Inappropriate Allocation Research Articles

Learning Automata-Based Methodology for Optimal Allocation of Renewable Distributed Generation Considering Network Reconfiguration

The inadequate capacity of distribution networks to consume renewable energy and the inappropriate allocation of renewable distributed generation (RDG) have become important issues. In this paper, a 3-level learning automata-based methodology in a master—slave structure is proposed for optimal RDG siting and sizing considering network reconfiguration. The RDG allocation optimization, i.e., the master problem, is proposed in the first level, with the objective of minimizing the annual investment cost and operation cost. Network reconfiguration is modeled as a slave problem in the second level to promote the consumption of RDG and decrease the operation cost. The RDG power control strategy, including active power curtailment and reactive power compensation, is introduced as a secondary slave problem in the third level. Considering the stochastic characteristics of renewable energy and loads, intelligent algorithms based on learning automata are proposed and embedded into the master—slave structure. The simulation results on the standard test systems demonstrate the feasibility and effectiveness of proposed method.

Utility of preclinical drug versus food choice procedures to evaluate candidate medications for methamphetamine use disorder.

Substance use disorders are diagnosed as a manifestation of inappropriate behavioral allocation toward abused drugs and away from other behaviors maintained by more adaptive nondrug reinforcers (e.g., money and social relationships). Substance use disorder treatment goals include not only decreasing drug-maintained behavior but also promoting behavioral reallocation toward these socially adaptive alternative reinforcers. Preclinical drug self-administration procedures that offer concurrent access to both drug and nondrug reinforcers provide a translationally relevant dependent measure of behavioral allocation that may be useful for candidate medication evaluation. In contrast to other abused drugs, such as heroin or cocaine, preclinical methamphetamine versus food choice procedures have been a more recent development. We hypothesize that preclinical to clinical translatability would be improved by the evaluation of repeated pharmacological treatment effects on methamphetamine self-administration under a methamphetamine versus food choice procedure. In support of this hypothesis, a literature review suggests strong concordance between preclinical pharmacological treatment effects on methamphetamine versus food choice in nonhuman primates and clinical medication treatment effects on methamphetamine self-administration in human laboratory studies or methamphetamine abuse metrics in clinical trials. In conclusion, this literature suggests preclinical methamphetamine versus food choice procedures may be useful in developing innovative pharmacotherapies for methamphetamine use disorder.

Are Long-Run Effects from Oil and Gas Disturbances Different? Insights for Trinidad and Tobago

This paper answers two primary questions on Trinidad and Tobago’s economy: (1) How long are the effects from oil and gas disturbances on the economy? (2) How do the long-run effects from oil and gas disturbances differ within the economy? Trinidad and Tobago was ideal for this investigation due to its well-developed gas and oil exploration infrastructure. To achieve this task an estimation of a VECM model, with cointegration restrictions based on a long-run macroeconomic model were conducted. Benchmark analysis was performed that compared VECM against traditional time series models showing the benefits of utilizing cointegration relationships that were embedded within the data. In addition to teasing out the long-run effects of oil and gas disturbances, a SVEC model was estimated. It was found that there was a clear distinction between oil and gas disturbances with oil shocks being larger in magnitude and duration. Also, disturbances had opposing dynamics on CPI, interest rate, inflation and narrow money velocity, but were positively correlated with the effective real exchange rate in the long- run. These findings are important; because, without them it is probable that a wrong policy mix or inappropriate portfolio allocation would be performed, resulting in a sub-optimal result.

Early Detection of Disseminated Intravascular Coagulation During Septic Shock: A Multicenter Prospective Study.

Inadequate stratification of septic shock patients may result in inappropriate treatment allocation in randomized clinical trials, especially regarding anticoagulant. We previously reported that endothelial-derived microparticles are relevant biomarkers of sepsis-induced disseminated intravascular coagulation. In this validation cohort, we assess microparticles as surrogates of cell activation to improve early disseminated intravascular coagulation diagnosis and patient stratification. Prospective observational study in septic shock patients. Four medical ICUs in university hospitals. Two hundred sixty-five patients with septic shock from four ICUs were consecutively enrolled. Disseminated intravascular coagulation was diagnosed according to Japanese Association for Acute Medicine 2006 score. Endothelial- and leukocyte-derived circulating procoagulant microparticles were isolated and quantified by prothrombinase assay at admission, day 3, and day 7. None. Two hundred fifty-nine patients were analyzed. Sixty-one had disseminated intravascular coagulation at admission, and 32 developed disseminated intravascular coagulation during the first 24 hours after admission. Multiple logistic regression model confirmed that endothelial cell-derived microparticles were associated with disseminated intravascular coagulation: CD105-microparticles (odds ratio, 2.13) and CD31-microparticles (odds ratio, 0.65) (p < 0.05). Furthermore, CD11a-microparticles to leukocyte ratio evidenced leukocyte activation (odds ratio, 1.59; p < 0.05). Prediction of disseminated intravascular coagulation was also analyzed after exclusion of patients with disseminated intravascular coagulation at admission. A new multiple logistic regression analysis demonstrated the association of CD105-microparticles (> 0.60 nM eq. PhtdSer; odds ratio, 1.67; p < 0.01), platelets count (≤ 127 g/L; odds ratio, 0.99; p < 0.01), and prothrombin time (≤ 58%; odds ratio, 0.98; p < 0.05) with disseminated intravascular coagulation. A combining score at admission is predictive of the absence of disseminated intravascular coagulation (area under the curve, 72.9%; specificity, 71.2%; sensitivity, 71.0%, with a negative predictive value of 93.1% and a positive predictive value of 31.0%). Procoagulant microparticles from endothelial cells and leukocytes reflect a vascular injury during sepsis-induced disseminated intravascular coagulation that precedes obvious activation of coagulation. A combination of prothrombin time, endothelium-derived CD105-microparticles, and platelet count at admission could predict the absence of disseminated intravascular coagulation and allow a better stratification in future randomized clinical trials.

Ergonomic Redesign of an Industrial Control Panel.

Operator's role in industrial control centers takes place in time, which is one of the most important determinants of whether an expected action is going to be successful or not. In certain situations, due to the complex nature of the work, the existing interfaces and already prepared procedures do not meet the dynamic requirements of operator's cognitive demands, making the control tasks unnecessarily difficult. This study was conducted to identify ergonomic issues with a specific industrial control panel, and redesign its layout and elements to enhance its usability. Task and link analysis methodologies were implemented. All essential functions and supporting operations were identified at the required trivial levels. Next, the weight of any possible link between the elements of the panel was computed as a composite index of frequency and importance. Finally, all components were rearranged within a new layout, and a computerized mockup was generated. A total of 8 primary tasks was identified, including 4 system failure handling tasks, switching between manual and automated modes, and 3 types of routine vigilance and control tasks. These tasks were broken down into 28 functions and 145 supporting operations, accordingly. Higher link values were observed between hand rest position and 2 elements. Also, 6 other components showed robust linkages. In conclusion, computer modeling can reduce the likelihood of accidents and near misses in industrial control rooms by considering the operators' misperception or mental burden and correcting poor design of the panels and inappropriate task allocation.

Palliative systemic therapy for advanced non-small cell lung cancer: Investigating disparities between patients who are treated versus those who are not

BackgroundPalliative systemic therapy (ST) in advanced non-small cell lung cancer (NSCLC) is associated with improved overall survival (OS) and quality of life, yet many patients remain untreated. We explored differences between patients who did and did not receive palliative ST in order to gain evidence to support and advocate for the untreated. MethodsWe performed a retrospective analysis of newly diagnosed patients with advanced, incurable NSCLC seen as outpatients at our institution between 2009 and 2012. Demographics, treatment, and survival data were collected. Results528 patients were seen: 291 (55%) received palliative ST, while 237 (45%) received none. Demographics were as follows: Median age 67, 55% male, 50% ECOG performance status (PS) 0–1, 48% with weight loss. Untreated patients were older (median 71 vs. 64, p<0.01), less fit (PS 0–1 in 27% vs. 69%, p<0.01), and more likely to have lost weight (57% vs. 41%, p<0.01). Reasons for no treatment included poor PS (67%) and patient choice (23%). Median OS was shorter amongst untreated patients (3.9 vs. 10.7 months, HR 1.80 [95% CI 1.4–2.3], p<0.01). In multivariate analysis, not receiving ST was associated with shorter OS. ConclusionUnsurprisingly, untreated patients had poorer prognostic features and worse OS. However, it is concerning that, despite being seen in an active academic center, nearly half of all referred patients with advanced NSCLC received no anti-cancer treatment. Current research primarily seeks to improve outcomes in treated patients with good PS. This review suggests that this is an inappropriate allocation of research effort. Our research should be more equitably split between good and poor performance patient groups if we are to improve the survival of all patients with advanced NSCLC. Potential strategies include more rapid diagnosis prior to functional decline, and the development of therapies effective and tolerated in a sicker population.

Developing Subdomain Allocation Algorithms Based on Spatial and Communicational Constraints to Accelerate Dust Storm Simulation.

Dust storm has serious disastrous impacts on environment, human health, and assets. The developments and applications of dust storm models have contributed significantly to better understand and predict the distribution, intensity and structure of dust storms. However, dust storm simulation is a data and computing intensive process. To improve the computing performance, high performance computing has been widely adopted by dividing the entire study area into multiple subdomains and allocating each subdomain on different computing nodes in a parallel fashion. Inappropriate allocation may introduce imbalanced task loads and unnecessary communications among computing nodes. Therefore, allocation is a key factor that may impact the efficiency of parallel process. An allocation algorithm is expected to consider the computing cost and communication cost for each computing node to minimize total execution time and reduce overall communication cost for the entire simulation. This research introduces three algorithms to optimize the allocation by considering the spatial and communicational constraints: 1) an Integer Linear Programming (ILP) based algorithm from combinational optimization perspective; 2) a K-Means and Kernighan-Lin combined heuristic algorithm (K&K) integrating geometric and coordinate-free methods by merging local and global partitioning; 3) an automatic seeded region growing based geometric and local partitioning algorithm (ASRG). The performance and effectiveness of the three algorithms are compared based on different factors. Further, we adopt the K&K algorithm as the demonstrated algorithm for the experiment of dust model simulation with the non-hydrostatic mesoscale model (NMM-dust) and compared the performance with the MPI default sequential allocation. The results demonstrate that K&K method significantly improves the simulation performance with better subdomain allocation. This method can also be adopted for other relevant atmospheric and numerical modeling.

What is the influence of randomisation sequence generation and allocation concealment on treatment effects of physical therapy trials? A meta-epidemiological study

ObjectiveTo determine if adequacy of randomisation and allocation concealment is associated with changes in effect sizes (ES) when comparing physical therapy (PT) trials with and without these methodological characteristics.DesignMeta-epidemiological study.ParticipantsA...

A fast and resource efficient mining algorithm for discovering frequent patterns in distributed computing environments

The advancement of electronic technology enables us to collect logs from various devices. Such logs require detailed analysis in order to be broadly useful. Data mining is a technique that has been widely used to extract hidden information from such data. Data mining is mainly composed of association rules mining, sequent pattern mining, classification and clustering. Association rules mining has attracted significant attention and been successfully applied to various fields. Although the past studies can effectively discover frequent patterns to deduce association rules, execution efficiency is still a critical problem. To speed up execution, many methods using parallel and distributed computing technology have been proposed in recent years. Most of the past studies focused on parallelizing the workload in a high end machine or in distributed computing environments like grid or cloud computing systems; however, very few of them discuss how to efficiently determine the appropriate number of computing nodes, considering execution efficiency and load balancing. An intuition is that execution speed is proportional to the number of computing nodes—that is, more the number of computing nodes, faster is the execution speed. However, this is incorrect for such algorithms because of the inherently algorithmic design. Allocating too many computing nodes can lead to high execution time. In addition to the execution inefficiency, inappropriate resource allocation is a waste of computing power and network bandwidth. At the same time, load cannot be effectively distributed if there are too few nodes allocated. In this paper, we propose a fast, load balancing and resource efficient algorithm named FLR-Mining for discovering frequent patterns in distributed computing systems. FLR-Mining is capable of determining the appropriate number of computing nodes automatically and achieving better load balancing as compared with existing methods. Through empirical evaluation, FLR-Mining is shown to deliver excellent performance in terms of execution efficiency and load balancing.

Treatment of an Anonymous Recipient

This study developed a game simulation based on problem solving in the management of urban waste. We then investigated the factors affecting the decisions made by players. During gameplay, the players sought to guide the development of a city via management strategies involving a balance of economic growth and environmental protection. Nature served as an anonymous recipient of the pollution caused by the actions of players. Within a very limited time period, the players had to determine the degree to which they could conserve nature, learn the limits of growth, and develop insight into the dynamic operations necessary to manage a clean city. It was found that the 34 Taiwanese undergraduate students valued economic growth highly and were willing to sacrifice nature for the sake of progress. In contrast, 35 students from Taiwanese elementary schools tended to strive for a balance between conserving nature and promoting economic growth through the building of sustainable houses that produce less pollution. However, this led to an inappropriate allocation of resources, embodying a self-interested ethos. This game taught players about the costs associated with waste processing as well as the values of fairness and reciprocity, particularly with regard to resource utilization and solid-waste management.

Use of Preclinical Drug vs. Food Choice Procedures to Evaluate Candidate Medications for Cocaine Addiction.

Drug addiction is a disease that manifests as an inappropriate allocation of behavior towards the procurement and use of the abused substance and away from other behaviors that produce more adaptive reinforcers (e.g. exercise, work, family and social relationships). The goal of treating drug addiction is not only to decrease drug-maintained behaviors, but also to promote a reallocation of behavior towards alternative, nondrug reinforcers. Experimental procedures that offer concurrent access to both a drug reinforcer and an alternative, nondrug reinforcer provide a research tool for assessment of medication effects on drug choice and behavioral allocation. Choice procedures are currently the standard in human laboratory research on medications development. Preclinical choice procedures have been utilized in biomedical research since the early 1940's, and during the last 10-15 years, their use for evaluation of medications to treat drug addiction has increased. We propose here that parallel use of choice procedures in preclinical and clinical studies will facilitate translational research on development of medications to treat cocaine addiction. In support of this proposition, a review of the literature suggests strong concordance between preclinical effectiveness of candidate medications to modify cocaine choice in nonhuman primates and rodents and clinical effectiveness of these medications to modify either cocaine choice in human laboratory studies or metrics of cocaine abuse in patients with cocaine use disorder. The strongest evidence for medication effectiveness in preclinical choice studies has been obtained with maintenance on the monoamine releaser d-amphetamine, a candidate agonist medication for cocaine use analogous to use of methadone to treat heroin abuse or nicotine formulations to treat tobacco dependence.

A time study of physicians' work in a German university eye hospital to estimate unit costs.

BackgroundTechnical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians’ work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output.MethodsA self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit.ResultsForty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations.ConclusionThe presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff.

Cross-country comparisons of key drivers, critical success factors and risk allocation for public-private partnership projects

Public-private partnerships (PPPs) are an effective and established strategy for procuring infrastructure. Although numerous countries have implemented PPPs for infrastructure development in recent years, not all projects have been successful. Most PPP failures result from inappropriate risk allocation and a lack of information on success factors in specific countries. For this study, we compared the categories of key drivers, critical success factors (CSFs), and preferred risk allocation in PPPs established in Taiwan, Singapore, China, the United Kingdom, and Indonesia. Mean value analysis, confirmatory factor analysis, and dimensional importance were used to analyze and compare these categories. Data on PPPs in Taiwan, Singapore, China, and the United Kingdom were obtained through comprehensive literature reviews. Data for Indonesia were obtained through structured surveys distributed to PPP practitioners and academicians. Considering Indonesia as the baseline, the results revealed that Indonesia and Taiwan exhibit several similar indicators of key drivers. Furthermore, comparisons with several countries revealed that Indonesian CSFs are most similar to those of China. Regarding risk allocation preference, the analytical results indicated that Singapore exhibits the most similarity with Indonesia. This study provides useful information for people seeking to invest in PPP projects, enabling them to enhance their understanding of key drivers, CSFs, and risk allocation in the researched countries. Based on our findings, international investors can apply investment strategies by considering the similarities and differences in each country.

How the environment determines banking efficiency: a comparison of banking firms in Taiwan, Hong Kong, and Mainland China

This study uses the three-stage data envelopment analysis (DEA) model to explore the true managerial efficiency of the banking firms in Taiwan, Hong Kong, and Mainland China. The empirical results indicate that the environmental conditions have a significant impact on banking efficiency. When the country-specific situations are important factors in explaining efficiency difference, the common frontier estimates obtained by neglecting those factors can generate biased and overestimated inefficiency levels. With findings obtained from the slack variable analyses, the current study can provide inefficient banks with ways to reduce their input waste through the adjustment of input allocations. The findings also confirm the importance of the three-stage DEA and its applications in determining the true managerial efficiencies of banks. Without the three-stage DEA, the management could be misguided when making strategic decisions and conducting inappropriate resource allocation.

OPTIMUM ALLOCATION OF DISTRIBUTED GENERATION BY LOAD FLOW ANALYSIS METHOD: A CASE STUDY

DG is nothing but a small scale generation element connected directly to the distribution network or near customer load center. DG affects the flow of power and voltage conditions at customers and utility equipment. These impacts may manifest themselves either positively or negatively depending on the distribution system operating characteristics and the DG characteristics. DG has a limited size of 10MW or less especially when DG is used in a distribution network. DG is installed at the place where it becomes unfeasible to build a central generation plant. DG is installed to improve the voltage profile as well as minimize losses. DG allocation is a crucial factor. Optimum DG allocation provides a variety of benefits. But inappropriate DG allocation can cause low or over voltage in the network. In this paper a case study is carried out for the Dharwad region, Karnataka. Load flow based method and ETAP software is used to determine the optimum location & optimum size of DG for voltage profile improvement & loss reduction.

Economic Water Reallocation in the Zayande Rood Basin (Iran) Among Different Uses via Designed Software

A 15-meter decrease in underground water level and several-years of drought which have afflicted the Gavkhooni swamp, signify inappropriate allocation of the available water. The rapid growth in population as well as increase in water demand due to municipalities, expansion of industrial activities, farming has put a lot of pressure on existing water in the Zayande Rood basin.This paper claims that the centralized method of water allocation directed under the supervision of a public institution has lost its credibility and does not harmonize with the institutional setting of the water market. With the use of a non-centralized method, such an institutional setting can be more efficiently utilized. But before implementing changes, with a laboratory-type experience we can examine probable changes. Therefore in this article a computerized water allocation system for the purpose of using the water market has been devised and it is shown that efficiency increases. Such allocation has been implemented for the river basin of Zayande Rood in (Isfahan) Iran.

Payment by results: validating care cluster allocation in the real world

Aims and methodTo validate care cluster allocation for payment by results (PbR) in mental health and to evaluate clustering and auditing methodologies. We applied exclusion criteria to the patient population of a mental health trust. An automated validation compared cluster with expected ICD-10 codes or scores on the Health of the Nation Outcome Scales (HoNOS) and Mental Health Clustering Tool (MHCT). Six hundred ‘mismatched’ cases were reviewed in depth to better understand the reasons why these cases appeared misclustered.ResultsThere was a significant mismatch between ICD-10 codes, HoNOS and MHCT scores and allocated care cluster, with differences between services and localities. Some clusters appeared to be more accurately allocated. The ‘deep dive’ analysis indicated that most mismatches occurred because psychosis was allocated to a non-psychotic cluster and vice versa, but also as a result of inherent weaknesses of the MHCT.Clinical implicationsHigh levels of inappropriate care cluster allocation highlight the need to improve practice. Weaknesses in the MHCT and ICD-10 coding mean that the final arbiter should be clinical judgement. Auditing will, by necessity, have a significant margin of error.

Hepatocellular Carcinoma Surveillance In Hepatitis C Patients: How Are We Doing?

Purpose: In the U.S., hepatitis C virus (HCV) is the number one cause of death from liver disease and the number one indication for liver transplantation. Those with HCV are at increased risk for hepatocellular carcinoma (HCC), the ninth leading cause of cancer-related death in the U.S. The current guideline from the American Association for the Study of Liver Diseases (AASLD) for HCC surveillance in HCV patients is performance of abdominal ultrasound every 6 months in HCV cirrhosis patients only. As of 2010, the AASLD no longer recommends serum alpha fetoprotein (AFP) testing as an HCC screening tool. We examined whether we are following HCC screening guidelines in the setting of the outpatient hepatology clinic. Methods: A systematic chart review was performed. Using a random date generator, patient charts were selected from hepatology clinic days. Only mono-infected patients with HCV were included. Patients who were co-infected with hepatitis B or HIV, had another liver diagnosis, were post-transplant, and/or required abdominal imaging for other clinical reasons were excluded. An appropriate screening interval was defined as 6 +/- 2 months (4 to 8 months). Cirrhotic patients were identified by use of the term “cirrhosis” in clinic notes only. Results: Fifty-three patients met the inclusion criteria over 8 days sampled. Of these 53 patients, 16 were identifi ed as cirrhotic, and 37 as non-cirrhotic. All of the 16 cirrhotic patients (100%) had imaging; however, seven (43.8%) were imaged less frequently than the defined interval, and 11 (68.8%) had serum AFP levels drawn. Of the 37 non-cirrhotic patients, 23 (62.2%) had imaging, and 26 (70.3%) had serum AFP levels drawn. Conclusion: Patients with non-cirrhotic HCV are likely being over-screened for HCC in the clinic setting. Additionally, serum AFP levels continue to be used for surveillance, even though these have been dropped from the guidelines. Over-screening with either imaging or serum AFP may account for inappropriate allocation of healthcare dollars and increased morbidity in patients undergoing unnecessary follow-up testing, such as CT scans. More thorough investigation of the non-cirrhotic patients may be necessary, as these patients may have “advanced fibrosis,” and thus qualify for screening under European Association for the Study of the Liver (EASL) guidelines. All patients with HCV cirrhosis are receiving imaging surveillance, but some less frequently than recommended, increasing the risk of advanced-stage HCC diagnosis. Administrative practices may need to be implemented to ensure strict follow-up with HCV cirrhosis patients. Further investigation is recommended to examine if some or all of our findings are prevalent in other hepatology clinics nationwide.

Human Resource Allocation Model in Pavement Engineering

Human resource allocation holds the key to success in the construction of labor-intensive public infrastructures. However, due to the difficulty in obtaining relevant onsite data, there has been a lack of quantitative numerical analysis and discussion in published literature. In this study, a database for assessing human resource allocation in pavement engineering was established by collecting detailed information from various construction projects. Fourteen influence factors were summarized through literature review and consultation with experts in the field. Thirty two road-smoothing projects were then randomly selected. Using the rough set approach and an artificial neural network model, a model for assessing human resource allocation in pavement engineering was developed. The model validity is verified by an average accuracy of 88.63%. Therefore, this proposed model can be viewed as a useful tool for estimating human resource demand in pavement engineering. It can also effectively alert the authority to avoid a shortage in manpower, preventing the construction project from falling behind schedule or even early termination as a result of inappropriate resource allocation.

Radiology Services Costs and Utilization Patterns Estimates in Southeastern Europe—A Retrospective Analysis from Serbia

ObjectiveAssessment of costs matrix and patterns of prescribing of radiology diagnostic, radiation therapy, nuclear medicine, and interventional radiology services. Another aim of the study was insight into drivers of inappropriate resource allocation. MethodsAn in-depth, retrospective bottom-up trend analysis of services consumption patterns and expenses was conducted from the perspective of third-party payer, for 205,576 inpatients of a large tertiary care university hospital in Serbia (1,293 beds) from 2007 to 2010. ResultsA total of 20,117 patients in 2007, 17,436 in 2008, 19,996 in 2009, and 17,579 in 2010 were radiologically examined, who consumed services valued at €2,713,573.99 in 2007, €4,529,387.36 in 2008, €5,388,585.15 in –2009, and €5,556,341.35 in 2010. ConclusionsThe macroeconomic crisis worldwide and consecutive health policy measures caused a drop in health care services diversity offered in some areas in the period 2008 to 2009. In spite of this, in total it increased during the time span observed. The total cost of services increased because of a rise in overall consumption and population morbidity. An average radiologically examined patient got one frontal chest graph, each 7th patient got an abdomen ultrasound examination, each 19th patient got a computed tomography endocranium check, and each 25th patient got a head nuclear magnetic resonance. Findings confirm irrational prescribing of diagnostic procedures and necessities of cutting costs. The consumption patterns noticed should provide an important momentum for policymakers to intervene and ensure higher adherence to guidelines by clinicians.