Alternative assumptions may result in similar emissions and climate responses, but the socio-economic assumptions and the feasibility or likelihood of individual scenarios are not part of the assessment. Uncertain processes that will affect how fast the world warms for a given emissions pathway are dominated by cloud formation, but also include water vapor and ice feedbacks, ocean circulation changes, and natural cycles of greenhouse gases. According to the WBCSD definition, eco-efficiency is achieved through the delivery of "competitively priced goods and services that satisfy human needs and bring quality of life while progressively reducing environmental impacts of goods and resource intensity throughout the entire life-cycle to a level at least in line with the Earth's . Overall hospital cirrhosis mortality rate was 8.00%. OECD Secretariat. Over the past three decades, the approach to formulating the different scenarios has evolved from a climate-centric to an increasingly societal development-centric concept, albeit with the same underlying goal of providing insight into a range of plausible climate outcomes. Global Environmental Change 42, 169-180. Differences between the spatial structure of the data and the structure of the reality it represents must also be understood and considered in order to adequately model the impact of spatial uncertainty on model applications. Resource intensities Construction and commissioning of a power system require resources: capital, materials, energy, and space, meaning land or sea area. Unmeasured structural variables, unmeasured processes of care, and unmeasured clinical granularity at the patient level may have . Patient covariates included age, sex, race/ethnicity, cause of cirrhosis including hepatitis C virus positivity, alcoholic liver disease, or other, and presence of cirrhotic complications including ascites, variceal bleed, hepatic encephalopathy, portal hypertension, hepatorenal syndrome, liver transplant, hepatocellular carcinoma, requirement of paracentesis or esophagogastroduodenoscopy. Access to over 100 million course-specific study resources, 24/7 help from Expert Tutors on 140+ subjects, Full access to over 1 million Textbook Solutions, pulvinar tortor nec facilisis. Our study demonstrates that several hospital structural domains - case mix, payer mix, staffing patterns, and the presence of specialty liver transplant service line - are predictors of inpatient cirrhosis outcomes, account for a sizable fraction (15%) of the overall variation in mortality. Consumption is oriented toward low material growth and lower resource and energy intensity. Hertwich, E. G. (2008). Pellentesque dapibus efm risus ante, dapibus a molestie consequat, ultrices ac magna. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Stocker, T.F., D. Qin, G.-K. Plattner, M. Tignor, S.K. (2000, August). The rate of future global warming depends on future emissions, feedback processes that dampen or reinforce disturbances to the climate system, and unpredictable natural influences on climate, like volcanic eruptions. Based on our study, resource intensity seems to be responsible for some of this variation, but the totality of differences between hospitals was not completely adjusted for in the analysis. European Journal of Marketing, 40(5/6), 533553. Figure 5. Intensity - Definition, Meaning & Synonyms | Vocabulary.com Bithas, K., & Kalimeris, P. (2018). We merged NIS and AHA data using a common hospital identifier for each cirrhosis admission in each year. CrossRef Invasive diagnostic and therapeutic procedures including endoscopy, paracentesis, and liver transplantation were significantly protective (all, P < 0.01). This approach assumed that structural factors contribute to variation in mortality between hospitals, and adjusting for them would attenuate the measured variance, i.e., more of the differences between hospitals would be explained by the model as more significant structural factors were included. Matthews, T.K. Donec aliquet. Question 5 5 / 5 pts Prognosis is defined as. Quantified eco-efficiency: An introduction with applications. Science of the Total Environment, 619620, 338351. UN-2. We first created a risk and reliability-adjusted logistic regression model for mortality for any given hospital compared to an average hospital. PubMedGoogle Scholar, London Metropolitan University, Guildhall Faculty of Business and Law London Metropolitan University, London, UK, Cologne Business School, Ingolstadt, Germany, College of Business, Loyola University New Orleans, New Orleans, LA, USA, International Training Centre of the IL, International Labor Organization, Turin, Italy, Department of Economics, Society and Politics, University of Urbino Carlo Bo, Urbino, Italy, Instituto Politcnico da Guarda, Guarda, Portugal, Aydogan, S. (2021). This alarming phenomenon naturally lends itself to questions about what factors within hospitals contribute to this variation. "[2] The term was coined by the World Business Council for Sustainable Development (WBCSD) in its 1992 publication "Changing Course," and at the 1992 Earth Summit, eco-efficiency was endorsed as a new business concept and means for companies to implement Agenda 21 in the private sector. Core tip: Cirrhosis mortality varies across hospitals, but it is not well-understood what differences between hospitals contribute to this variation. Amit K Mathur, Ryan Day, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Division of Transplant Surgery, Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, United States, Amit K Mathur, Robert D and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Phoenix, AZ 85054, United States, Apurba K Chakrabarti, Jessica L Mellinger, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, United States, Michael L Volk, Department of Medicine, Loma Linda University, Loma Linda, CA 92350, United States. The thick red line depicts the multi-model mean while the thin red lines show the multi-model 90% range. The RF concept is valuable for comparing the influence on global mean surface temperature of most individual agents affecting the Earths radiation balance. ", https://en.wikipedia.org/w/index.php?title=Resource_consumption&oldid=1138425383, This page was last edited on 9 February 2023, at 16:37. Clark, P., Shakun, J., Marcott, S. et al., 2016: Consequences of twenty-first-century policy for multi-millennial climate and sea-level change. Using this model, we then used the empirical Bayes technique to estimate a risk and reliability adjusted odds ratio for mortality via the random effects estimate[4,5]. IPCC, 2013: Climate Change 2013: Technical Summary. Greenberg CC, Ashley SW, Schrag D. Centralization of cancer surgery: what does it mean for surgical training? Hospital volume, length of stay, and readmission rates in high-risk surgery. Indicators of dematerialization and the materials intensity of use. These metrics may be proxies for financial difficulties in resource-strapped facilities that may not have services available that complicated cirrhosis patients require. There is faith in the ability to effectively manage social and ecological systems, including by geo-engineering if necessary. There were no significant differences in total bed capacity, but ICU bed capacity was roughly 20% larger in the highest quintile compared to the other groups. Google Scholar. In fact, the beneficial effect of a liver transplant program was observed in non-transplant cases within that facility. We did this by first creating a hierarchical logistic regression model where patient covariates and year of admission were treated as fixed effects (level 1 variables) and hospital (level 2 variables) was treated as a random effect. - For a company, it is resource use per value added of the company. [4] Furthermore, the concept of eco-efficiency was first described by McIntyre and Thornton in 1978,[5] but it wasn't until 1992, when the term was formally coined and widely publicized by Stephan Schmidheiny in Changing Course. Resource productivity and resource intensity are key concepts used in sustainability measurement as they measure attempts to decouple the connection between resource use and environmental degradation. Baker, Susan. Hollenbeck BK, Wei Y, Birkmeyer JD. The strong reliance on fossil fuels and the lack of global environmental concern result in potentially high challenges to mitigation. The results of the WBCSD's work creating the "linkage between environmental performance and the bottom line was published in 1997 in its report Environmental Performance and Shareholder Value."[6]. The CMIP model results, as driven by scenarios, have become standard reference inputs for work concerning climate change science, impacts, vulnerability, adaptation, and mitigation. In a multivariable risk-adjusted model evaluating predictors of cirrhosis mortality, both patient and facility factors were significant (Table (Table2).2). American Economic Review, 59(3), 289297. Birkmeyer JD, Finlayson SR, Tosteson AN, Sharp SM, Warshaw AL, Fisher ES. Resource intensity is a measure of the resources (e.g. "[1][6] Furthermore, there are two different levels upon which to orchestrate the ratios: micro and macro. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change [Masson-Delmotte, V., P. Zhai, A. Pirani, S.L. Specifically, it may refer to: Measures of resource consumption are resource intensity and resource efficiency. We used data from the 2005-2011 Nationwide Inpatient Sample and the American Hospital Association Annual survey to identify hospitalizations for decompensated cirrhosis and corresponding facility characteristics. a) shows the radiative forcing due to volcanic, solar and well-mixed greenhouse gases (WMGHGs). Huesemann, M.H., and J.A. Processes of care are the way in which care is delivered in a particular context and how prevailing structural resources are used for patients. Created by rosshaller Terms in this set (33) Prospective payment system payment rates for healthcare services are established in advance for a specific time period. GHG Emission Pathways for each RCP from 2000-2100. DOI:doi:10.1007/s10584-013-0971-5, O'Neill, B., Tebaldi, C., Van Vuuren, D., et al., 2016:The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6, Geoscience Model Development 9, 34613482. URL: https://www.wcrp-climate.org/wgcm-cmip, World Climate Research Program (WCRP), 2021: PMIP Paleoclimate Modeling Intercomparison Project. The relationship between resource dependence and market orientation: The specific case of non-profit organizations. Retrieved from, BSD Global. official website and that any information you provide is encrypted The particular forcing values were chosen to allow easy comparison of the new scenarios to the RCPs used in the CMIP5 and IPCC AR5. the CMIPsadvance our understanding of the multi-scale dynamic interactions between natural and social systems that affect climate. According to the WBCSD, critical aspects of eco-efficiency are:[6][9][10]. An official website of the United States government. Figure 9. (2006). resource intensity fifth concept of case mix complexity refers to set of patients attributes that include this element government the major third pary reimburser in the US 1965 medicare was established in this year part a hospital insurance part b supplemental medical insurance october Eco-efficiency - Wikipedia From a case mix perspective, the lowest performing hospitals had a greater proportion of the relatively lower risk patients (APR-DRG minor and moderate), whereas the highest performing hospitals had a greater proportion of the highest mortality risk patients (APR-DRG major and extreme). While independent of the regularly produced IPCC-UNFCCC Assessment Reports, CMIP results nevertheless are coordinated and directly inform the Assessments. Facility level predictors of risk-adjusted mortality were higher Medicaid case-mix (OR = 1.00, P = 0.029) and LPN staffing (OR = 1.02, P = 0.015). In national economic and sustainability accounting it can be calculated as units of resource expended per unit of GDP. Length of stay averaged 6.0 1.6 days, and varied significantly by hospital performance (P < 0.001). DOI:doi:10.1007/s10584-011-0148-z, World Climate Research Program (WCRP), 2021: WCRP Coupled Model Intercomparison Project (CMIP). For inpatient cirrhosis care, these resources include hospital bed capacity, staffing patterns of physicians and nurses, teaching status, endoscopic and imaging services, critical care and transplant personnel, and other specialized services. water, energy, materials) needed for the production, processing and disposal of a unit of good or service, or for the completion of a process or activity; it is therefore a measure of the efficiency of resource use. Retrieved 9 February 2013, from <, Government of Canada. Resource Intensity for Children and Youth: The Development of an Individual models can also have systematic biases that present themselves as strong outliers. Eco-efficiency is routinely a concept used because it combines performance along two of the three axes of sustainable development,[4] making it easier for academics and leading thinkers to tease out the associated social issues.[6]. Their strength is that they can be used as a metric for both economic and environmental cost. Resource efficiency is vital ideas for assessing dematerialization policies that are driven by efficiency (Environmental Justice Organizations, Liabilities and Trade 2019). "Growthphilia": there is nothing wrong with, This page was last edited on 20 November 2022, at 21:31. Resource intensity is defined as refers to the - Course Hero World Development, 33(7), 10291044. CMIP6 experimental organization. For purposes of informing societal decisions, shorter time horizons are highly relevant. RCP2.6 is representative of a scenario that aims to keep global warming likely below 2C above pre-industrial temperatures. While MIPs are given priority by CMIP, and organizations can participate in as many or few as they are able, the DECK experiments are mandatory for any model to enter into the CMIP. Taylor & Francis. Unsustainable consumption by the steadily growing human population may lead to resource depletion and a shrinking of the earth's carrying capacity. URL: https://iiasa.ac.at/web/home/research/researchPrograms/TransitionstoNewTechnologies/RCP.en.html, Kriegler, E., Edmonds, J., Hallegatte, S., et al., 2014: A new scenario framework for climate change research: the concept of shared climate policy assumptions, Climatic Change 122:401414. "[6] It was their involvement which catapulted eco-efficiency into development. Figure 8shows global average temperature rise for the primary Scenarios presented in IPCC AR6. A resource intensity is the amount of the resource required to create one unit of power-generating capacity. These findings should help design cirrhosis care protocols and encourage care-networking between hospitals that have vast resource differences. Recent initiatives to develop cirrhosis quality improvement programs by the sharing of regional or national data between hospitals holds significant promise, particularly for hospitals with higher than expected mortality. Through international scientific cooperation and partnerships, the World Climate Research Program(WCRP) supports the coordination of partners and modeling groups participating in the Coupled Model Inter-comparison Projects, or CMIPs. Huppes, G., & Mansanobu, I. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA. Indicators to measure decoupling of environmental pressure from economic growth. Carbon dioxide (CO2) from fossil fuel use and industry is the single largest contributor to total emissions at 64%, while CO2from land use change and forestry accounts for 11% and methane (CH4) contributes 18%. To distinguish the magnitude of climate forcing, the numbering reflects a designated amount of radiative forcing (a measure of the extent to which GHGs in the atmosphere warm or cool the climate) measured in watts per square meter (W/m2) reached by 2100 (i.e., 2.6, 4.5, 6.0 and 8.5 W/m2 of change over pre-industrial, respectively). They are chosen to span a wide range without any tie to likelihood; the scenarios serve as what if cases. SSP3 Regional Rivalry(High challenges to mitigation and adaptation)A resurgent nationalism, concerns about competitiveness and security, and regional conflicts push countries to increasingly focus on domestic or, at most, regional issues. The statistical approach and study design cannot be used to determine causality, and population-based conclusions can lead to incorrect inferences when applied to individual patient treatments. Radiative forcing (RF) is a measure of the net change in the energy balance of the Earth system in response to some external perturbation; positive RF leads to a warming and negative RF to a cooling. When applied to a single person it is expressed as the resource use of that person per unit of consumption. Resource intensity remains a predictor of survival which is likely driven by the development of care processes based on the local care environment within hospitals. Figure Figure11 demonstrates the range of risk and reliability-adjusted odds ratios (aOR) for in-hospital mortality, or hospital performance in cirrhosis. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Industrialization and globalized markets have increased the tendency for overconsumption of resources. the response of the climate system to external drivers (such as increasing greenhouse gases). Anthropogenic emissions have driven the changes in WMGHG concentrations during the Industrial Era. Bulte, E. H., Damania, R., & Deacon, R. T. (2005). Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. The global climate continues to change rapidly compared to the pace of the natural variations in climate that have occurred throughout Earths history. Volume, process of care, and operative mortality for cystectomy for bladder cancer. Nguyen GC, Segev DL, Thuluvath PJ. The authors were able to merge the Healthcare Cost and Utilization Projects Nationwide Inpatient Sample data on hospital discharges with the American Hospital Association Annual Survey data on hospital structural resources to create a hierarchical logistic regression model to better understand hospital-level predictors of risk-adjusted mortality and how much hospital factors contribute to the overall variation in cirrhosis mortality between hospitals. Trends in globally averaged temperature, sea level rise, upper-ocean heat content, land-based ice melt, arctic sea ice, depth of seasonal permafrost thaw, and other climate variables provide consistent evidence of a warming planet. Mapping environmental justice: resource intensity and productivity. Patient demographic distributions varied significantly across quintiles, including age, sex, race, and payer mix. This distribution was reversed in the lowest performing group - Northeastern hospitals made up more than 34% of this group. SO2 emissions). Scenariosshould be used as tools to help understand the characteristics and magnitude of emerging climate signals to inform decisions. Maycock, T. Waterfield, O. Yeleki, R. Yu, and B. Zhou (eds.)]. Liver transplant centers had 17% lower odds of mortality non-transplant facilities across all cirrhosis admissions. This notion and some of the findings of this study naturally imply that further capital investments by hospitals may improve clinical outcomes in cirrhosis. The pattern of observed changes in the climate system is consistent with an increased greenhouse effect. By exclusion, based on our conceptual model, this residual variation can be attributable to processes of care and random error. Annual cirrhosis volume, case mix, nurse staffing, liver transplant services, and other facility characteristics accounted for this variation, but it is notable that the majority of variation between hospitals remains unexplained. For a complete description of SSP Narratives, see O'Neill et al. URL: https://www.wcrp-climate.org/modelling-wgcm-mip-catalogue/cmip6-endorsed-mips-article/1064-modelling-cmip6-pmip. Climate records over past centuries and millennia indicate that average temperatures in recent decades over much of the world have been much higher, and have risen faster during this time period, than at any time for which the historical global distribution of surface temperatures can be reconstructed. Resource intensity remains a predictor of survival which is likely driven by the development of care processes based on the local care environment within hospitals. GDP) and the (added) environment impacts of the product or service (e.g. Specifically, we aimed to identify specific factors that were different between hospitals based on their risk-adjusted performance, whether these factors were associated with survival, and to what extent did they explain variation in cirrhosis mortality across hospitals. Finlayson EV, Birkmeyer JD. resource intensity in English dictionary . Observed changes over the 20th century include increases in global air and ocean temperature, rising global sea levels, long-term sustained widespread reduction of snow and ice cover, and changes in atmospheric and ocean circulation as well as regional weather patterns, which influence seasonal rainfall conditions. Facility characteristics were derived from the American Hospital Association (AHA) Annual Survey. These two factors are the changes in the mix of materials and product composition of output. Different colors illustrate the two existing data sets for volcanic forcing and four estimates of solar forcing and the grey line represents WMGHGs for the period 850-2000. b) represents the simulated (red) and reconstructed (shading) Northern Hemisphere temperature anomalies. First, incremental eco-efficiency, which "specifies the effects of the total value of a product system or sector and its total concomitant environmental effects. Driven by an increasing commitment to achieving development goals, inequality is reduced both across and within countries. government site. All these factors lead to rapid growth of the global economy, while global population peaks and declines in the 21st century. When applied to a single person it is expressed as the resource use of that person per unit of consumption. We designed the statistical models to conceptually understand what factors account for differences in the mortality rate (risk and reliability-adjusted) between hospitals. HIT 205 DRG Quiz week 4 .docx - Question 1 5 / 5 pts How PDF 1 Measuring the resource intensity of production and consumption - OECD Conceptually, variation in cirrhosis mortality between hospitals, using the Donabedian model of health care quality, are attributable to differences in: (1) patient characteristics and severity of disease; (2) the structure of health care facilities; and (3) processes of cirrhosis care[1]. (2013). Climate models are mathematical representations of processes important in the Earths climate system. Resource Intensity - an overview | ScienceDirect Topics Patient and hospital characteristics by hospital performance quintile in risk and reliability-adjusted cirrhosis mortality. The study cohort included 72733 hospital admissions from 2005-2011 that were divided amongst 805 hospitals. Reimbursement Chapter 6 Flashcards | Quizlet We utilized admissions from NIS that contained an AHA Annual Survey identifier and had corresponding data in the AHA Survey. Energy intensity is frequently used in sustainability issues. The RCPs include a stringent mitigation scenario (RCP2.6), two intermediate scenarios (RCP4.5 and RCP6.0) and one scenario with high GHG emissions (RCP8.5). Investments in education and technological development decline. Structural factors are vital components to cirrhosis care delivery, and account for a significant proportion of the variation in cirrhosis mortality observed between hospitals. We excluded admissions to hospitals with a cirrhotic volume less than 25 patients annually as well as admissions missing data on sex, insurance type, hospital bed size, or had inconsistent or undefined liver transplant program status across the study period[1,2]. Resource Intensity Weights (RIWTM) are the relative case weights for CMGsTM that are used to calculate the relative cost and intensity of resource consumption for various diagnostic, surgical, and demographic features of an individual. 2021 The World Bank Group, All Rights Reserved. Nurse staffing with LPNs was 40% greater in low performing hospitals compared to the highest quintile, however physician staffing was similar. In the early 1970s Paul R. Ehrlich and John Holdren developed the lettering formula I = PAT to describe the impact of human activity on the environment. Hospital characteristics associated with failure to rescue from complications after pancreatectomy. Geoscientific Model Development, 9(5), 19371958. Ghaferi AA, Osborne NH, Birkmeyer JD, Dimick JB. URL: https://ar5-syr.ipcc.ch/ipcc/ipcc/resources/pdf/IPCC_SynthesisReport.pdf, IPCC, 2021: Summary for Policymakers. Medium-low emissions scenario (RCP4.5): A stabilization scenario which assumes action is taken to curb climate change by all countries resulting in a global average temperature rise of no more than 2 C and 3 C above pre-industrial temperature levels by the year 2100. Past climate information also documents the behavior of slow components of the climate system including the carbon cycle, ice sheets and the deep ocean for which instrumental records are short compared to their characteristic time scales of responses to perturbations, thus informing on mechanisms of abrupt and irreversible changes. CMIP5 used Representative Concentration Pathways(RCPs) and CMIP6 introduces the Shared Socio-economic Pathways (SSPs). Retrieved from. "This concept involves changes in production and consumption patterns that lead to sustainable use of natural resources;" [8] business has taken a key role in accelerating the use of this concept because businesses both consume and produce. The https:// ensures that you are connecting to the Scenarios without additional efforts to constrain emissions (baseline scenarios) lead to pathways ranging between RCP6.0 and RCP8.5. Recent data suggest that cirrhosis mortality differs widely across hospitals in the United States. These changes are caused by extra heat in the climate system due to the addition of greenhouse gases to the atmosphere. Hospital-adjusted odds ratios (aOR) for mortality ranged from 0.48 to 1.89.
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