse weather such as rain and fog. Therefore, this study proposes obstacle recognition distance as a measure of effectiveness to evaluate the performance of road lighting during adverse weather. There is a lack of actual research on whether obstacle recognition distance can be used as a measure of effectiveness for road lighting during adverse weather. Therefore, in this study, 30 subjects were used to measure the subjects’ obstacle recognition distance according to changes in weather conditions, road lighting grade, and road lighting color temperature. As a result, it was analyzed that there was a clear trend of change in obstacle recognition distance depending on the change in each condition. It was found that, under the same road lighting performance conditions, there was a difference of up to 72.86% by weather condition; under the same weather conditions, there was a difference of up to 22.75% by road lighting grade; and by color temperature, there was a difference of up to 21.87%. In addition, a statistical significance test was performed to support the existence of a difference, and the results were synthesized to suggest that obstacle recognition distance can be used as a performance measure of effectiveness of road lighting in adverse weather.

Impact of the COVID-19 vaccination campaigns in Argentina during 2021: An observational quantification of the death probability for confirmed cases in Buenos Aires province

BackgroundA SARS-CoV-2 (COVID-19) vaccination campaign was launched in Argentina in January 2021. The vaccines then available were administered to the population in several different schemes. This observational study presents a quantification of the impact of the different schemes on the probability of death for confirmed COVID-19 cases in Argentina's Buenos Aires Province. The results provide a local measure of the schemes' effectiveness that heretofore has been lacking. MethodsThe study's main source of information is the Integrated Health Information System database, which contains 1,538,113 records of confirmed SARS-CoV-2 (COVID-19) cases reported in 2021 in the Province. To assess the real-world effectiveness of the vaccination campaign, two categorical variables representing vaccination status were defined. Probability of death was formulated as a generalized linear model with a logistic link and includes variables for geography, a socio-economic level index, symptom onset, sex, and vaccination status. The effectiveness level was derived from the death probability estimates. FindingsThe study's findings indicated that the most effective vaccine was rAd26-rAd5 (Sputnik), with ChAdOx1-S (AZ/Covishield) and BBIBP-CorV (Sinopharm) following in efficacy, for both single and multiple doses. The effectiveness of a single dose was consistently below 50%, while it ranged from 50% to 90% for two or more doses. Notably, the analysis of variables such as the municipality of residence of the infected persons and the season of symptom onset yielded particularly intriguing insights. The socioeconomic level of a municipality emerged as a moderately strong predictor of the probability of death, which was marginally higher in municipalities with lower-income populations. Additionally, the data revealed an increased probability of death during the winter season. InterpretationThe vaccination campaigns carried out in Buenos Aires Province in 2021 significantly contributed to reducing the number of deaths due to SARS-CoV-2 (COVID-19) among its population. However, the extent of this impact varied considerably depending on individual characteristics such as age, health status, and vaccination schedule adherence.

Implementation and Impact of Perinatal Food Is Medicine Programs: A Qualitative Research Study

BackgroundImproving social determinants of health, such as access to nutritious food, is crucial for achieving health equity. Nutrition insecurity, especially during pregnancy and postpartum, can lead to poor maternal and birth outcomes. Food is Medicine (FIM) programs, which integrate food into the health care system to prevent or manage disease, have the potential to improve nutrition insecurity, but research about perinatal FIM programs is limited. ObjectiveThe purpose of this study was to explore perceptions of public health impacts of perinatal FIM programs from the perspectives of both program implementers and program supporters and implementation strategies used to enhance program adoption, implementation, and maintenance. DesignQualitative data were collected through semi-structured interviews. The interview guide was based on the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. Participants/settingProgram implementers (n = 16) and program supporters (n = 20) were recruited across the United States through purposive sampling in 2022 and 2023. AnalysisData were analyzed using deductive thematic analysis and an iterative feedback loop with the project partner. ResultsInterviews were completed with program implementers and program supporters and generated meaning units (n = 1,942), which were coded into themes aligned with each Reach, Effectiveness, Adoption, Implementation, Maintenance dimension. Perinatal FIM programs reached multiple priority populations who were mainly recruited through health care systems. Effectiveness measures typically included nutrition patterns and practices, as well as return on investment. Motivations for adopting programs primarily included partnerships and connections, financing, and policies and laws. Program components varied and were adapted to meet participants and setting needs. Policy, evidence, funding, and partnerships could lead to program maintenance. Implementation strategies applied by the program supporters included financial strategies and infrastructure changes. ConclusionsThere is a need to identify the core functions and adaptable forms of perinatal FIM programs, which could lead to identification of standard evaluation metrics. This could result in greater uptake by potential delivery agents, increased funding and policy support, and enhanced benefits for perinatal population experiencing health disparities.

The Drucker indexes and profitability: a first look

AbstractThe Drucker Institute has computed metrics regarding customer satisfaction, employee engagement and development, innovation, social responsibility, and financial strength. They currently track 902 firms, and the Wall Street Journal annually publishes the Drucker 250—the top 250 firms based on an overall effectiveness measure. This paper offers the first analysis of whether these indexes can explain differences in the economic performance of business firms. The two main conclusions of our analysis are first, the individual aspects of the Drucker indexes do not always positively impact profit, and second, the impacts differ across industries. Our analysis concludes with possible reasons for the poor results and suggestions for future research.

Measuring Effectiveness of Islamic Studies Distance Education in The Digital Era at The International Open University (IOU) Indonesia

International Open University (IOU) is an international accredited campus that created new breakthrough by offering the concept of distance education since its inception. IOU is a pioneer in implementing distance learning with a concentration on Islamic Studies through digital media. Entering Indonesia as the country with the largest Muslim population, IOU opened a special Indonesian language program. This study is a form of Measures of Effectiveness (MOE) of Islamic Studies distance education through digitalization at the IOU Indonesia. The method used in this research is descriptive qualitative. The data collection techniques used were observations, interviews, and literature review. The results of the study concluded that IOU Indonesia in some cases has its own independent program, but in general it is based on the central that has all the components of distance education through digitalization except for controls for students or graduates. IOU Indonesia also fulfills the basic principles of learning Islamic Studies.

Cost-effectiveness of Dementia Medication

Aim:: This review has examined and organized the available research on dementia medication care costs. Although the accessible database in this area is growing and is still quite limited, there are many clear scientific methods. Objective:: The use of Memantine, a non-competitive antagonist with low to moderate affinity for the NMDA (N-methyl-D-aspartate) receptor, has been approved for the treatment of mild to moderately severe Alzheimer's disease (AD). The efficacy of cholinesterase inhibitors (ChEIs) in the treatment of dementia varies depending on the drug type and ease of administration. Numerous techniques have been employed to evaluate the quality of life (QOL) of individuals suffering from dementia. QOL data is a well-established measure of an intervention's effectiveness. Up to now, cost-effectiveness studies have concentrated on both pharmaceutical and non-pharmacological therapy. Each unit of QoL-AD improvement costs USD27.82578 at mean values. Methods:: Searches were conducted to observe studies of the pharmacoeconomic impact of dementia medications with the help of previous articles published in journals and collected from Google Scholar with name search dementia or Alzheimer's cross-referenced with pharmacoeconomic or costs and effectiveness.

The Effectiveness of the Regional Regulation Formation Agency in Producing Initiative Regional Regulations

This research aims to analyze the effectiveness of the Regional Regulation Formation Agency in Producing Initiative Regional Regulations in the DPRD of North Sulawesi. This research uses the theory of Richard M. Steers with measures of effectiveness, namely goal achievement, integration and adaptation. This research used a qualitative descriptive method with 4 informants consisting of the deputy chairman of the DPRD of North Sulawesi, the chairman of BAPEMPERDA (Regional Regulation Establishment Agency), members of BAPEMPERDA, and BAPEMPERDA staff. The results of this research show that the performance of BAPEMPERDA is still not optimal, seen from the lack of effectiveness in making regional regulations, to the point that they do not reach directly to the community. Based on research findings, several things that need to be suggested to the DPRD (Regional People's Representative Council), especially BAPEMPERDA North Sulawesi, are the need for commitment from DPRD members so that a regional regulation can be effective, not only in terms of quality, but can be felt by the constituents, namely the community.

A practical method for assessing sustainable traffic levels of roundabouts in urban areas using the macroscopic fundamental diagram

In traffic engineering, queue lengths, waiting times, and delay values are denoted as measures of effectiveness (MOEs). In the case of roundabouts, MOEs are generally calculated starting from the gap-acceptance theory in which the driver behaviour needs to be properly modelled. This research presents an unconventional technique, based on Macroscopic Fundamental Diagrams (MFDs), to describe sustainable traffic levels and (MOEs) of roundabouts, in terms of capacity, speed, density and delay. The deduction of MFDs is based on relatively simplified theoretical hypotheses, but the outcomes could be of interest in several practical applications. MFDs are estimated in the cases of single and double-lane roundabouts, modelled by microscopic simulations starting from a real-world case study in Italy. MFDs are obtained for a wider sample size of origin-destination traffic matrices taking into consideration time intervals of 5 min and 1 h. The results of this research demonstrate that the traffic distribution between arms can influence the shape of a roundabout-MFD. However, the proposed procedure allows us to evaluate the performance of a roundabout as a whole, taking into account numerous MOEs including the total capacity, the critical density and the Level of Service (LOS). Therefore, the use of MFDs could represent a complementary procedure for evaluating the performance of roundabouts.

Evaluation of the effectiveness of the Indian government’s policies to strengthen health warning labels on smokeless tobacco products: findings from the 2010–2019 Tobacco Control Project India Surveys

BackgroundSmokeless tobacco (SLT) packaging in India had a single symbolic (a scorpion) health warning label (HWL) in 2009 covering 40% of the front surface. In 2011, it was replaced with...

Fuzzy logic in association rule mining: limited effectiveness analysis

ABSTRACT This paper presents a comparative effectiveness analysis of fuzzy and non-fuzzy association rule mining (ARM). The corresponding motivation is the lack of relevant papers devoted to the effectiveness comparison between fuzzy and non-fuzzy ARM. The current research applies the results of fuzzy/non-fuzzy ARM to associative classification and uses the classification accuracy of the corresponding classifiers as the effectiveness measure. The research demonstrates that basic effectiveness comparison between fuzzy and non-fuzzy ARM does not necessarily speak in favour of fuzzy ARM. However, then the research demonstrates that fuzzy ARM has a distinctive ability to handle data inconsistencies, which results in the ability of corresponding fuzzy classifiers to not only provide class predictions but also indicate their certainty in the provided output. The research reveals some distinct correlation between classification accuracy and the degree of certainty in fuzzy associative classification: the greater certainty nearly always results in the better classification accuracy. This ability of fuzzy associative classifiers to indicate their certainty in the performed classification and the corresponding ability of fuzzy ARM to handle data inconsistencies are not applicable in non-fuzzy associative classifiers and ARM. Therefore, these abilities are used in the paper to substantiate the relevance of applying fuzzy logic in ARM.

Prospects for online adaptive radiation therapy (ART) for head and neck cancer

BackgroundThe aim of the present study is to examine the impact of kV-CBCT-based online adaptive radiation therapy (ART) on dosimetric parameters in comparison to image-guided-radiotherapy (IGRT) in consecutive patients with tumors in the head and neck region from a prospective registry.MethodsThe study comprises all consecutive patients with tumors in the head and neck area who were treated with kV-CBCT-based online ART or IGRT-modus at the linear-accelerator ETHOS™. As a measure of effectiveness, the equivalent-uniform-dose was calculated for the CTV (EUDCTV) and organs-at-risk (EUDOAR) and normalized to the prescribed dose. As an important determinant for the need of ART the interfractional shifts of anatomic landmarks related to the tongue were analyzed and compared to the intrafractional shifts. The latter determine the performance of the adapted dose distribution on the verification CBCT2 postadaptation.ResultsAltogether 59 consecutive patients with tumors in the head-and-neck-area were treated from 01.12.2021 to 31.01.2023. Ten of all 59 patients (10/59; 16.9%) received at least one phase within a treatment course with ART. Of 46 fractions in the adaptive mode, irradiation was conducted in 65.2% of fractions with the adaptive-plan, the scheduled-plan in the remaining. The dispersion of the distributions of EUDCTV-values from the 46 dose fractions differed significantly between the scheduled and adaptive plans (Ansari-Bradley-Test, p = 0.0158). Thus, the 2.5th percentile of the EUDCTV-values by the adaptive plans amounted 97.1% (95% CI 96.6–99.5%) and by the scheduled plans 78.1% (95% CI 61.8–88.7%). While the EUDCTV for the accumulated dose distributions stayed above 95% at PTV-margins of ≥ 3 mm for all 8 analyzed treatment phases the scheduled plans did for margins ≥ 5 mm. The intrafractional anatomic shifts of all 8 measured anatomic landmarks were smaller than the interfractional with overall median values of 8.5 mm and 5.5 mm (p < 0.0001 for five and p < 0.05 for all parameters, pairwise comparisons, signed-rank-test). The EUDOAR-values for the larynx and the parotid gland were significantly lower for the adaptive compared with the scheduled plans (Wilcoxon-test, p < 0.001).ConclusionsThe mobile tongue and tongue base showed considerable interfractional variations. While PTV-margins of 5 mm were sufficient for IGRT, ART showed the potential of decreasing PTV-margins and spare dose to the organs-at-risk.

Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis.

The application of antiseptic skin agents prior to incision minimizes the rate of surgical site infection. Despite their ubiquity, the optimal skin preparation agent remains uncertain. A retrospective economic analysis was conducted to complement the results from the NEWSkin Prep trial which prospectively compared three preparation agents. A cost and cost-effectiveness analysis was performed from a healthcare service perspective to compare chlorhexidine with 70% ethanol, and aqueous povidone-iodine, against povidone-iodine with 70% ethanol. Resource use estimates accounted for hospital admissions, readmissions associated with surgical site infection, outpatient and general practitioner attendances, visits from community nurses and therapeutic consumables. The measure of effectiveness comprised the net difference in number of patients with surgical site infections per 1000 patients. Costs were compared using a two-sample Welch's t-test. Deterministic and probabilistic sensitivity analyses were performed to evaluate the incremental cost-effectiveness ratio. The null hypothesis that the mean costs for the trial arms were significantly different was not rejected (Welch's t-test P value: 0.771 for chlorhexidine with 70% ethanol against povidone-iodine with 70% ethanol; and 0.955 for aqueous povidone-iodine against povidone-iodine with 70% ethanol). Based on bootstrap averages, the chlorhexidine with 70% ethanol intervention generated 8.0 fewer surgical site infections per 1000 patients and net cost savings of €151,698 (Euros) per 1000 patients compared with povidone-iodine with 70% ethanol, and aqueous povidone-iodine produced a net cost saving of €37,494 per 1000 patients but generated an additional 11.6 surgical site infections per 1000 patients compared with povidone-iodine with 70% ethanol. The comparison of chlorhexidine with 70% ethanol to povidone-iodine with 70% ethanol was sensitive to the inclusion of cost outliers, while the comparison of aqueous povidone-iodine to povidone-iodine with 70% ethanol was sensitive to the estimated cost per surgical site infection. Based on the outcomes from the NEWSkin Prep study, this economic analysis found no definitive evidence in favour of any one of the study comparators. Future model-based economic analyses of alternative skin preparations should critically address the quality of evidence and integrate the results from the NEWSkin Prep study.

Analyses of patients who self-administered diazepam nasal spray for acute treatment of seizure clusters

For acute treatment of seizure clusters in patients with epilepsy, intranasal administration of acute seizure therapies has been shown to provide accessibility and ease of use to care partners as well as the potential for self-administration by patients. Diazepam nasal spray (Valtoco®) was approved by the US Food and Drug Administration for acute treatment of intermittent, stereotypic episodes of frequent seizure activity (ie, seizure clusters, acute repetitive seizures) in patients with epilepsy aged ≥6 years. Self-administration consistent with the prescribing information is feasible and was reported by a subgroup of patients (n = 27 of 163) in a long-term phase 3 safety study. Data regarding self-administration among these patients with seizure clusters are examined here to explore the safety profiles and measures of effectiveness, as well as the quality of life of those who self-treated. In addition, this focused look at patients who self-administered diazepam nasal spray may offer some insights into the characteristics of patients who may be appropriate for self-administration.

Cost-effectiveness analysis of hospital treatment volume and survival outcomes in endometrial cancer in Japan.

Hospital treatment volume affects survival in patients with endometrial cancer; notably, initial treatment at high-volume centers improves survival outcomes. Our study assessed the effect of hospital treatment volume on cost-effectiveness and survival outcomes in patients with endometrial cancer in Japan. A decision-analytic model was evaluated using the following variables and their impact on cost-effectiveness: 1) hospital treatment volume (low-, intermediate-, and high-volume centers) and 2) postoperative recurrent risk factors based on pathological findings (high- and intermediate-risk or low-risk). Data were obtained from the Japan Society of Obstetrics and Gynecology database, systematic literature searches, and the Japanese Diagnosis Procedure Combination database. Quality-adjusted life years (QALY) was used as a measure of effectiveness. The model was built from a public healthcare perspective and the impact of uncertainty was assessed using sensitivity analyses. A base-case analysis showed that the incremental cost-effectiveness ratio at high-volume centers was below a willingness-to-pay (WTP) threshold of ¥5,000,000 with a maximum of ¥3,777,830/4.28 QALY for the high- and intermediate-risk group, and ¥2,316,695/4.57 QALY for the low-risk group. Treatment at the high-volume centers showed better efficiency and cost-effectiveness in both strategies compared to intermediate- or low-volume centers. Sensitivity analyses showed that the model outcome was robust to changes in input values. With the WTP threshold, treatment at high-volume centers remained cost-effective in at least 73.6% and 78.2% of iterations for high- and intermediate-risk, and low-risk groups, respectively. Treatment at high-volume centers is the most cost-effective strategy for guiding treatment centralization in patients with endometrial cancer.

A Study on the Effectiveness and Efficiency of Public or Private Hospitals within Pakistan

Hospitals play a very important role in human lives. People are in search of quality and timely healthcare facilities. This paper talks about the efficiency and effectiveness of healthcare services. One needs to identify the factors and mechanisms to enhance the performance of government and private hospitals. This study aims to find the important variables that were required to find the best solution for public and private hospitals in Pakistan. The major contributions of the paper are as follows. The paper first deliberates on the need for technical excellence as compared to interpersonal excellence for hospital management. It also performs a qualitative review of the literature on the important variables for determining the effectiveness and efficiencies of the hospital. Then, the paper presents a public survey about the effectiveness and efficiency of public and private hospitals using different questionnaires. These questionnaires were filled by the relatives of patients or patients themselves when they visited hospitals. On this dataset, the paper applies a machine learning algorithm i.e., random forest, to predict which hospital type is suitable for them while considering the variables. These variables include; the services of the hospital, admission process, treatment, doctor's behavior, timely treatment, and knowledge of the staff about SOPs. The data was split into 75 % training and 25 % testing dataset. Python’s Library SK-learn was used for implementation. The accuracy of the classifier on the test dataset is 96.91 %. The paper then determines the variables that are contributing the most to the measure of effectiveness and efficiencies of hospitals. The algorithm also ranks these features that can be used to improve a hospital's performance. It also provides a benchmark to the patients in the selection of hospitals for healthcare facilities.