This research investigates the impact of alternative allocation mechanisms that can be employed in the context of vaccine inventory rationing. Available vaccine inventory can be allocated to arrivals from high priority (target groups such as healthcare professionals) and low priority (non-target groups) demand classes using Partitioned Allocation (PA), Standard Nesting (SN), and Theft Nesting (TN). In any one of the mechanisms, a part of the available inventory is reserved for the exclusive use of the high priority demand class. They differ, however, in how the unreserved portion of the inventory is utilized: Under PA, demand from the high (low) priority class consumes only the reserved (unreserved) quantity. Under SN, demand from the high priority class first consumes the reserved quantity, once and if this quantity is exhausted, high priority demand competes with low priority demand for the remaining inventory. Under TN the sequence of allocation is reversed: both demand classes first compete for the unreserved inventory. Once this portion of inventory is exhausted, high priority demand is fulfilled from the reserved inventory and low priority demand is rejected. We develop service level (probability of fulfilling the entire demand) and fill rate (fraction of demand fulfilled) expressions for all three allocation mechanisms. Based on these expressions, numerical analyses are conducted to illustrate which allocation mechanism a health planner should choose depending on the availability of vaccines, and how the health planner should set the reserved quantity for the high priority class. We observe that (1) there exist certain conditions under which one of the allocation mechanisms outperforms the others and (2) this effect is determined by the decision maker’s choice of the performance measure.

This study is a cost-analysis that calculates the impact of three interventions for patients identified as ‘at risk’ for Acute Coronary Syndrome - a cardio-vascular exercise programme, point-of-care digital diagnostics, and telemonitoring adherence tools. The methodology utilizes a model of the annualized costs of ACS for the entire treatment value chain, and measures the impact of the three interventions by the change in treatment cost, incremental net benefit, and QALY. The results demonstrate that the largest impact is measured when all three interventions are utilized simultaneously producing a cumulative savings of €4424 and 0.126 QALY per patient. We also find a significant decrease in Emergency Room visits by 15% and changes in rates of utilization of Catharization (?59%), Angioplasty (?59%), Bypass (?17%), Medication (?14%) and Rehabilitation (?13%).

The objective of this paper is to investigate the impact that individual raters have on maturity assessments of organizations in the particular context of business process management (BPM). The hypotheses tested relate to the extent of the impact of individuals on maturity score variances and with the enforcing effect of organizational size on the disagreement among employees within organizations. Eight multilevel random-effects analyses for eight separate maturity dimensions clarify the intra-class correlation (agreement) within organizations. The analyses are based on a data set with a strictly hierarchical two-level data structure of employees (1755) nested within organizations (61). Results show that variance within organizations is significantly larger than zero and is even more important than variance between organizations. We conclude that a large individual background effect exists when rating an organization's business process maturity. In addition, we find that the larger the organizations are, the more disagreement within organizations is visible. Copyright © 2012 John Wiley & Sons, Ltd.