Measuring the size of global logistics expenditure is a difficult task. What is an estimate of logistics expenditures for the global economy? The objective of this research is to answer this question. Using neural networks, an artificial intelligence methodology, logistics expenditures have been estimated at the country level. There are two main contributions from this research. The first is an update of previous estimates of global logistics expenditures. The second is continuous improvement of the estimation method, including information quality and availability as well as mathematical model refinement. 相似文献
The objective of this research was to estimate logistic expenditure for the global economy. An Artificial Neural Network was used to generate national estimates. The estimation set constitutes 24 countries representing approximately 75% of the global Gross Domestic Product. The model utilizes variables that capture economic activity, transportation activity, income level, country size, and geographic location. This research updates previous estimates and represents continuous improvement of the estimation method, including new input variables, better information quality, mathematical model refinement, and methods of model validation. 相似文献
To investigate the evolving use and expected impact of pay-for-performance (P4P) and risk-based provider reimbursement on patient access to innovative medical technology.
Methods:
Structured interviews with leading private payers representing over 110 million commercially-insured lives exploring current and planned use of P4P provider payment models, evidence requirements for technology assessment and new technology coverage, and the evolving relationship between the two topics.
Results:
Respondents reported rapid increases in the use of P4P and risk-sharing programs, with roughly half of commercial lives affected 3 years ago, just under two-thirds today, and an expected three-quarters in 3 years. All reported well-established systems for evaluating new technology coverage. Five of nine reported becoming more selective in the past 3 years in approving new technologies; four anticipated that in the next 3 years there will be a higher evidence requirement for new technology access. Similarly, four expected it will become more difficult for clinically appropriate but costly technologies to gain coverage. All reported planning to rely more on these types of provider payment incentives to control costs, but didn’t see them as a substitute for payer technology reviews and coverage limitations; they each have a role to play.
Limitations:
Interviews limited to nine leading payers with models in place; self-reported data.
Conclusion:
Likely implications include a more uncertain payment environment for providers, and indirectly for innovative medical technology and future investment, greater reliance on quality and financial metrics, and increased evidence requirements for favorable coverage and utilization decisions. Increasing provider financial risk may challenge the traditional technology adoption paradigm, where payers assumed a ‘gatekeeping’ role and providers a countervailing patient advocacy role with regard to access to new technology. Increased provider financial risk may result in an additional hurdle to the adoption of new technology, rather than substitution of provider- for payer-based gatekeeping. 相似文献
Aims: To compute the financial and mortality impact of InSight, an algorithm-driven biomarker, which forecasts the onset of sepsis with minimal use of electronic health record data.Methods: This study compares InSight with existing sepsis screening tools and computes the differential life and cost savings associated with its use in the inpatient setting. To do so, mortality reduction is obtained from an increase in the number of sepsis cases correctly identified by InSight. Early sepsis detection by InSight is also associated with a reduction in length-of-stay, from which cost savings are directly computed.Results:InSight identifies more true positive cases of severe sepsis, with fewer false alarms, than comparable methods. For an individual ICU with 50 beds, for example, it is determined that InSight annually saves 75 additional lives and reduces sepsis-related costs by $560,000.Limitations:InSight performance results are derived from analysis of a single-center cohort. Mortality reduction results rely on a simplified use case, which fixes prediction times at 0, 1, and 2?h before sepsis onset, likely leading to under-estimates of lives saved. The corresponding cost reduction numbers are based on national averages for daily patient length-of-stay cost.Conclusions:InSight has the potential to reduce sepsis-related deaths and to lead to substantial cost savings for healthcare facilities. 相似文献
