ABSTRACT In extreme circumstances such as pandemics, the presence of patients in hospital emergency departments becomes untenable. Healthcare professionals and organizations worldwide are leaning on technology as a crucial ally to deal with the COVID-19 outbreak. This article focuses on the positive impact of telemedicine for helping service provision, from enabling virtual triage to mitigating the negative psychological effects of social isolation. The authors discuss the challenges and opportunities to telemedicine practices. 相似文献
Aims: This study analyzed discrepancies in the quantity of medical services supplied by physicians under different payment systems for patients with different health statuses and illnesses by means of a field experiment.
Methods: Based on the laboratory experiment of Heike Hennig-Schmidt, we designed a field experiment to examine fee-for-service (FFS), capitation (CAP), and diagnosis-related group (DRG) payment systems. Medical students were replaced with 220 physicians as experimental subjects, which more closely reflected the clinical choices made by physicians in the real world. Under the three payment mechanisms, the quantity of medical services provided by physicians when they treated patients with different health statuses and illnesses were collected. Finally, relevant statistics were computed and analyzed.
Results: It was found that payment systems (sig. = 0.000) and patient health status (sig. = 0.000) had a stronger effect on physicians’ choices regarding quantity of medical services than illness types (sig. = 0.793). Additionally, under the FFS and CAP payment systems, physicians overserved patients in good and intermediate health while underserving patients in bad health. Under the DRG payment system, physicians overserved patients in good health and underserved patients in intermediate and bad health. Correspondingly, under FFS and CAP, the proportional loss of benefits was the highest for patients in bad health and the lowest for patients in good and intermediate health; while under DRGs, patients in good and intermediate health had the largest and smallest loss of benefits, respectively.
Limitations: In order to increase external effects of experiment results, we used the field experiment to replace laboratory experiment. However, the external effects still existed because of the blurring and abstraction of the parameters.
Conclusions: Medical treatment cost and price affected the quantity of medical services provided by physicians. Therefore, we proposed that a mix of payment systems could address the common interests of physicians and patients, as well as influence incentives from payment systems. 相似文献
The approach, descent, and climb phases of flights in terminal maneuvering areas (TMAs) are some of the critical parts of a flight in which more than half of accidents happen. For an ANSP (Air Navigation Service Provider), to fulfill the responsibility with a high-quality service degree while maintaining safety, these difficult areas should be designed carefully and equipped with the most efficient procedures. Point merge system (PMS), which is defined as a systemized method for sequencing arrival flows, is launched in Istanbul's new TMA (LTFM TMA) being designed by DHMI (Devlet Hava Meydanları Isletmesi) to improve safety and efficiency. In this paper, the airspace complexity is based on adjusted density and structural index, and safety indicators. To investigate the effects of the radical changes made in re-organized LTFM TMA on the safety issue in comparison with the previous terminal maneuvering area, LTBA TMA, six months' data consisting of 75215 arrival and departure flights are used. Results reflect that the LTFM TMA, one of the world's busiest terminal airspaces, has statistically significantly lower scores in terms of conflict numbers per aircraft, complexity metrics, adjusted density, the hour of interactions, and flight hours than LTBA TMA. Lastly, there exists no longer a significant relationship between conflict types and complexity after launching the new design and structure. 相似文献