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- Performance assessment of primary health care services using data envelopment analysis and the quality-adjusted malmquist indexPublication . De Mattos Capeletti, Nuno; Amado, Carla; Santos, SérgioPrimary Health Care (PHC) is intended to provide a comprehensive response to the patients' health needs. Considering the increasing demand to optimise the use of the available resources while keeping a high-quality standard, it is essential to investigate the health services' performance. We propose a methodology based on the Data Envelopment Analysis (DEA) technique, examining the volume of activities performed and considering the impact of these activities by using a quality indicator directly related to care outcomes. To perform a longitudinal analysis and observe the changes in quality separately, a Quality-Adjusted Malmquist Productivity Index is implemented. The methodology is illustrated by analysing the performance and the evolution in productivity and quality of the primary care services delivered by the municipalities of the Brazilian state of Santa Catarina from 2008 to 2014. Our findings reinforce the view that adequate planning and structuring of PHC services must consider not only the volume of activity but also the impact of the services delivered.
- Development and application of a composite circularity indexPublication . Garrido, Susana; Rodríguez-Antón, José; Amado, Carla; Santos, Sérgio; Dias, Luís C.Resource depletion and environmental pollution are increasingly a matter of concern for their adverse effects on ecosystems, human health, and the economy. Circular Economy (CE) practices can help us address these chal-lenges. This paper proposes a composite circularity index (CI) to assess the level of implementation of CE practices. The main advantage of the proposed index is its ability to combine multiple indicators of circularity for different units operating in a given sector (given as inputs), using a 'Benefit of the Doubt' model. This new model is innovative in the manner it deals with ordinal scales and also by considering both relative and absolute performance indices. These indices are computed using mathematical programming tools, building on ideas from Data Envelopment Analysis models.Although the model can be applied to any sector, this work addresses the hotel industry in particular. The selection of indicators for this CI was based on seven blocks of the Circular Economy Action Plan and a literature review of circular practices. An application of the proposed index is performed by using data from Portuguese and Spanish hotels. The proposed CI allows the identification of the organizations with the best and worst performance in implementing the CE practices and clarifying the benchmarks they could follow to improve their level of circularity. Moreover, the index analysis also provides specific targets for improvement, indicating which circular practices should be improved for the lower performers to reach the implementation levels of the best performers.
- Labor inspectorates' efficiency and effectiveness assessment as a learning path to improve work-related accident preventionPublication . Santos, Antonio J. R.; Santos, Sérgio; Amado, Carla; Rebelo, Efigénio; Mendes, JúlioLabor inspectorates, by monitoring and enforcing labor legislation, giving information and technical advice to employers and employees, promoting awareness-raising campaigns and implementing occupational risk prevention policies, play a fundamental role in promoting safer and healthier working conditions and, ultimately, in reducing the number of work-related accidents. Even so, every year, hundreds of thousands of people die from accidents at work and around 2 million die from occupational diseases, highlighting that considerable room for improvement remains. The identification and sharing of best practices in labor inspection can be a useful first step in this direction. The main purpose of this research is to propose Data Envelopment Analysis as a suitable technique for assessing the performance of labor inspectorates and identifying best practices. The potential of the proposed methodology is tested by using it to assess the efficiency and the effectiveness of the 32 local branches of the Portuguese Authority for Working Conditions, a key player of the Portuguese system of occupational risk prevention, and by exploring its value in identifying best practices and possible paths for performance improvement.
- Assessing the impact of COVID-19 on the performance of organ transplant services using data envelopment analysisPublication . Manoel, Márcia N. F.; Santos, Sérgio; Amado, CarlaOrgan transplant is one of the best options for many medical conditions, and in many cases, it may be the only treatment option. Recent evidence suggests, however, that the COVID-19 pandemic might have detrimentally affected the provision of this type of healthcare services. The main purpose of this article is to use Data Envelopment Analysis and the Malmquist Index to assess the impact that the pandemic caused by the novel coronavirus SARS-CoV-2 had on the provision of solid organ transplant services. To this purpose, we use three complementary models, each focusing on specific aspects of the organ donation and transplantation process, and data from Brazil, which has one of the most extensive public organ transplant programs in the world. Using data from 17 States plus the Federal District, the results of our analysis show a significant drop in the performance of the services in terms of the organ donation and transplantation process from 2018 to 2020, but the results also indicate that not all aspects of the process and States were equally affected. Furthermore, by using different models, this research also allows us to gain a more comprehensive and informative assessment of the performance of the States in delivering this type of service and identify opportunities for reciprocal learning, expanding our knowledge on this important issue and offering opportunities for further research.