This study conducted a large-scale survey in Dhaka, Bangladesh; the survey involved 95 major hospitals, more than 3000 emergency room patients, and 2 of the largest ambulance operators. Currently, most ambulances are parked within the vicinity of hospitals and are either dispatched or fetched by the acquaintances of the patient on demand, resulting in lengthy round trips. Reducing the response time of ambulances would certainly improve the emergency service, and pre-positioning of the ambulances could be a solution to reducing the response time. This study used two approaches to address the problem. First, the location-allocation problem was solved to find the optimal number of ambulance locations by maximising the demand coverage. Second, separate location-allocation for the peak and off-peaks, using K-means clustering, was applied to systematically optimise the ambulance positioning in small clusters near demand points. These approaches could substantially improve the existing emergency response time. Distributing ambulances near demand points yielded greater improvements in response time than when the ambulances are stationed near hospitals. 相似文献
By using a Kaleckian model with debt accumulation, Hein (2007; Metroeconomica, 56 (2), pp. 310–39) found that the long‐run equilibrium value of the debt–capital ratio is positive and stable only if interest rates are extremely high and if the short‐run equilibrium exhibits the ‘debt‐led’ growth regime. However, this conclusion crucially depends on the assumption that the retention ratio of firms is equal to unity. By relaxing this assumption, we show that there exists a positive and stable long‐run equilibrium even under the ‘debt‐burdened’ regime without any constraint on the nominal interest rate. 相似文献
The growth in the demand for low-cost airlines has coincided with the growth in the airport industry. One attempt by airports to attract such carriers has been to construct dedicated terminals called low-cost terminals. The ability of these to accommodate fast aircraft-operation time in airfields is heavily influenced by its configuration and location in the airport. Here we evaluate the location and configuration of the dedicated terminal by considering the aircraft taxiing distance and passenger walking distance. Result show a single pier to be preferable configuration for a low-cost terminal. Time and cost efficiency seem to be driven largely by the location of the terminal, rather than its configuration. 相似文献
This paper constructs an open economy Kaleckian model in which international competition affects the bargaining process between firms and workers, and investigates the effects of such bargaining on the macroeconomy. We show that the effects of a change in the bargaining power on aggregate demand depends not only on the demand regimes but also on which agents bears more of the burden arising from the international price competition. Moreover, if the real exchange rate has a small impact on the trade balance, the economy is stable, whereas if it has a larger impact on the trade balance, the economy is unstable. 相似文献
This paper presents results of a voluntary‐contribution‐mechanism experiment with partial communication. It was found that the trend of mean investments depended on whether a communication network was connected and on how fast all subjects could share information. When each subject could communicate with two other subjects and the network was connected, the mean investment increased from 33 percent to 58 percent of the optimal investment. On the other hand, when each subject could communicate with only one other subject and the network was not connected, the mean investment decreased from 34 percent to 19 percent of the optimal investment. 相似文献
Many airlines use the main deck of aircraft to carry passengers and belly capacity to accommodate cargo and baggage. When problems regarding the weight and balance requirements of the aircraft arise, the cargo is the first to be considered for unloading: a practice is known as “short-shipping”. This paper develops a simulation model for estimating the probability of occurrence of short-shipping. Risk analysis is used to estimate the uncertainty of several factors such as the weight of passengers, baggage, and fuel. 相似文献
The unprecedented demand for travel experienced in Asia, in conjunction with the economic development of the1980s, has resulted in a number of detrimental effects on urban systems. Economic development has certainly intensified per capita income enhancing personal mobility. In Asia, private vehicle ownership and usage have continued to be recognised as an obligatory element of travel for many. Undoubtedly there is a direct relationship between vehicle ownership and public transport usage. Inter-regional and inter-temporal investigations of travel behaviour in Asian cities are therefore necessary to develop an understanding of the future transportation system including suitability and the role of public transport. Since travel data are scarce in Asian countries, inter-regional or inter-temporal travel behaviour investigations do not exist to date. Several travel demand models are developed using discrete choice modelling techniques and Bangkok, Kuala Lumpur, Manila, and Nagoya as case studies. Estimation results of the mode choice models are successfully incorporated to compare travel behaviour trends in selected cities in Asia. The developed models are tested for spatial and temporal transferability. 相似文献
Objectives: Atrial fibrillation (AF) affects an estimated 1.5 million individuals in Japan, increasing their stroke risk and imposing considerable costs on the Japanese healthcare system. To reduce stroke incidence, guidelines recommend using anticoagulants in moderate-to-high risk non-valvular AF (NVAF) patients; however, many patients receive no treatment, aspirin only, or remain poorly-controlled on vitamin K antagonists (VKAs) due to high VKA discontinuation rates and non-adherence to guidelines. A prevalence-based Markov model was developed to estimate the clinical and budgetary impact of treating these patients with XareltoTM (rivaroxaban, Bayer AG) in Japan.
Methods: Population, baseline risk of events, and associated management costs were estimated using data from Japanese publications where available. Treatment efficacy and safety were derived from published data and the J-ROCKET AF trial. Drug and physician visit costs were based on data from the Ministry of Health, Labor, and Welfare, the J-ROCKET AF trial, and Japanese clinical guidelines.
Results: This model demonstrates that increased use of rivaroxaban in inadequately-managed NVAF patients could avoid 456 081 non-fatal ischemic strokes (IS) and 76 975 cardiovascular deaths over 10 years in Japan. This clinical benefit offsets the increased incidence of myocardial infarctions and anticoagulant-related bleeding. Decreased event costs could lead to a ¥188.4 billion decrease in net spending over the analysis time horizon.
Conclusions: Introducing rivaroxaban may decrease the burden of NVAF in Japanese society. From a clinical perspective, the reduction in IS and embolic events outweighs the increased risk of anticoagulant-related bleeding; from an economic perspective, reduced event costs offset drug and physician visit costs, resulting in cost savings. 相似文献