Priority evaluation factors for blockchain application services in public sectors.

Blockchain is rapidly becoming established as the core technology of the Fourth Industrial Revolution. By combining blockchain to improve processes in existing industries, innovative new services will emerge, but services not effectively applied by blockchain will also develop. This study investigated the factors to be considered when applying the characteristics of blockchain technology to business. We developed a framework of blockchain service utility evaluation indexes using the analytic hierarchy process method. The Delphi method is used to identify highly effective blockchain application service cases by applying the evaluation framework to actual use cases in the public sector. By proposing a framework of utility evaluation factors for blockchain application services, this study provides a systematic foundation for blockchain business review. We address the question of "why blockchain should be applied to this service" by providing a more comprehensive approach than existing research, such as a fragmentary decision tree. Blockchains are expected to become more active along with the full-scale digital transformation of industries, and thus, we must examine the ways to broadly use blockchain as a base technology in a form applicable to the diverse industries and societies constituting the digital economy. Accordingly, this study presents an evaluation solution for promoting efficient policies and developing successful blockchain application services.

Research on the cooperative mechanism of government and enterprise for basin ecological compensation based on differential game.

Ecological compensation is an important means of basin pollution control, the existing researches mainly focus on the government level ignoring the important role of enterprises. Therefore, this paper introduces enterprises into the process of ecological compensation. Firstly, suppose the ecological compensation system composed of government and enterprises, the government is in the dominant position. The ecological compensation input of the government and enterprise will produce social reputation, and the ecological compensation of enterprise will also produce advertising effect. Consumer demand will be affected by social reputation and advertising effect. Then, the compensation strategies of the government and enterprise are analyzed by constructing the differential game model. The research shows that under certain conditions, the cost-sharing mechanism can realize the Pareto improvement of the benefits of government, enterprise and the whole system. Under the cooperative mechanism, the benefit of the government, enterprise and the whole system is optimal. Finally, the validity of the conclusion is verified by case analysis, and the sensitivity analysis of the relevant parameters is carried out. The conclusion can provide reference for government to establish sustainable watershed ecological compensation mechanism.

Hierarchical distance and employees' commitment as conditioning of team-based work in the Spanish public sector.

Team-based work (TBW) plays a crucial role in the success and quality of public services. In the context of the Spanish public sector, our study evaluates if a low level of hierarchical distance (HD) in public organizations condition the public employees' commitment (EC) as well as TBW, assessed in terms of participation and consensus among team members. Simultaneously, we evaluated to what extent EC help to enhance TBW. Employing a sample of 213 government organizations from the south of Spain through a model of structural equations, we were able to answer the above questions. Our results revealed that team-based work functions more successfully within public organizations where there exists little verticality in their structures, norms, values and rules - in simplest terms, where there is minimal organizational HD. Such results also suggest that although regulations exist in the Spanish public sector, should public organizations attempt to be less vertical and more horizontal, they would perhaps have public servants that were more committed to their organizations. As a result, servants view the organization as their own and remain loyal. Finally, from an academic perspective, this study could be one of few to research and evaluate the hierarchical role and employees' commitment to the functioning of public employees based on participation and consensus in their work teams.

Supportive management practice and intrinsic motivation go together in the public service.

Drawing on over 4,000,000 individual and 2,000 agency observations across five countries, this paper examines the relationship between features of an employee's work environment and intrinsic motivation in public agencies. It finds that practices which foster employees' sense of autonomy, competence, and relatedness are associated with substantially higher levels of intrinsic motivation across a broad range of settings. This is true both at the individual and agency level and when examining changes within agency over time. These patterns appear to be at least partially a result of differential selection in and out of the agency, with lower levels of supportive practices associated with greater desire to exit for employees with higher levels of intrinsic motivation. Nonfinancial elements of job design are strongly associated with intrinsic motivation, as are potentially more difficult to alter features of an agency, such as satisfaction with compensation and managerial quality. There is also suggestive evidence that the relationship between agency practices and employee intrinsic motivation is stronger when tasks are more difficult to monitor.

Effect of School-Based Body Mass Index Reporting in California Public Schools: A Randomized Clinical Trial.

Importance: Annually, US schools screen millions of students' body mass index (BMI) and report the results to parents, with little experimental evidence on potential benefits and harms. Objective: To determine the impact of school-based BMI reporting on weight status and adverse outcomes (weight stigmatization and weight-related perceptions and behaviors) among a diverse student population. Design, Setting, and Participants: Cluster randomized clinical trial. The Fit Study (2014-2017) randomized 79 California schools to BMI screening and reporting (group 1), BMI screening only (group 2), or control (no BMI screening or reporting [group 3]) in grades 3 to 8. The setting was California elementary and middle schools. Students in grades 3 to 7 at baseline participated for up to 3 years. A modified intent-to-treat protocol was used. Data analysis was conducted from April 13, 2017, to March 26, 2020. Interventions: School staff assessed BMI each spring among students in groups 1 and 2. Parents of students in group 1 were sent a BMI report each fall for up to 2 years. Main Outcomes and Measures: Changes in BMI z score and in adverse outcomes (based on surveys conducted each fall among students in grades 4 to 8) from baseline to 1 and 2 years of follow-up. Results: A total of 28 641 students (14 645 [51.1%] male) in grades 3 to 7 at baseline participated in the study for up to 3 years. Among 6534 of 16 622 students with a baseline BMI in the 85th percentile or higher (39.3%), BMI reporting had no effect on BMI z score change (-0.003; 95% CI, -0.02 to 0.01 at 1 year and 0.01; 95% CI, -0.02 to 0.03 at 2 years). Weight dissatisfaction increased more among students having BMI screened at school (8694 students in groups 1 and 2) than among control participants (5674 students in group 3). Results of the effect of BMI reporting on other adverse outcomes were mixed: compared with the control (group 3), among students weighed at school (groups 1 and 2), weight satisfaction declined more after 2 years (-0.11; 95% CI, -0.18 to -0.05), and peer weight talk increased more after 1 year (0.05; 95% CI, 0.01-0.09); however, concerning weight control behaviors declined more after 1 year (-0.06; 95% CI, -0.10 to -0.02). Conclusions and Relevance: Body mass index reports alone do not improve children's weight status and may decrease weight satisfaction. To improve student health, schools should consider investing resources in evidence-based interventions. Trial Registration: ClinicalTrials.gov Identifier: NCT02088086.

Assessing public behavioral health services data: a mixed method analysis.

BACKGROUND: Measuring behavioral health treatment accessibility requires timely, comprehensive and accurate data collection. Existing public sources of data have inconsistent metrics, delayed times to publication and do not measure all factors related to accessibility. This study seeks to capture this additional information and determine its importance for informing accessibility and care coordination. METHODS: The 2018 National Survey for Substance Abuse and Treatment Services (N-SSATS) data were used to identify behavioral health facilities in Indiana and gather baseline information. A telephone survey was administered to facilities with questions parallel to the N-SSATS and additional questions regarding capacity and patient intake. Quantitative analysis includes chi-square tests. A standard qualitative analysis was used for theming answers to open-ended questions. RESULTS: About 20% of behavioral health facilities responded to the study survey, and non-response bias was identified by geographic region. Among respondents, statistically significant differences were found in several questions asked in both the study survey and N-SSATS. Data gathered from the additional questions revealed many facilities to have wait times to intake longer than 2 weeks, inconsistency in intake assessment tools used, limited capacity for walk-ins and numerous requirements for engaging in treatment. CONCLUSION: Despite the low response rate to this study survey, results demonstrate that multiple factors not currently captured in public data sources can influence coordination of care. The questions included in this study survey could serve as a framework for routinely gathering these data and can facilitate efforts for successful coordination of care and clinical decision-making.

Atualização das ações do Governo para o combate ao novo Coronavírus - 11/04/2020

Coletiva de Imprensa Participam: Cipriano Maia – Secretário de Estado da Saúde Pública Luciana Daltro de Pádua Castro - Assessora Jurídica do Governo do RN

Real-Life Incentives Driving Public-Private Partnership in Diagnostic Services.

BACKGROUND: Diagnostic services are highly critical in the success of treatment processes, overly costly nonetheless. Accordingly, hospitals generally seek the private partnership in the provision of such services. This study intends to explore the incentives owned by both public and private sector in their joint provision of diagnostic services under the public-private partnership agreement. METHOD: A qualitative, exploratory study was employed in Tehran hospitals from October 2017 to March 2018. Around 25 face-to-face, semi-structured interviews were conducted with the purposively recruited hospital managers, heads of diagnostic services and managers of private companies. Interviews were transcribed and analyzed using conventional content analysis, assisted by "MAXQDA-12". RESULTS: Three main categories and nine sub-categories represented the incentives of public sector, and four main categories and seven sub-categories signified those of private sector. The incentives of public sector included the status-quo remediation, upstream requirements, and personal reasons. As such, the individual, social and economic incentives and legal constraints were driving the behavior of the private sector. CONCLUSIONS: Financial problem and gain were the most noted incentives by the partners. Attention to the either side's incentives and aims is likely to ensure the durability and effectiveness of such partnerships in the health sector.

Coletiva de imprensa: anúncios do Governo SP - 12/08/2020

O Vice-Governador Rodrigo Garcia anunciou nesta quarta-feira (12) a ampliação do programa Poupatempo de 75 para 340 unidades, maior expansão de seus 23 anos de história. Para isso, o Poupatempo vai incorporar à sua gestão todos os serviços prestados pelo Detran.SP. Assim, as unidades do Detran.SP serão transformadas em postos presenciais do Poupatempo. “O número de unidades presenciais crescerá quatro vezes nos próximos dois anos. Junto a essa expansão sem precedentes, o Poupatempo continua seu processo de digitalização. No início de 2019, quando assumimos o governo, tínhamos sete serviços digitais no portal do Poupatempo. Nestes 18 meses de governo, multiplicamos isso mais de dez vezes. Hoje temos cerca de 82 serviços digitais pelo aplicativo do Poupatempo”, disse Garcia. As novas unidades vão manter todos os serviços prestados pelo departamento de trânsito e incorporar os outros serviços prestados pelo Poupatempo. No total, serão oferecidos 133 diferentes tipos de serviço. Até 2022, serão disponibilizados 242 serviços digitais nas 340 unidades. A transição para as 252 novas unidades será gradual e concluída também até 2022. Esta reestruturação operacional possibilitará ao Estado alcançar uma economia de cerca de R$ 100 milhões por ano. Além de expandir a capilaridade dos serviços prestados, a medida resultará em atendimento público de forma presencial e remota (pelo celular), por meio do Poupatempo Digital, para todos os municípios paulistas – incluindo o alcance a cidades menores. “Desde quando iniciamos esta gestão, temos incessantemente buscado impulsionar a transformação digital no governo estadual com menos custos, oferecendo serviços públicos nas plataformas digitais de modo simples, intuitivo e acessíveis a todos”, afirma o Presidente da Prodesp, André Arruda. A Prodesp é a empresa de tecnologia do estado de São Paulo responsável por operacionalizar a implantação e administrar os postos do Poupatempo. Os novos postos serão mais modernos, enxutos e com atendentes realizando diversos tipos de serviços. “Integrar nossos serviços ao programa fará a população ganhar ainda mais. As pessoas serão atendidas nas novas unidades com mais comodidade, de forma simples, eficiente e com toda segurança – e contando também com um maior leque de serviços prestados, além daqueles referentes a CNH e documentação veicular”, destaca o Diretor-Presidente do Detran.SP, Ernesto Mascellani. Todas as inovações digitais desenvolvidas pela Prodesp até o momento permitiram colocar os principais serviços do Poupatempo e do Detran.SP na palma da mão de todos os cidadãos. Acelerado pela pandemia do coronavírus, o portal e o aplicativo Poupatempo Digital se mostraram fundamentais para a manutenção dos atendimentos. Mais de sete milhões de interações/atendimentos foram feitos em quatro meses. Isto representa mais de 65% dos atendimentos diários nas unidades físicas, estimados em 120 mil. Atualmente existem mais de 200 serviços sendo digitalizados pelo Poupatempo, em comparação com os sete oferecidos no início de 2019. Apenas cinco serviços que apresentam maior volume de transações permanecerão sem digitalização, como os atendimentos para emissão da primeira via do RG e a renovação da CNH, que requerem coleta biométrica e exigem a ida ao posto. A partir da próxima quarta-feira (19) haverá a retomada dos atendimentos nos postos físicos, com permissão de agendamentos a partir da terça-feira (18). Esta etapa de reabertura priorizará apenas o que houver exigência presencial, como primeira emissão de CNH e expedição de RG. A partir desta data já começarão a operar na nova modalidade as unidades do Poupatempo da Sé, Itaquera, São Bernardo do Campo, Mauá, Mogi das Cruzes, Santos, Guarujá e Bauru. O cronograma de retomada dos atendimentos presenciais será semanal, até 28 de outubro. A reabertura das unidades segue as diretrizes da aderência ao Plano São Paulo, com a flexibilização permitida apenas para cidades que estiverem nas fases amarela e laranja, e com fluxo de pessoas equivalente a 30% da capacidade de cada unidade. Do total de 340 postos, 252 retornam ainda na modalidade Ciretrans e oito unidades como Poupatempo. As Ciretrans que ainda permanecem exclusivas para atendimentos relativos a assuntos de trânsito serão transformadas semanalmente, até a transição plena da remodelação, prevista para estar concluída até 2022.Saiba mais em www.pessoacomdeficiencia.sp.gov.br

Live SP Globalmeetings: integração nas políticas de proteção social com foco em pequenos municípios

É hoje!! #Live: Integração nas políticas de proteção social com foco em pequenos municípios. O bate-papo começa às 17h e vai reunir secretários de governo e representantes de instituições. Assista http://youtube.com/governosp

Novo secretário estadual de saúde

Saiba mais em www.saopaulo.sp.gov.br/coronavirus/vacina

Especial COVID-19: debate "O papel da OSS na resposta à pandemia"

“O Estado tem que se qualificar cada vez mais para contratar bem: saber o que está encomendando e ter as ferramentas regulatórias”., pontuou o moderador do debate, Marcus Pestana, ex-presidente do Conass.

Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda.

OBJECTIVES: To elicit citizen preferences for national budget resource allocation in Uganda, examine respondents' preferences for health vis-à-vis other sectors, and compare these preferences with actual government budget allocations. METHODS: We surveyed 432 households in urban and rural areas of Mukono district in central Uganda.We elicited citizens' preferences for resource allocation across all sectors using a best-worst scaling (BWS) survey. The BWS survey consisted of 16 sectors corresponding to the Uganda national budget line items. Respondents chose, from a subset of four sectors across 16 choice tasks, which sectors they thought were most and least important to allocate resources to. We utilized the relative best-minus-worst score method and a conditional logistic regression to obtain ranked preferences for resource allocation across sectors. We then compared the respondents' preferences with actual government budget allocations. RESULTS: The health sector was the top ranked sector where 82% of respondents selected health as the most important sector for the government to fund, but it was ranked sixth in national budget allocation, encompassing 6.4% of the total budget. Beyond health, water and environment, agriculture, and social development sectors were largely underfunded compared to respondents' preferences. Works and transport, education, security, and justice, law and order received a larger share of the national budget compared to respondents' preferences. CONCLUSIONS: Among respondents from Mukono district in Uganda, we found that citizens' preferences for resource allocation across sectors, including for the health sector, were fundamentally misaligned with current government budget allocations. Evidence of respondents' strong preferences for allocating resources to the health sector could help stakeholders make the case for increased health sector allocations. Greater investment in health is not only essential to satisfy citizens' needs and preferences, but also to meet the government's health goals to improve health, strengthen health systems, and achieve universal health coverage.

Responsabilização de Gestores

Ulisses Viana, Procurador do Estado de MS, fala sobre o tema "Responsabilização de Gestores".

Coronavírus: órgãos públicos serão fechados?

Saiba mais em www.saopaulo.sp.gov.br/coronavirus

Contracting as a bridging factor linking outer and inner contexts during EBP implementation and sustainment: a prospective study across multiple U.S. public sector service systems.

BACKGROUND: Bridging factors are relational ties (e.g. partnerships), formal arrangements (e.g. contracts or polices) and processes (e.g. data sharing agreements) linking outer and inner contexts and are a recent evolution of the Exploration-Preparation-Implementation-Sustainment (EPIS) framework. Bridging factor research can elucidate ways that service systems may influence and/or be influenced by organizations providing health services. This study used the EPIS framework and open systems and resource dependence theoretical approaches to examine contracting arrangements in U.S. public sector systems. Contracting arrangements function as bridging factors through which systems communicate, interact, and exchange resources with the organizations operating within them. METHODS: The sample included 17 community-based organizations in eight service systems. Longitudinal data is derived from 113 contract documents and 88 qualitative interviews and focus groups involving system and organizational stakeholders. Analyses consisted of a document review using content analysis and focused coding of transcripts from the interviews and focus groups. A multiple case study analysis was conducted to identify patterns across service systems and organizations. The dataset represented service systems that had sustained the same EBP for between 2 and 10 years, which allowed for observation of bridging factors and outer-inner context interactions over time. RESULTS: Service systems and organizations influenced each other in a number of ways through contracting arrangements. Service systems influenced organizations when contracting arrangements resulted in changes to organizational functioning, required organizational responses to insufficient funding, and altered interorganizational network relationships. Organizations influenced service systems when contract arrangements prompted organization-driven contract negotiation/tailoring, changes to system-level processes, and interorganizational collaboration. Service systems and organizations were dependent on each other as implementation progressed. Resources beyond funding emerged, including adequate numbers of eligible clients, expertise in the evidence-based practice, and training and coaching capacity. CONCLUSION: This study advances implementation science by expanding the range and definition of bridging factors and illustrating specific bi-directional influences between outer context service systems and inner context organizations. This study also identifies bi-directional dependencies over the course of implementation and sustainment. An analysis of influence, dependencies, and resources exchanged through bridging factors has direct implications for selecting and tailoring implementation strategies, especially those that require system-level coordination and change.

An integrated approach for designing in-time and economically sustainable emergency care networks: A case study in the public sector.

Emergency Care Networks (ECNs) were created as a response to the increased demand for emergency services and the ever-increasing waiting times experienced by patients in emergency rooms. In this sense, ECNs are called to provide a rapid diagnosis and early intervention so that poor patient outcomes, patient dissatisfaction, and cost overruns can be avoided. Nevertheless, ECNs, as nodal systems, are often inefficient due to the lack of coordination between emergency departments (EDs) and the presence of non-value added activities within each ED. This situation is even more complex in the public healthcare sector of low-income countries where emergency care is provided under constraint resources and limited innovation. Notwithstanding the tremendous efforts made by healthcare clusters and government agencies to tackle this problem, most of ECNs do not yet provide nimble and efficient care to patients. Additionally, little progress has been evidenced regarding the creation of methodological approaches that assist policymakers in solving this problem. In an attempt to address these shortcomings, this paper presents a three-phase methodology based on Discrete-event simulation, payment collateral models, and lean six sigma to support the design of in-time and economically sustainable ECNs. The proposed approach is validated in a public ECN consisting of 2 hospitals and 8 POCs (Point of Care). The results of this study evidenced that the average waiting time in an ECN can be substantially diminished by optimizing the cooperation flows between EDs.

Understanding the Role of Values in Health Policy Decision-Making From the Perspective of Policy-Makers and Stakeholders: A Multiple-Case Embedded Study in Chile and Colombia.

BACKGROUND: Chile and Colombia are examples of Latin American countries with health systems shaped by similar values. Recently, both countries have crafted policies to regulate the participation of private for-profit insurance companies in their health systems, but through very different mechanisms. This study asks: what values are important in the decision-making processes that crafted these policies? And how and why are they used? METHODS: An embedded multiple-case study design was carried out for 2 specific decisions in each country: (1) in Chile, the development of the Universal Plan of Explicit Entitlements -AUGE/GES - and mandating universal coverage of treatments for high-cost diseases; and (2) in Colombia, the declaration of health as a fundamental right and a mechanism to explicitly exclude technologies that cannot be publicly funded. We interviewed key informants involved in one or more of the decisions and/or in the policy analysis and development process that contributed to the eventual decision. The data analysis involved a constant comparative approach and thematic analysis for each case study. RESULTS: From the 40 individuals who were invited, 28 key informants participated. A tension between 2 important values was identified for each decision (eg, solidarity vs. individualism for the AUGE/GES plan in Chile; human dignity vs. sustainability for the declaration of the right to health in Colombia). Policy-makers used values in the decisionmaking process to frame problems in meaningful ways, to guide policy development, as a pragmatic instrument to make decisions, and as a way to legitimize decisions. In Chile, values such as individualism and free choice were incorporated in decision-making because attaining private health insurance was seen as an indicator of improved personal economic status. In Colombia, human dignity was incorporated as the core value because the Constitutional Court asserted its importance in its use of judicial activism as a check on the power of the executive and legislative branches. CONCLUSION: There is an opportunity to open further exploration of the role of values in different health decisions, political sectors besides health, and even other jurisdictions.

Economics of COVID-19: challenges and the way forward for health policy during and after the pandemic.

The emergence of novel coronavirus disease 2019 (COVID-19) pandemic provides unique challenges for health system. While on the one hand, the government has to struggle with the strategies for control of COVID-19, on the other hand, other routine health services also need to be managed. Second, the infrastructure needs to be augmented to meet the potential epidemic surge of cases. Third, economic welfare and household income need to be guaranteed. All of these have complicated the routine ways in which the governments have dealt with various trade-offs to determine the health and public policies. In this paper, we outline key economic principles for the government to consider for policymaking, during, and after the COVID-19 pandemic. The pandemic rightfully places long due attention of policymakers for investing in health sector. The policy entrepreneurs and public health community should not miss this once-in-a-lifetime "policy window" to raise the level of advocacy for appropriate investment in health sector.