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Publications

Publications by SYSTEM

2018

Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method

Authors
Sultan, WIM; Crispim, J;

Publication
BMC HEALTH SERVICES RESEARCH

Abstract
Background: While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. Methods: This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Results: Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p < 0.01) are: bed occupancy rate (BOR); the outpatient-inpatient ratio (OPIPR); hospital's size (SIZE); and the availability of primary healthcare centers within the hospital's catchment area (PRC). There is a strong effect of OPIPR on efficiency differences between hospitals: A one unit increase in OPIPR will lead a decrease of 19.7% in the predicted inefficiency level holding all other factors constant. Conclusion: To date, no previous studies have examined the efficiency of public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals' managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful. © 2018 The Author(s).

2018

Operational flexibility in forest fire prevention and suppression: a spatially explicit intra-annual optimization analysis, considering prevention, (pre)suppression, and escape costs

Authors
Pacheco, AP; Claro, J;

Publication
EUROPEAN JOURNAL OF FOREST RESEARCH

Abstract
Increasing wildfire threats and costs escalate the complexity of forest fire management challenges, which is grounded in complex interactions between ecological, social, economic, and policy factors. It is immersed in this difficult context that decision-makers must settle on an investment mix within a portfolio of available options, subject to limited funds and under great uncertainty. We model intra-annual fire management as a problem of multistage capacity investment in a portfolio of management resources, enabling fuel treatments and fire preparedness. We consider wildfires as the demand, with uncertainty in the severity of the fire season and in the occurrence, time, place, and severity of specific fires. We focus our analysis on the influence of changes in the volatility of wildfires and in the costs of escaped wildfires, on the postponement of capacity investment along the year, on the optimal budget, and on the investment mix. Using a hypothetical test landscape, we verify that the value of postponement increases significantly for scenarios of increased uncertainty (higher volatility) and higher escape costs, as also does the optimal budget (although not proportionally to the changes in the escape costs). Additionally, the suppression/prevention budget ratio is highly sensitive to changes in escape costs, while it remains mostly insensitive to changes in volatility. Furthermore, we show the policy implications of these findings at operational (e.g., spatial solutions) and strategic levels (e.g., climate change). Exploring the impact of increasing escape costs in the optimal investment mix, we identified in our instances four qualitative system stages, which can be related to specific socioecological contexts and used as the basis for policy (re)design. In addition to questioning some popular myths, our results highlight the value of fuel treatments and the contextual nature of the optimal portfolio mix.

2018

Does it pay to invest in better suppression resources?: policy analysis of alternative scenarios with simulation

Authors
Pacheco, AP; et. al.,;

Publication
Advances in forest fire research 2018

Abstract

2018

Flexible design of a helipad network for forest firefighting helicopters, applied to the case of Sardinia

Authors
Torres, H; et. al.,;

Publication
Advances in forest fire research 2018

Abstract

2018

Bi-level and Bi-objective p-Median Type Problems for Integrative Clustering: Application to Analysis of Cancer Gene-Expression and Drug-Response Data

Authors
Ushakov, AV; Klimentova, X; Vasilyev, I;

Publication
IEEE-ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS

Abstract
Recent advances in high-throughput technologies have given rise to collecting large amounts of multidimensional heterogeneous data that provide diverse information on the same biological samples. Integrative analysis of such multisource datasets may reveal new biological insights into complex biological mechanisms and therefore remains an important research field in systems biology. Most of the modern integrative clustering approaches rely on independent analysis of each dataset and consensus clustering, probabilistic or statistical modeling, while flexible distance-based integrative clustering techniques are sparsely covered. We propose two distance-based integrative clustering frameworks based on bi-level and bi-objective extensions of the p-median problem. A hybrid branch-and-cut method is developed to find global optimal solutions to the bi-level p-median model. As to the bi-objective problem, an epsilon-constraint algorithm is proposed to generate an approximation to the Pareto optimal set. Every solution found by any of the frameworks corresponds to an integrative clustering. We present an application of our approaches to integrative analysis of NCI-60 human tumor cell lines characterized by gene expression and drug activity profiles. We demonstrate that the proposed mathematical optimization-based approaches outperform some state-of-the-art and traditional distance-based integrative and non-integrative clustering techniques.

2018

Planning woody biomass supply in hot systems under variable chips energy content

Authors
Marques, A; Rasinmaki, J; Soares, R; Amorim, P;

Publication
BIOMASS & BIOENERGY

Abstract
The growing economic importance of the biomass-for-bioenergy in Europe motivates research on biomass supply chain design and planning. The temporally and geographically fragmented availability of woody biomass makes it particularly relevant to find cost-effective solutions for biomass production, storage and transportation up to the consumption facility. This paper addresses tactical decisions related with optimal allocation of wood chips from forest residues at forest sites to terminals and power plants. The emphasis is on a "hot-system" with synchronized chipping and chips transportation at the roadside. Thus, decisions related with the assignment of chippers to forest sites are also considered. We extend existing studies by considering the impact of the wood chips energy content variation in the logistics planning. This is a key issue in biomass-for-bioenergy supply chains. The higher the moisture content of wood chips, the lower its net caloric value and therefore, a larger amount of chips is needed to meet the contracted demand. We propose a Mixed Integer Programming (MIP) model to solve this problem to optimality. Results of applying the model in a biomass supply chain case in Finland are presented. Results suggest that a 20% improvement in the supplier profit can be obtained with the proposed approach when compared with a baseline situation that relies on empirical estimates for a fixed and known moisture content in the end of an obliged storage age.

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