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Artigo em Inglês | MEDLINE | ID: mdl-34886029


Important in testing services in medical laboratories is the creation of a flexible balance between quality-response time and minimizing the cost of the service. Beyond the different Lean methods implemented so far in the medical sector, each company can adapt the model according to its needs, each company has its own specifics and organizational culture, and Lean implementation will have a unique approach. Therefore, this paper aims to identify the concerns of specialists and laboratory medical services sector initiatives in optimizing medical services by implementing the Lean Six Sigma method in its various variants: a comparative analysis of the implemented models, with emphasis on measuring externalities and delimiting trends in reforming/modernizing the method, a comprehensive approach to the impact of this method implementation, and an analysis of available databases in order to underline the deficit and information asymmetry. The results highlighted that in the case of clinical laboratories, the Lean Six Sigma method is conducive to a reduction of cases of diagnostic errors and saves time but also faces challenges and employees' resistance in implementation.

Artigo em Inglês | MEDLINE | ID: mdl-34769684


Economic crises cause significant shortages in disposable income and a sharp decline in the living conditions, affecting healthcare sector, hitting the profitability and sustainability of companies leading to raises in unemployment. At micro level, these sharp decreases in earnings associated with unemployment and furthermore with the lack of social protection will impact the quality of life and finally the health of individuals. In time of crisis, it becomes vital to support not only the critical sectors of the economy, the assets, technology, and infrastructure, but to protect jobs and workers. This health crisis has hit hard the jobs dynamics through unemployment and underemployment, the quality of work (through wages, or access to social protection), and through the effects on specific groups, with a higher degree of vulnerability to unfavorable labor market outcomes. In this context, providing forecasts as recent as possible for the unemployment rate, a core indicator of the Romanian labor market that could include the effects of the market shocks it becomes fundamental. Thus, the paper aims to offer valuable forecasts for the Romanian unemployment rate using univariate vs. multivariate time series models for the period 2021-2022, highlighting the main patterns of evolution. Based on the univariate time series models, the paper predict the future values of unemployment rate based on its own past using self-forecasting and implementing ARFIMA and SETAR models using monthly data for the period January 2000-April 2021. From the perspective of multivariate time series models, the paper uses VAR/VECM models, analyzing the temporal interdependencies between variables using quarterly data for the period 2000Q1-2020Q4. The empirical results pointed out that both SETAR and VECM provide very similar results in terms of accuracy replicating very well the pre-pandemic period, 2018Q2-2020Q1, reaching the value of 4.1% at the beginning of 2020, with a decreasing trend reaching the value of 3.9%, respectively, 3.6% at the end of 2022.

Qualidade de Vida , Desemprego , Economia , Emprego , Humanos , Renda , Romênia , Fatores Socioeconômicos
Artigo em Inglês | MEDLINE | ID: mdl-34682701


Financial inclusion is strongly differentiated by age groups and countries and the pandemic has highlighted the increased gaps and inequalities but also the weaknesses of the system, in terms of flexibility, access and facilities of the customer-bank relationship and also from the perspective of the financial education of young generations and vulnerable people, active in the labor market. Based on the available data provided by the Global Findex database, and some findings after more than one year of COVID-19 crisis we outlined the main aspects of financial digitization, by categories of people and countries. At the same time, we identified the challenges and problems during the pandemic that significantly adjusted the consumption pattern of citizens and increased the need for on-line access for financial transactions. Starting from the analysis of the inequality of access to financial instruments in the last years, from the informational asymmetry in financial education and the challenges of the pandemic period, we underlined the main coordinates of changing the model of sustainable financial inclusion-based on five pillars-access, education, support tools, CSR and resilience. The research results highlight the need for convergence in providing opportunities to consider financial inclusion as a public good and an active tool to increase consumers' satisfaction and the quality of life of individuals.

COVID-19 , Qualidade de Vida , Humanos , Pandemias , SARS-CoV-2 , Fatores Sexuais
Artigo em Inglês | MEDLINE | ID: mdl-34299677


Population development is reflected by sustainable development indicators, among them are the indicators describing longevity and healthy aging. Longevity is reflected by life expectancy, and healthy aging is reflected by healthy life expectancy; high values of these indicators reflect good conditions of living for people. Life expectancy and healthy life expectancy analyses are of big interest among academics, policymakers, medical researchers, and others in order to direct the flow of funds in the most effective way possible to the population groups in most need. High life expectancy and low birth rate will lead to aging of the population, having profound implications on the school age population, politics, healthcare, labor force, social protection, social security issues, and public finances. Healthy life expectancy reflects health conditions, including the impacts of mortality and morbidity. As cardiovascular disease causes more than half of all deaths across Europe, this paper examines the influence of cardiovascular disease on longevity and healthy aging across Europe. The methodology was chosen so as to test the research hypotheses: (a) principal component analysis provided the socio-economic factors that are correlated to longevity and healthy aging; (b) regression analysis identified the relationship between healthy aging and cardiovascular disease; and (c) hierarchical cluster analysis allowed us to find common features of the groups of countries according to healthy aging and longevity.

Doenças Cardiovasculares , Envelhecimento Saudável , Doenças Cardiovasculares/epidemiologia , Humanos , Expectativa de Vida , Longevidade , Mortalidade , Dinâmica Populacional
Entropy (Basel) ; 23(3)2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33803384


Unemployment has risen as the economy has shrunk. The coronavirus crisis has affected many sectors in Romania, some companies diminishing or even ceasing their activity. Making forecasts of the unemployment rate has a fundamental impact and importance on future social policy strategies. The aim of the paper is to comparatively analyze the forecast performances of different univariate time series methods with the purpose of providing future predictions of unemployment rate. In order to do that, several forecasting models (seasonal model autoregressive integrated moving average (SARIMA), self-exciting threshold autoregressive (SETAR), Holt-Winters, ETS (error, trend, seasonal), and NNAR (neural network autoregression)) have been applied, and their forecast performances have been evaluated on both the in-sample data covering the period January 2000-December 2017 used for the model identification and estimation and the out-of-sample data covering the last three years, 2018-2020. The forecast of unemployment rate relies on the next two years, 2021-2022. Based on the in-sample forecast assessment of different methods, the forecast measures root mean squared error (RMSE), mean absolute error (MAE), and mean absolute percent error (MAPE) suggested that the multiplicative Holt-Winters model outperforms the other models. For the out-of-sample forecasting performance of models, RMSE and MAE values revealed that the NNAR model has better forecasting performance, while according to MAPE, the SARIMA model registers higher forecast accuracy. The empirical results of the Diebold-Mariano test at one forecast horizon for out-of-sample methods revealed differences in the forecasting performance between SARIMA and NNAR, of which the best model of modeling and forecasting unemployment rate was considered to be the NNAR model.

Healthcare (Basel) ; 9(2)2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33546111


Medicinal oxygen plays an important role in healthcare, being essential for the existence and maintenance of the health of millions of people, who depend on medicinal oxygen every day, both in hospitals and at home. Medicinal oxygen is the primary treatment administrated to the majority of patients suffering from respiratory problems and low levels of oxygen in the blood, and in the context of the actual health crisis caused by the new COVID-19, the challenge is represented by increasing the supply of medicinal oxygen while reducing cost so that it is accessible where it is needed most, free at the point of use. It will take increased investment and commitment to put oxygen at the center of strategies for universal health coverage. In this context, it becomes essential to investigate the main characteristics of the Romanian market of medicinal oxygen, highlighting top key players, market development, key driving factors, types of products, market perspectives as well as shedding light on the segmentation of this particular market based on considerations regarding regions, hospital competence class and hospital specialization. Also, the research aims to explore the regional disparities in the decision of using O93%medicinal oxygen, revealing the main factors related to the usage of this type of product among Romanian public hospitals. The research relies on the first quantitative survey regarding medicinal oxygen usage among 121 public hospital units from a total of 461 public hospitals in 2018, which meet the specific requirements: includes the entire population according to the list published on the website of the Ministry of Health, is the most recent data and does not show repetition. The sampling was of probabilistic stage-type stratification, with the following sampling layers: hospital county distribution, hospital competence class officially assigned by the Ministry of Health and also area of residence (urban/rural). In order to analyze the main characteristics of the Romanian oxygen market, the following methods have been used: analysis of variance (ANOVA) together with Kruskal-Wallis, Pearson correlation coefficient as well as Goodman and Kruskal gamma, Kendall's tau-b and Cramer's V, as well as multilevel logistic regression analysis using hierarchical data (hospitals grouped in regions). The Romanian market of medicinal oxygen is rather an oligopoly market characterized by the existence of a small number of producers and two types of products currently used for the same medical purpose and having a substitutable character: medicinal oxygen O99.5%, and medicinal oxygen O93%. An overwhelming proportion of public hospitals agree that both types of medicinal oxygen serve the same therapeutic purpose. The Romanian market of medicinal oxygen highlighted a significant segmentation on considerations based on regions, hospital competence class and hospital specialization. Regarding the main perspectives, the Romanian market of medical oxygen keeps the growth trend registered globally, with development perspectives for competitors. Exploring the regional disparities in the decision of using O93 medicinal oxygen, the empirical results acknowledged the important role of unitary price, hospital capacity and the relevance of this product seen as a medicine. Medicinal oxygen is vital in sustaining life, proving its utility mainly in the context of the actual health crisis. In this context, the Romanian local market exhibits prospects for further development, being characterized by an important segmentation depending on regions, hospital competence class and hospital specialization.