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Publicações

Publicações por CESE

2018

Are public hospitals reforming efficiently in West Bank?

Autores
Sultan, WIM; Crispim, J;

Publicação
CONFLICT AND HEALTH

Abstract
BackgroundThe structure, function, and capacity of the health care system in the Occupied Palestinian Territories (OPT) had been largely shaped by the complex political history of the country. Since the establishment of the Palestinian Authority in 1994, the reform efforts were subsidized much by the international aids to rebuild the country's institutional capacity. No previous studies have provided a realistic evaluation of Palestinian achievements in the conduct of public healthcare, we examine the relative productive efficiency of public hospitals (their managers' success in the usage of resources) during 2010-2015 within West Bank and Jordan. Then, we estimate the efficiency of policies within which managers operate (the program efficiency) across the two countries.MethodsWe employ the Data Envelopment Analysis (DEA) models to distinguish between within-country managerial efficiencies and public policy program efficiencies across the two countries. The study follows two key steps, the first step evaluates managerial efficiencies and explores trends in performance within each country. Then, we examine the program efficiencies across the two countries.ResultsPublic hospitals improved their year-specific overall efficiency from 75 to 80% in the West Bank and from 78 to 86% in Jordan in 2010 and 2015 respectively. Changes in efficiency are driven by scale effects in West Bank and by managerial enhancements in Jordan. Program efficiency in West Bank outperformed Jordan during 2010-2012, there was no significant difference in mean program efficiencies between the two countries during 2013-2015.ConclusionsThis work addresses a gap in the DEA literature by empirically investigating the efficiency of public hospitals as distinct from program efficiency in a developing country, namely, Palestine. Findings stimulate hospital managers to enhance potential improvements, policymakers to allocate resources, and international donors to focus on the right adoption of new technology to get better benefits from their considerable investments in public hospitals.

2018

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

Autores
Sultan, WIM; Crispim, J;

Publicação
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

Business Experiments in footwear Cyber-Physical Production Systems

Autores
Dias, R; Toscano, C;

Publicação
Atas da Conferencia da Associacao Portuguesa de Sistemas de Informacao

Abstract
The Portuguese footwear industry registered a strong performance over the last few years and the openness to adopt new technologies was a key factor. Among these, the implementation of innovative logistic systems for the transport and assignment of work-in-process in manufacturing processes was a key technology. By means of case research it was analyzed an internal logistic system, deployed in a Portuguese large footwear producer, which reveals some weaknesses at the physical and cyber levels. A lack of managing applications was detected at the factory and enterprise levels, which contribute to lower levels of visibility of production and productivity. This article presents the development of a Cyber-Physical Production System, in the context of the Horizon 2020 research and innovation program BEinCPPS, that comprises four application experiments. These experiments were successful and the results demonstrated a relevant increase of production efficiency and decrease of maintenance costs.

2018

Strategic decision-making in the pharmaceutical industry: A unified decision-making framework

Autores
Marques, CM; Moniz, S; de Sousa, JP;

Publicação
COMPUTERS & CHEMICAL ENGINEERING

Abstract
The implementation of efficient strategic decisions such as process design and capacity investment under uncertainty, during the product development process, is critical for the pharmaceutical industry. However, to tackle these problems the widely used multi-stage/scenario-based optimization formulations are still ineffective, especially for the first-stage (here-and-now) solutions where uncertainty has not yet been revealed. This study extends the authors' previous work addressing the stochastic product-launch planning problem, by developing a new Multi-Objective Integer Programming model, embedded in a unified decision-making framework, to obtain the final design strategy that "maximizes" productivity while considering the decision-maker preferences. An approximation of the efficient Pareto-front is determined, and a subsequent Pareto solutions analysis is made to guide the decision process. The developed approach clearly identifies the process designs and production capacities that "maximize" productivity as well as the most promising solutions region for investment. Moreover, a good balance between investment and capacity allocation was achieved.

2018

Metaheuristic Algorithms in Maritime Operations Optimization

Autores
Homayouni, SM; Fontes, DBMM;

Publicação
Metaheuristic Algorithms in Maritime Operations Optimization

Abstract
Metaheuristic Algorithms in Maritime Operations Optimization focuses on the seaside and port side problems regarding the maritime transportation. The book reviews and introduces the most important problems regarding the shipping network design, long-term and short-term scheduling and planning problems in both bulk and container shipping as well as liquid maritime transportation. Application of meta heuristic algorithm is important for these problems, as most of them are hard and time-consuming to be solved optimally.

2018

Adoption of industry 4.0 technologies in supply chains

Autores
Dalmarco, G; Barros, AC;

Publicação
Contributions to Management Science

Abstract
The widespread use of internet is changing the way supply chain echelons interact with each other in order to respond to increasing customer requests of personalized products and services. Companies acquainted with the concept of industry 4.0 (i4.0) embrace the use of internet to improve their internal and external processes, delivering the dynamic and flexible response customers want. This chapter aims to discuss how supply chains may benefit from the adoption of i4.0 technologies by their partners and highlights some of its implementation challenges. Eight technologies cover most of i4.0 applications: additive manufacturing; big data & analytics; cloud computing; cyber-physical systems; cyber security; internet of things; collaborative robotics; and visual computing. At individual level, technologies such as additive manufacturing, collaborative robots, visual computing and cyber-physical systems establish the connectivity of a certain company. However, the integration of the whole supply chain, based on the principles of i4.0, demands that information provided by each company (Big Data) is shared through a collaborative system based on Cloud Computing and Internet of Things technologies. To safely share useful information, Cyber Security techniques must be implemented in individual systems and cloud solutions. Summing up, even though the adoption of i4.0 demands an individual initiative, it will only raise the supply chain’s competitive advantage if all companies adapt their manufacturing and supply chain processes. The main advantage foreseen here is based on an improved communication system of the whole supply chain, bringing consumers closer to the production process. © 2018, Springer International Publishing AG, part of Springer Nature.

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