Delayed Hospital Discharge and Mental Health: The Policy Implications of Recent Research

In 2003, the Community Care (Delayed Discharges etc.) Act introduced charges for social services departments unable to discharge patients from hospital within agreed timescales. As details of this reimbursement policy have begun to emerge, it has become apparent that the new system may also be extended to mental health services. In response, this narrative review of the literature on delayed hospital discharges and mental health reports findings from 12 studies, which raise important and timely concerns about the feasibility of reimbursement. Although a significant number of people experience delayed discharges from acute psychiatric services, the task of defining delayed discharges is complex and subjective, dependent on the professional background and seniority of the person making the judgement. Reasons behind delayed discharges are also multi‐factorial in nature and cannot be attributed to social services departments alone.     

论破产程序中的母公司债权

由于母子公司关系的特殊性,在子公司破产程序中母公司债权应采取与普通债权不同的处理方式,包括不得行使抵销权,有担保债权和其他优先债权也应经过考查确定是否应对其加以限制等。母公司债权居次受偿的条件应当是:主观恶意、违反诚信义务的行为、由此给子公司或子公司债权人造成的损失、该行为与损失之间的因果关系。在母子公司财产混同足以引起债权人误解时,可以限制母公司的取回权。     

日立U-3400紫外—可见近红外分光光度计备用电池故障处理

如何解决进口仪器中备用电池的问题。     

Maternity services and the discharge process: A review of practice in Queensland

BackgroundEfforts to increase postnatal support available to women and families are hampered by inadequate referral mechanisms. However, the discharge process in maternity services has received little research attention.AimTo review current discharge practices in Queensland, in order to identify mechanisms to minimise fragmentation in the care of women and families as they transition from hospital-based postnatal care to community-based health and other services.MethodsA survey of discharge practices in Queensland hospitals that offer birthing services (N = 55) and content analysis of discharge summary forms used by those hospitals.FindingsFifty-two Queensland birthing hospitals participated in the study. Discharge summaries were most commonly sent to General Practitioners (83%), less commonly to Child and Family Health Nurses (CFHNs; 52%) and rarely to other care providers. Discharge summaries were usually disseminated within one week of discharge (87%), but did not capture any information about care provided by domiciliary services. Almost one-fifth (19%) of hospitals did not seek women's consent for the disclosure of their discharge summary and only 10% of hospitals had processes for women to check accuracy. Significant gaps in the content of discharge summaries were identified, particularly in psychosocial and cultural information, and post-discharge advice. The format of discharge summaries diminished their readability.ConclusionDischarge summaries (format and content) should be consistent, comprehensive and specific to maternity services. Discharge summaries should be generated and disseminated electronically at the time of discharge from the maternity service. Women should review their discharge summaries and direct and consent to its dissemination.     

Some limit theorems of delayed sums for rowwise conditionally independent stochastic arrays

This paper is concerned with the asymptotic property of delayed sums for rowwise conditionally independent stochastic arrays. The main technique of the proofing is to construct non negative random variables with one parameter and to apply the Borel–Cantelli lemma to obtaining almost everywhere convergence. The relevant results for non homogeneous Markov chains indexed by a tree are extended.     

Plug-in estimators for the mean value and variance functions in delayed renewal processes

Abstract

In this paper, we deal with the problem of estimating the delayed renewal and variance functions in delayed renewal processes. Two parametric plug-in estimators for these functions are proposed and their unbiasedness, asymptotic unbiasedness and consistency properties are investigated. The asymptotic normality of these estimators are established. Further, a method for the computation of the estimators is given. Finally, the performances of the estimators are evaluated for small sample sizes by a simulation study.     

生育进度效应调整指标研究的新进展

随着经济和社会的不断发展,生育推迟现象在全世界范围内日益普遍。由于生育推迟所产生的进度效应会对生育水平造成影响,因此,如何测度生育进度效应便成了人口学界研究的重要内容。自Bongaarts和Feeney的去进度效应总和生育率提出以来,各种新的改进方法与指标不断出现。本文对生育进度效应调整指标的新进展及具体指标进行梳理与比较。从时期角度出发,主要包括方差效应调整后的TFR、PATFR^*、调整后的TFR_SUVN和ITFR四种指标;从队列角度出发,主要包括TFRp^*、TFR?和ACF三种指标,这些指标有各自的优缺点。研究发现:首先,由于不同去进度效应改进指标的假设、适用条件、研究角度、改进方向都不同,很难有一套数据同时适用于多种去进度方法,因此,生育进度效应的诸多改进指标并没有哪个指标"更好",只有"更合适";其次,绝对的去进度效应只能停留在理论层面,而实际上却很难做到,种种去进度方法都只是一种"相对的去",而不是"绝对的去"。过去我们所熟悉的进度效应是生育推迟,而目前世界范围内生育推迟速度开始逐渐放缓,...     

Managing finished-goods inventory under capacitated delayed differentiation

Delayed differentiation or postponement is widely advocated to mitigate conflicts between product diversity and inventory cost savings. Manufacturers practicing postponement often suffer from severely constrained finishing capacities and noticeable finishing lead times. Therefore, inventories are still needed for finished products. Using the concept of inventory shortfall, this paper studies base-stock inventory models with and without demand forecasting and provides a computationally efficient method to set optimal inventory targets for finished products under capacitated postponement. Computations show inventory-saving benefit quickly vanishes after the capacity reaches a certain level. The value of forecasted advance-demand information (ADI) to postponement is justified, but can easily be overstated. Finishing capacities usually force manufacturers to build ahead according to demand forecast. When capacity limitation becomes severe, intuitions often guide producers to build to forecast even more than finishing lead times ahead. Results of this research indicate that these intuitions may be invalid and build to forecast more than finishing lead times ahead may not be a good practice. Further studies reveal that under capacitated postponement the forecasted advance-demand information is useful only when the variance of demand forecast errors is less than that of demands, and show that the optimal forecast lead time can be obtained in the same way as if the capacity is unlimited.     

On the probability of ruin in a continuous risk model with two types of delayed claims

ABSTRACT

This article studies a risk model involving one type of main claims and two types of by-claims, which is an extension of the general risk model with delayed claims. We suppose that every main claim may not induce any by-claims or may induce one by-claim belonging to one of the two types of by-claims with a certain probability. In addition, assume that the by-claim and its associated main claim may occur at the same time and that the occurrence of the by-claim may be delayed. An integro-differential equation system for survival probabilities is derived by using two auxiliary risk models. The expression of the survival probability is obtained by applying Laplace transforms and Rouché theorem. Furthermore, we provide a method for solving the survival probability when the two by-claim amounts satisfy different exponential distributions. As a special case, an explicit expression of survival probability is given when all the claim amounts obey the same exponential distribution. Finally, numerical results are provided to examine the proposed method.