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EFFICIENCY OF HEALTHCARE SYSTEMS IN EUROPEAN COUNTRIES - THE DEA NETWORK APPROACH

100%

Kujawska J.

Metody Ilościowe w Badaniach Ekonomicznych

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2018

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tom 19

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nr 1

60-70

EN

Healthcare systems in Europe are constantly undergoing reforms which adapt them to social, economic and political requirements. The aim of this article is to examine the efficiency of healthcare systems in 30 European countries in 2014. The Network Data Envelopment Analysis (NDEA) model was used. The efficiency of the countries’ overall health systems and their two main components were examined: the public health system and the medical care system. The models include variables that are out of control of policy makers and the ones that can be controlled by them. The research results show that countries which reformed their healthcare systems achieved higher efficiency more often.

2

Zróżnicowanie w dostępie do onkologicznych usług zdrowotnych w województwach Polski

100%

Kujawska J.

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tom 48

246-255

PL

Nowotwory złośliwe to druga w kolejności przyczyna śmiertelności na świecie. Liczba zachorowań na raka w ostatniej dekadzie wzrosła. W Polsce występują trudności w dostępie do lecznictwa onkologicznego. Pierwszą trudnością jest zbyt długi czas oczekiwania na wizytę u specjalisty. Kolejna to nieskuteczna diagnostyka, która powoduje, że nowotwór jest wykrywany w zaawansowanym stadium. Pochodną tych problemów jest rozmieszczenie ośrodków onkologicznych, przede wszystkim w dużych miastach, co powoduje długi czas dojazdu do punktu ambulatoryjnych świadczeń onkologicznych. Następną trudnością w dostępności jest organizacja systemu opieki zdrowotnej oparta na limitowaniu liczby udzielanych świadczeń. Celem opracowania jest wskazanie nierówności w dostępie do usług onkologicznych (w tym radioterapii) w województwach z wykorzystaniem metody DEA. Wyniki badań pokazują duże zróżnicowanie w dostępie do posiadanych zasobów osobowych i rzeczowych związanych z onkologiczną opieką zdrowotną. W województwie opolskim jest prawie 5 razy mniej lekarzy niż w mazowieckim, a koszty lecznictwa onkologicznego są dwa razy niższe. Częściowym rozwiązaniem poprawiającym sprawność opieki onkologicznej jest rezygnacja z kosztownych usług stacjonarnych na rzecz zwiększenia udziału usług realizowanych w formie ambulatoryjnej lub opieki jednodniowej. Z zastosowanego modelu DEA wynika, że w pełni efektywne województwa pod względem dostępu do opieki onkologicznej to: lubuskie, opolskie i podlaskie. W województwach tych są najniższe koszty jednostkowe na pacjenta. Należy jednak pamiętać, że wczesne wykrycie nowo-tworu i skuteczna terapia powodują niższe koszty bezpośrednie i pośrednie absencji chorobowej.

EN

Malignant neoplasms are the second leading cause of death in the world. The number of cancer cases in the last decade has increased significantly. In Poland there are difficulties in access to the oncological treatment. The first difficulty is too long time for a visit for medical specialist. Another is the ineffective diagnostic, which causes the cancer is detected at an advanced stage. Moreover, in Poland, we have the distribution of medical centers primarily in large cities only and long travel time to the point outpatient cancer services. Another difficulty in accessibility is the poor organization of the health care system, based on limited number of services provided. The aim of the study is to identify differences in access to cancer services (including radiotherapy) in Polish provinces using the DEA method. The results show wide variation in access to personal and tangible resources associated with oncological health. In the Opole province is almost 5 times less doctors than in the Mazowieckie but the oncology treatment costs are two times lower. Solution for improving the efficiency of cancer care is to give up costly fixed-line services in favor of increasing the share of services provided in the form of outpatient or daycare. DEA model shows that the most effective province in terms of access to cancer care are: Lu-buskie, Opole and Podlasie. These provinces have lowest unit costs per patient. Note, however, that early detection of cancer and effective therapy contribute to incur lower direct and indirect costs of sickness absence.

3

OCENA DOSTĘPNOŚCI DO LECZNICTWA ONKOLOGICZNEGO W POLSKICH WOJEWÓDZTWACH

100%

Kujawska J.

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nr 3

214-224

PL

Zróżnicowanie w dostępie do usług opieki zdrowotnej, to poważne wyzwanie dla systemów zdrowotnych we wszystkich krajach świata. W artykule podjęto próbę oceny dostępności do lecznictwa onkologicznego w układzie przestrzennym 16 województw wykorzystując metodę DEA. Jako miernik dostępu przyjęto poziom zgonów a jako podstawowe bariery dostępu liczbę łóżek i lekarzy. Wykorzystano informacje statystyczne pochodzące z GUS z 2013 r. Wyniki pozwalają ocenić zróżnicowanie przestrzenne dostępu do leczenia onkologicznego oraz określić wymagane zmiany zasobów (lekarzy i łóżek), które mają ten dostęp poprawić.

EN

Differentiation in access to health care services is a serious challenge for health systems in all countries of the world. The article attempts to assess the accessibility of oncological treatment in a spatial arrangement of Polish regions using DEA method. As a measure of access the level of deaths was adopted and as the primary barrier to access the number of beds and doctors. Data from the Central Statistical Office for 2013 were used. The results allow assessing the spatial differentiation of access to oncological treatment and the required changes in the resources (doctors and beds) to improve the access.

4

Effect of Vermicomposting on the Concentration of Heavy Metals in Soil with Drill Cuttings

63%

Kujawska J. , Wójcik-Oliveira K.

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tom Vol. 20, nr 1

152--157

EN

Organic and non-organic pollution present in the drilling waste may negatively impact flora and fauna. The tests conducted on earthworms may serve as indicators for the assessment of pollution bioavailability, i.a. heavy metals, polycyclic aromatic hydrocarbons, due to the relatively stable ratios between the concentration of certain pollutants in earthworms and soil. Moreover, earthworms are capable of metal bioaccumulation in tissues; therefore, they can be utilized as an ecological indicator of soil pollution. The studies on bioaccumulation of heavy metals from soils with the addition of drilling wastes in tissues of earthworms were conducted. The reduction percentage (R) of each scenario was calculated for the total concentration of all heavy metals. As data showed, all heavy metal content was reduced from its initial concentration.

5

Comparison of Mechanical Properties of Ad Hoc T-Section Reinforced Concrete Beams Made of Concrete with the Use of Natural and Recycled Aggregate

63%

Sadowska-Buraczewska B. , Kujawska J.

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tom Vol. 18, no 6

465--475

EN

Sustainable construction represents a pivotal aspect of contemporary engineering endeavors, which are directed towards the minimization of the detrimental impact of the construction sector on the environment. This is achieved through the efficient utilization of resources and the reduction of waste generation. The study presented an analysis of the mechanical properties of ad hoc reinforced concrete beams made of concrete with recycled and natural aggregate. The objective of this study was to assess the potential of recycled aggregates as a substitute for natural aggregates in reinforced concrete structures, with the aim of contributing to the sustainable development of construction. The experiments compared the behavior of reinforced concrete beams with the same degree of reinforcement but differing in the type of aggregate. The results demonstrated that recycled aggregate beams exhibited lower stiffness and higher deformation under load compared to natural aggregate beams, particularly at loads close to the breaking force. Nevertheless, similar failure modes and cracking patterns were observed in both types of beams, indicating that concrete with recycled aggregate could be employed effectively in specific structural applications.

6

Application of zeolites in removal of hazardous metal ions from drilling mud wastewater

51%

Borowski G. , Kujawska J. , Wasąg H.

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tom Vol. 55, iss. 6

1467--1474

EN

In this study, the adsorption behavior of natural and activated zeolites with respect to Cd2+, Cr3+, Pb2+and Zn2+, was studied in order to consider theirabilityto remove hazardousmetals fromdrilling mud. The batch method was employed, using initial metal concentrations in solution in the range of0.1 to 2.5 mg/dm3. It was determined that independently of the concentration, the adsorption ratios of zeolite towardsmetal cations match the Langmuir and Freundlich isotherms. The results of the research on the reduction of concentration of hazardousmetals from drilling mud wastewater by means of natural and activated zeoliteswere presented in the further part of this work. Natural and activated zeolites were introduced in portions (from 0.2to 10 g) to 100 cm3of wastewater; then, the content of metalions was determined using an inductively coupled plasma spectrometer. The experimental data showed that the applicationof activated zeolite enabled the removal rate of Cr3+, Pb2+, Zn2+and Cd2+close to 93%, 45%, 56% and 84%, respectively. In the case of the natural zeolite, the degree of hazardousmetals removal was lower by only a few percent, but still high enough to beinteresting from the practical point of view. Satisfactory effects of hazardousmetal ionsremoval from drilling muds were achieved using 2 to 5 g of zeolite. The obtained results proved that the natural zeolite constitutes an important material for efficient removal of hazardousmetalionsfrom drilling mud wastewater.