Ser eficiente é um requisito para a sustentabilidade das empresas concessionárias de distribuição de energia elétrica no Brasil. A busca pela eficiência deve estar em harmonia com a melhoria contínua da qualidade, da segurança e da satisfação dos consumidores e das partes envolvidas. O desafio de atender múltiplos objetivos requer que as empresas do setor desenvolvam soluções inovadoras, com a mudança de processos, tecnologia, estrutura e a capacitação das pessoas. Desenvolver um modelo operacional eficiente e uma gestão rigorosa dos custos são fatores-chave para o sucesso das empresas, considerando o contexto regulatório de revisão tarifária que incentiva a melhoria do desempenho. O modelo operacional é definido a partir da organização logística dos recursos para atendimento da demanda de serviços, que define também os custos fixos e variáveis de pessoal (salário, horas extras, refeições), infraestrutura (manutenção de prédios, ferramentas e equipamentos) e deslocamentos (manutenção de veículos, combustível), por exemplo. A melhor alocação e o melhor dimensionamento de bases operacionais possibilitam a redução dos custos com deslocamento e infraestrutura, favorecendo o aproveitamento da força de trabalho em campo, a melhoria do atendimento dos clientes e da segurança dos colaboradores. Este trabalho apresenta uma metodologia de otimização de custos através da alocação de bases e equipes operacionais, com o modelamento matemático dos objetivos e restrições do negócio e a aplicação de algoritmo evolutivo para busca das melhores soluções, sendo uma aplicação de Pesquisa Operacional, no campo da Localização de Instalações, em distribuição de energia elétrica. O modelo de otimização desenvolvido possibilita a busca pelo ponto de equilíbrio ótimo que minimiza o custo total formado pelos custos de infraestrutura, frota (veículos e deslocamentos) e pessoal. O algoritmo evolutivo aplicado no modelo oferece soluções otimizadas pelo melhoramento de conjuntos de variáveis binárias com base em conceitos da evolução genética. O modelo de otimização fornece o detalhamento de toda a estrutura operacional e de custos para uma determinada solução do problema, utilizando premissas de produtividade e deslocamentos (velocidades e distâncias) para definir as abrangências de atuação das bases operacionais, recursos (equipes, pessoas, veículos) necessários para atendimento da demanda de serviços, e projetar todos os custos fixos e variáveis associados. A metodologia desenvolvida neste trabalho considera também a projeção de demanda futura para a aplicação no estudo de caso, que evidenciou a efetividade da metodologia como ferramenta para a melhoria da eficiência operacional em empresas de distribuição de energia elétrica. / Being efficient is a requirement for the sustainability of electricity distribution companies in Brazil. The quest for efficiency must be in harmony with the continuous improvement of quality, safety and satisfaction of customers and all stakeholders involved. The challenge of attending multi-objectives requires companies in the sector to develop innovative solutions with the change of processes, technology, structure and enabling their professionals to drive this. Developing an efficient operational model and a strict cost management are keys for companies to achieve success, considering the regulatory context of tariff reviewing that encourages performance improvement. The operational model is defined from the logistics organization of resources to meet the demand of services, which also defines fixed and variable costs with people/teams (payments, overtime, meals), infrastructure (maintenance of building, tools and equipments) and fleet (maintenance of vehicles and fuel costs), for example. The best allocation and the best design of operational facilities (or operational bases) will reduce infrastructure costs and truck rolls, releasing workforce to attend customers and reducing displacements risks. This work presents a cost optimization methodology through the allocation of operational bases and teams, with the mathematical modelling of business objectives, constraints and using Evolutionary Algorithm to find the best solution, as an application of Operations Research in the field of Facility Location in electricity distribution. The optimization model enables the search for the optimal balance point that minimizes the total cost formed by infrastructure, fleet and people. The Evolutionary Algorithm applied in the model offers optimized solutions through the improvement of sets of binary variables based on genetic evolution concepts. The optimization model also gives detailed information about the operational structure and costs for a given allocation solution, using productivity and displacements (speed, distances) information to define the service regions for each operational base and resources (people, vehicles) needed to attend the demand of services, defining all fixed and variable costs for this. The methodology presented in this paper also considers the future demand of services (forecast), used in a case study that showed the effectives of this methodology as a tool for the improvement of operational efficiency in electricity distribution companies.

Os gastos com saúde vêm crescendo em ritmo alarmante e os hospitais universitários, as unidades mais complexas dos sistemas de saúde, enfrentam grandes desafios para reduzir custos e melhorar a eficiência operacional. Considerando-se que a gestão de relacionamento com fornecedores tem grande potencial para apoiar melhorias de desempenho no setor hospitalar e, conforme indicações da literatura acadêmica, tem limitada abordagem no setor hospitalar, decidiu-se aprofundar o estudo de gestão de relacionamento com fornecedores em organizações hospitalares. Tendo-se como referência uma revisão sistemática de literatura, desenvolveu-se um framework específico para gestão de relacionamento com fornecedores em hospitais. O framework estabelece aspectos relacionados com apoio da alta administração, estrutura organizacional, infraestrutura de tecnologia de informação e capacitações dos recursos humanos como requisitos que devem ser atendidos para possibilitar a implementação de processos de gestão de relacionamento com fornecedores em hospitais. Com o auxílio do framework, foram realizados estudo de casos em quatro hospitais universitários de grande porte, dois públicos e dois privados. Nos relatórios dos casos são analisados o atendimento aos requisitos mencionados, os processos utilizados nos hospitais universitários e as dificuldades enfrentadas para a gestão de relacionamento com fornecedores. Constatou-se que os hospitais universitários privados estão mais evoluídos que os públicos na implantação de gestão de relacionamento com fornecedores. Restrições impostas pela legislação de compras públicas, políticas públicas de gestão de recursos humanos e carência de recursos financeiros para investimentos na infraestrutura de tecnologia de informação impedem que os hospitais universitários públicos consigam melhores resultados com a gestão de relacionamento com fornecedores. Este estudo contribui para preencher uma lacuna referente à abordagem de gestão de relacionamento com fornecedores em hospitais universitários e disponibiliza informações que podem auxiliar os gestores hospitalares a aprimorar a gestão de relacionamento com fornecedores. / Health spending has been growing at an alarming rate, and university hospitals, the most complex units of health care systems, face major challenges in reducing costs and improving operational efficiency. Considering that supplier relationship management has great potential to support performance improvements in the hospital sector and, as indicated in the academic literature, has received limited approach in the healthcare sector, it was decided to deepen the study of supplier relationship management in hospitals. Based on a systematic literature review, a specific framework for supplier relationship management in hospitals was developed. The framework establishes aspects related to senior management support, organizational structure, information technology infrastructure and human resource skills as requisites that must be met to enable the implementation of supplier relationship management processes in hospitals. With the help of the framework, a case study was carried out in four large university hospitals, two public and two private hospitals. In the case study reports it was analyzed the attendance to the mentioned requisites, the processes used in university hospitals and the difficulties faced for the supplier relationship management. It was verified that private university hospitals are more developed than the public ones in the implementation of supplier relationship management practices. Constraints imposed by public procurement legislation, public policies for human resources management and lack of financial resources for investments in information technology infrastructure prevent public university hospitals from achieving better results with supplier relationship management. This study contributes to fill a gap regarding supplier relationship management approach in university hospitals and provides information that can help hospital managers to improve supplier relationship management.

Ser eficiente é um requisito para a sustentabilidade das empresas concessionárias de distribuição de energia elétrica no Brasil. A busca pela eficiência deve estar em harmonia com a melhoria contínua da qualidade, da segurança e da satisfação dos consumidores e das partes envolvidas. O desafio de atender múltiplos objetivos requer que as empresas do setor desenvolvam soluções inovadoras, com a mudança de processos, tecnologia, estrutura e a capacitação das pessoas. Desenvolver um modelo operacional eficiente e uma gestão rigorosa dos custos são fatores-chave para o sucesso das empresas, considerando o contexto regulatório de revisão tarifária que incentiva a melhoria do desempenho. O modelo operacional é definido a partir da organização logística dos recursos para atendimento da demanda de serviços, que define também os custos fixos e variáveis de pessoal (salário, horas extras, refeições), infraestrutura (manutenção de prédios, ferramentas e equipamentos) e deslocamentos (manutenção de veículos, combustível), por exemplo. A melhor alocação e o melhor dimensionamento de bases operacionais possibilitam a redução dos custos com deslocamento e infraestrutura, favorecendo o aproveitamento da força de trabalho em campo, a melhoria do atendimento dos clientes e da segurança dos colaboradores. Este trabalho apresenta uma metodologia de otimização de custos através da alocação de bases e equipes operacionais, com o modelamento matemático dos objetivos e restrições do negócio e a aplicação de algoritmo evolutivo para busca das melhores soluções, sendo uma aplicação de Pesquisa Operacional, no campo da Localização de Instalações, em distribuição de energia elétrica. O modelo de otimização desenvolvido possibilita a busca pelo ponto de equilíbrio ótimo que minimiza o custo total formado pelos custos de infraestrutura, frota (veículos e deslocamentos) e pessoal. O algoritmo evolutivo aplicado no modelo oferece soluções otimizadas pelo melhoramento de conjuntos de variáveis binárias com base em conceitos da evolução genética. O modelo de otimização fornece o detalhamento de toda a estrutura operacional e de custos para uma determinada solução do problema, utilizando premissas de produtividade e deslocamentos (velocidades e distâncias) para definir as abrangências de atuação das bases operacionais, recursos (equipes, pessoas, veículos) necessários para atendimento da demanda de serviços, e projetar todos os custos fixos e variáveis associados. A metodologia desenvolvida neste trabalho considera também a projeção de demanda futura para a aplicação no estudo de caso, que evidenciou a efetividade da metodologia como ferramenta para a melhoria da eficiência operacional em empresas de distribuição de energia elétrica. / Being efficient is a requirement for the sustainability of electricity distribution companies in Brazil. The quest for efficiency must be in harmony with the continuous improvement of quality, safety and satisfaction of customers and all stakeholders involved. The challenge of attending multi-objectives requires companies in the sector to develop innovative solutions with the change of processes, technology, structure and enabling their professionals to drive this. Developing an efficient operational model and a strict cost management are keys for companies to achieve success, considering the regulatory context of tariff reviewing that encourages performance improvement. The operational model is defined from the logistics organization of resources to meet the demand of services, which also defines fixed and variable costs with people/teams (payments, overtime, meals), infrastructure (maintenance of building, tools and equipments) and fleet (maintenance of vehicles and fuel costs), for example. The best allocation and the best design of operational facilities (or operational bases) will reduce infrastructure costs and truck rolls, releasing workforce to attend customers and reducing displacements risks. This work presents a cost optimization methodology through the allocation of operational bases and teams, with the mathematical modelling of business objectives, constraints and using Evolutionary Algorithm to find the best solution, as an application of Operations Research in the field of Facility Location in electricity distribution. The optimization model enables the search for the optimal balance point that minimizes the total cost formed by infrastructure, fleet and people. The Evolutionary Algorithm applied in the model offers optimized solutions through the improvement of sets of binary variables based on genetic evolution concepts. The optimization model also gives detailed information about the operational structure and costs for a given allocation solution, using productivity and displacements (speed, distances) information to define the service regions for each operational base and resources (people, vehicles) needed to attend the demand of services, defining all fixed and variable costs for this. The methodology presented in this paper also considers the future demand of services (forecast), used in a case study that showed the effectives of this methodology as a tool for the improvement of operational efficiency in electricity distribution companies.

The topic of the diploma thesis is the operational efficiency of heat sources . The thesis is divided into three parts. In the first part a theoretical solution of the heat sources efficiency can be found. In the second part there is a calculation solution of the project. The project solves the heating of a football stadium. Two variants of the heating source and warm water preparation are suggested and the variants are consequently compared and evaluated. The last part is experimental - the topic of the experiment is the efficiency of heat sources.

La presente tesis ha sido realizada con la finalidad de evaluar el impacto de la gestión de la cadena de suministros verde de frutas y verduras como estrategia sostenible para mejorar la eficiencia operacional de las empresas del rubro agro – exportador de la región Lambayeque. El objetivo principal, es identificar y evaluar la gestión de la cadena de suministros verde de frutas y verduras Como estrategia sostenible, analizando los elementos y principales actores que intervienen en la eficiencia operacional de la misma, teniendo en cuenta la realidad actual de las empresas seleccionadas para el estudio y así poder determinar su principal problemática. En la actualidad, el mundo globalizado está generando nuevas problemáticas y perspectivas, entre ellos los más significativos son los de índole industrial - ambiental, por lo cual resulta importante evaluar su efecto en relación de cada cadena de suministro a utilizar. Por esta razón, se busca que esta investigación sirva para comprender más sobre dicho tema. Para el desarrollo de esta investigación nos hemos apoyado en diversas entrevistas, encuestas y casos para generar un análisis completo y detallado, Por lo cual, la fuerza impulsora clave para mejorar la eficiencia de la cadena de suministro verde de frutas y verduras es construir el mecanismo de toma de decisiones en colaboración científica y racional de la cadena de suministro, a fin de resolver los problemas relacionados con la cadena de suministro verde de frutas y verduras. / This thesis has been carried out with the purpose of evaluating the impact of the management of the green fruit and vegetable supply chain as a sustainable strategy to improve the operational efficiency of companies in the agro - export sector of the Lambayeque region. The main objective is to identify and evaluate the management of the green supply chain of fruits and vegetables As a sustainable strategy, analyzing the elements and main actors that intervene in the operational efficiency of the same, taking into account the current reality of the selected companies for the study and thus be able to determine its main problem. At present, the globalized world is generating new problems and perspectives, among which the most significant are those of an industrial - environmental nature, for which it is important to evaluate its effect in relation to each supply chain to be used. For this reason, it is sought that this research serves to understand more about this topic. For the development of this research we have relied on various interviews, surveys and cases to generate a complete and detailed analysis. Therefore, the key driving force to improve the efficiency of the green supply chain of fruits and vegetables is to build the mechanism of decision-making in scientific and rational collaboration of the supply chain, in order to solve the problems related to the green supply chain of fruits and vegetables. / Tesis

This master’s thesis elaborates a design of water heating and heating system for a building of a rehabilitation center in Horný Hričov. The theoretical section describes operational efficiency of gas boilers and associated calculation methods. The experimental section covers measurements of condensing gas boiler at various temperatures of heating water conducted in university laboratory. Operational efficiency was then calculated using indirect method based on the measurement results. Subsequently, calculated values and values measured by an operational efficiency analyzer were compared. The comparison revealed minor deviations in operational efficiency values and different values of condensing heat utilization between the calculations and the analyzer results. The analytical section of the thesis consists of complex designs of two versions of the heating system and the water heating. The first design version uses condensing gas boilers as a heat source while the second version uses a water-air heat pump instead. The project section of the thesis is executed in the scope for a building permit and consists of a technical report and a design documentation.

Целью исследования является совершенствование инструментария повышения эффективности деятельности авиакомпаний в сфере региональных воздушных перевозок. Предложен методический подход к повышению эффективности региональных воздушных перевозок, элементами которого являются выработка стратегических решений по совершенствованию структуры парка воздушных судов, тактических решений по их распределению по маршрутам региональных перевозок, обоснование направлений совершенствования системы полетного сервиса и методическое обеспечение этих элементов. Предложенные автором рекомендации позволяют повысить эффективность деятельности авиакомпаний в сфере региональных воздушных перевозок. / The aim of the work is to improve the instruments of operational efficiency in the regional airlines. Methods to improving operational efficiency in the regional airlines consist of the development of strategic solutions to improve air fleet efficiency, tactical decisions of aircraft routing on regional air traffic, the rationale for the flight services improvement and methodological support of these elements. The author’s methods make it possible to improving operational efficiency in the regional airlines.

Digital platforms and tools have already taken over a large part of human daily lives and with the latest pandemic of COVID-19 it is clear how these technological trends have just increased, in both intensity and complexity, across most of the different aspects that comprehend our everyday activities. For instance, people are staying more at home and people now socialize, consume and work with help of different digital tools, which in other words means that the homes’ original role is changing to a more multifaceted and integral function. Based on such reality, this master thesis aims to investigate how property owners of housing rentals in Stockholm could extract value from these mentioned trends and context by incorporating new alternative income streams in their current business models. Moreover, this academic inquiry also intends to investigate the financial effect that these streams incorporation could have on a property valuation in the housing rental sector of Stockholm.  This thesis project follows two different, yet subsequential, lines of research, where the first one is an interview with local industry experts that provided insights in which kind of potential new value streams that property owners could incorporate in their current business models. They also shared information regarding which kind of digital tools are needed nowadays to make the new offering to the tenants in the most effective way within the Stockholm Private Rental Sector context. The industry experts also gave estimations of the cash flows enhancements that these service incorporation could bring to the owner . This information created the foundation that was used to later interview property owners. The property owners gave information of which kind of digital tools they used today, and what their view was about incorporating the new services and contracts that the industry experts had pointed out as possible new income streams. Both sets of interviews were analyzed with help of finding themes and reviewed literature that allowed the authors of this project to move on to evaluate the financial effect on a housing rental property in Stockholm whenever the new cash flows of the filtered income streams were considered.  The thesis has reached the conclusion that an incorporation of provision of services can create value for both the tenant and the property owner, even though specific services that should be incorporated aren't pointed out. The market was, at the time this thesis was written, immature and fast moving, which makes it hard to say which services will be successful in the Swedish market. Despite this are the results pointing out that contracts as home-electricity and insurances are among the services that have the lowest barrier to implement, and have already been tried by some actors in the industry. For those actors that have started an incorporation of provision of services have already noticed new cash-flows streams, even if they today are minor. The second conclusion is that those cash-flows will in the future trigger higher property values as properties will be a more attractive asset to possess. To be able to identify the demand and extract value from it in a successful way is a user-centered approach a key aspect, as the transaction must create new value for all actors involved / Digitala plattformer och verktyg har redan tagit över en stor del av människors dagliga liv och med den senast Corona-pandemin är det tydligt hur teknologiska trender har ökat, i både intensitet och komplexitet, och påverkar de flesta människors vardagsaktiviteter. Under Corona-pandemin har människor spenderat mer tid hemma och människor har socialiserar, konsumerar och arbetar med hjälp av olika digitala verktyg, vilket innebär att hemmets originella funktion har förändrats till en mer mångfacetterad funktion i människors liv. Baserad på detta så undersöker denna masteruppsatsen hur fastighetsägare, av hyresrätter i Stockholm, kan extrahera värde från dessa nämnda trender genom att inkorporera nya intäktsströmmar i deras befintliga affärsmodell. Denna akademiska uppsats undersöker också vilken påverkan dessa nya intäktsströmmar har på fastighetsvärden i hyresrättssektorn i Stockholm.  Metoden för att nå en slutsats är uppdelad i två processer, där den första är att intervjua vad som benämns i uppsatsen som industri-experter inom ämnet proptech. Dessa bidrar med insikt kring vilka nya intäktsströmmar som möjliga att inkorporera i fastighetsägares nuvarande affärsmodell. Dom understödjer också med information kring vilka digitala verktyg som är nödvändiga för att kunna inkorporera tjänsteförmedling på ett effektivt sätt till hyresgäster i Stockholms privata hyressektor. Utöver detta så ger industri-experterna estimeringar kring vilka värden som kunde tillfalla fastighetsägarens för varje enskild tjänsteförmedling. Denna information används som ett underlag vid nästa skede av intervjuprocessen med fastighetsägarna. Fastighetsägarna bidrar med information kring vilka digitala verktyg dom använde, vid tidpunkten denna uppsats skrevs, och deras syn på att inkorporera förmedling av de tjänster och kontrakt som industri-experterna pekar ut under första intervjuprocessen. Intervjuerna analyseras med hjälp av tematisk analys och parallellt med detta analyseras litteratur, vilket skapade möjlighet att utvärdera vilka finansiella effekter som en inkorporering av tjänsteförmedling kan få på hyresrättssektorn i Stockholm.  Uppsatsen når slutsatsen att inkorporering av tjänsteförmedling kan skapa värde för både hyresgästen och fastighetsägaren, även om de specifika tjänsterna inte pekas ut. Marknaden var vid tidpunkten när denna uppsats skrevs omogen och utvecklades snabbt vilket gör det svårt att svara på vilka tjänster som kommer vara framgångsrika i en svensk marknad. Trots detta pekar resultat på att kontakt som hushållsel och hemförsäkring hade låga ingångsbarriärer i marknaden att implementera, och vissa fastighetsägare har redan påbörjat denna process. Denna inkorporering har för dessa aktörer inneburit vissa nya intäktsströmmar, som dock är väldigt begränsade. Den andra slutsatsen är att de nya intäktsströmmar i framtiden kommer utlösa högre fastighetsvärderingar då fastigheter kommer bli en attraktivare tillgång att inneha. För att kunna identifiera efterfrågan och extrahera värdet ur en tjänsteförmedlingen, på ett framgångsrikt sätt, är en användarcentrerad strategi en viktig aspekt då transaktionerna som sker mellan fastighetsägaren och hyresgästen måste vara värdeskapande för alla inblandade aktörer.

[ES] La buena gestión de la atención primaria como puerta de entrada al sistema sanitario condiciona el funcionamiento de la atención especializada y la hospitalización, lo cual repercute directamente sobre la salud de la población. La sostenibilidad del sistema de salud público implica que los servicios de atención primaria sean eficientes. Objetivo Desarrollar un modelo para evaluar la eficiencia en cuanto a actividad realizada y resultados de salud de las unidades funcionales (UF) de atención primaria del Departamento de Salud Valencia Clínico - La Malvarrosa en los años 2015 a 2019. Metodología Se han integrado las bases de datos de la Conselleria de Sanitat Universal i Salut Pública y el Departamento de Salud Valencia Clínico - La Malvarrosa para obtener para cada UF: características de la población asignada, actividad asistencial y recursos humanos de los centros y consultorios de atención primaria. El análisis factorial pone de manifiesto las principales diferencias y similitudes encontradas entre las UF y permite reducir el número de variables utilizadas para elaborar los modelos de evaluación de la eficiencia, de manera que no se pierda poder explicativo, y facilite la interpretación de los resultados. Se ha utilizado el Análisis Envolvente de Datos (DEA) con orientación input y output y rendimientos variables a escala para la evaluación de la eficiencia. Los inputs incluidos han sido las tasas por 10.000 habitantes de: personal facultativo y personal de enfermería (inputs no discrecionales) y coste farmacéutico; como outputs se han incluido las tasas por 10.000 habitantes de: urgencias hospitalarias, consultas externas, derivaciones, hospitalizaciones evitables, mortalidad evitable y el indicador de eficiencia en la prescripción. Urgencias, hospitalizaciones evitables y mortalidad evitables se consideran outputs no deseables. Y como variables exógenas se han incluido el porcentaje de población mayor de 65 y 80 años y un indicador de morbilidad (case-mix). Se han analizado las puntuaciones de eficiencia de cada UF según tres modelos. Todos los modelos incorporan los mismos inputs y diferentes combinaciones de outputs relacionados con: Actividad asistencial (primer modelo), outcomes o resultados de salud (segundo modelo) y actividad asistencial + outcomes (tercer modelo, en el que se incluyen todos los outputs). Cada modelo se analiza con y sin variables exógenas. Resultados Se han evaluado los tres modelos con sus diferentes especificaciones para identificar las diferencias entre ellos y ver cuál de ellos permite diferenciar más claramente la eficiencia de las UF, teniendo en cuenta variables de calidad, y las características de la población. Se ha obtenido la puntuación de eficiencia de cada UF y se han identificado las UF que forman parte de la frontera eficiente del grupo estudiado. Los resultados han mostrado que existen diferencias en las puntuaciones de eficiencia estimadas en función de las variables introducidas como outputs. Determinadas UF se encuentran siempre en la frontera eficiente o muy cerca, mientras que otras UF son siempre ineficientes. Por otra parte, cuando se consideran outputs de actividad asistencial, las puntuaciones de eficiencia de todas las UF mejoran y aumenta el número de UF eficientes. Se detecta que la puntuación de eficiencia de las UF desciende, en general, a lo largo del periodo evaluado. Esta disminución es más pronunciada cuando se incluyen sólo los outputs de actividad. Conclusiones Se han obtenido diferentes resultados en función del modelo utilizado. El DEA permite analizar las ineficiencias de los centros de atención primaria, aunque es necesario identificar los objetivos esperados de las UF, ya que la perspectiva de los análisis influye en los resultados. / [CA] La bona gestió de l'atenció primària com a porta d'entrada al sistema sanitari condiciona el funcionament de l'atenció especialitzada i l'hospitalització, la qual cosa repercuteix directament sobre la salut de la població. La sostenibilitat del sistema de salut públic implica que els serveis d'atenció primària siguen eficients. Objectiu Desenvolupar un model per a avaluar l'eficiència quant a activitat realitzada i resultats de salut de les unitats funcionals (UF) d'atenció primària del Departament de Salut València Clínic - La Malva-rosa en els anys 2015 a 2019. Metodologia S'han integrat les bases de dades de la Conselleria de Sanitat Universal i Salut Pública i el Departament de Salut València Clínic - La Malva-rosa per a obtindre per a cada UF: característiques de la població assignada, activitat assistencial i recursos humans dels centres i consultoris d'atenció primària. L'anàlisi factorial posa de manifest les principals diferències i similituds trobades entre les UF i permet reduir el nombre de variables utilitzades per a elaborar els models d'avaluació de l'eficiència, de manera que no es perda poder explicatiu, i facilite la interpretació dels resultats. S'ha utilitzat l'Anàlisi Envolupant de Dades (DEA) amb orientació input i output i rendiments variables a escala per a l'avaluació de l'eficiència. Els inputs inclosos han sigut les taxes per 10.000 habitants de personal facultatiu i personal d'infermeria (inputs no discrecionals) i cost farmacèutic; com a outputs s'han inclòs les taxes per 10.000 habitants de consultes, urgències hospitalàries, derivacions, hospitalitzacions evitables, mortalitat evitable i l'indicador d'eficiència en la prescripció. Urgències, hospitalitzacions evitables i mortalitat evitables es consideren outputs no desitjables. I com a variables exògenes s'han inclòs el percentatge de població major de 65 i 80 anys i un indicador de morbiditat (case-mix). S'han analitzat les puntuacions d'eficiència de cada UF segons tres models. Tots els models incorporen els mateixos inputs i diferents combinacions d'outputs relacionats amb activitat assistencial (primer model), outcomes o resultats de salut (segon model) i activitat assistencial + outcomes (tercer model, en el qual s'inclouen tots els outputs). Cada model s'analitza amb i sense variables exògenes. Resultats S'han avaluat els tres models amb les seues diferents especificacions per a identificar les diferències entre ells i veure quin d'ells permet diferenciar més clarament l'eficiència de les UF, tenint en compte variables de qualitat, i les característiques de la població. S'ha obtingut la puntuació d'eficiència de cada UF i s'han identificat les UF que formen part de la frontera eficient del grup estudiat. Els resultats han mostrat que existeixen diferències en les puntuacions d'eficiència estimades en funció de les variables introduïdes com a outputs. Determinades UF es troben sempre en la frontera eficient o molt a prop, mentre que unes altres UF són sempre ineficients. D'altra banda, quan es consideren outputs d'activitat assistencial, les puntuacions d'eficiència de totes les UF milloren i augmenta el número d'UF eficients. Es detecta que la puntuació d'eficiència de les UF descendeix, en general, al llarg del període avaluat. Aquesta disminució és més pronunciada quan s'inclouen només els outputs d'activitat. Conclusions S'han obtingut diferents resultats en funció del model utilitzat. El DEA permet analitzar les ineficiències dels centres d'atenció primària, encara que és necessari identificar els objectius esperats de les UF, ja que la perspectiva de les anàlisis influeix en els resultats. / [EN] The proper management of primary healthcare as the gateway to the health system determines the performance of specialised healthcare and hospitalisation, which has a direct impact on the health of the population. The sustainability of the public health system requires the efficiency of primary healthcare services. Objectives To develop a model to evaluate the efficiency in terms of activity and health outcomes of the functional units (FU) of primary healthcare of the Valencia Clínico - La Malvarrosa Health District in the years 2015 to 2019. Methodology The databases of the Conselleria de Sanitat Universal i Salut Pública and the Valencia Clínico - La Malvarrosa Health District have been integrated to obtain for each FU: characteristics of the covered population, healthcare activity and human resources of the primary healthcare centres. The factorial analysis reveals the main differences and similarities found between the FUs and makes it possible to reduce the number of variables used to develop the efficiency evaluation models, so as not to lose explanatory power and to facilitate the interpretation of the results. Data Envelopment Analysis (DEA) with input and output orientation and variable returns to scale has been used to assess the efficiency. The inputs included were the rates per 10,000 inhabitants of: professional and nursing staff (non-discretionary inputs) and pharmaceutical cost; outputs included the rates per 10,000 inhabitants of: consultations, hospital emergencies, referrals, avoidable hospitalisations, avoidable mortality and the prescription efficiency indicator. Emergencies, avoidable hospitalisations and avoidable mortality are considered undesirable outputs. As exogenous variables we have included the percentage of the population over 65 and 80 years old and a morbidity indicator (case-mix). The efficiency scores of each FU have been analysed according to three models. All models incorporate the same inputs and different combinations of outputs related to: healthcare activity (first model), outcomes (second model) and healthcare activity + outcomes (third model, in which all outputs are included). Each model is analysed with and without exogenous variables. Results The three models have been evaluated with their different specifications to identify the differences between them and to see which of them allows the efficiency of the FU to be differentiated more clearly, considering quality variables and the characteristics of the population. The efficiency score of each FU has been obtained and the FUs that form part of the efficient frontier of the group studied have been identified. The results show that there are differences in the estimated efficiency scores depending on the variables introduced as outputs. Certain FUs are always on the efficient frontier or very close to it, while other FUs are always inefficient. On the other hand, when healthcare activity outputs are considered, the efficiency scores of all FUs improve and the number of efficient FUs increases. It is found that the efficiency score of the FU generally decreases over the period under evaluation. This decline is more pronounced when only activity outputs are included. Conclusions Different results have been obtained depending on the model used. The DEA makes it possible to analyse the inefficiencies of primary healthcare centres, although it is necessary to identify the expected objectives of the FU, as the perspective of the analysis influences the results. / González De Julián, S. (2023). Medida de la eficiencia en atención primaria: fronteras eficientes y modelos no paramétricos condicionados [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/196735

In the rapidly evolving landscape of global manufacturing, the ability to efficiently ramp upproduction for new products is crucial for maintaining competitive advantage. This thesis builds on ramp-up strategies proposed by Slamanig and Winkler (2011) and Schuh et al.(2005) put in relation to different International Manufacturing Network configurations (IMN) as described by Abele et al. (2008). Each IMN configuration introduces distinct challenges and advantages, focusing on efficient resource allocation and integration of the production network during ramp-up.Using Atlas Copco’s screw feeding system as a case study, the purpose of this research is to develop a strategic framework aimed to guide operational decisions to enhance ramp-up efficiency in a global manufacturing context. The research method involved a qualitative case study combined with a literature review. The qualitative case study consisted of interviews with key stakeholders, participation in workshops and production site visits. Based on the findings from the case study and the literature study, a framework guiding operational decisions related to ramp-up of new products is developed. The analysis results in practical recommendations and strategies to achieve ramp-up objectives such as target output volume, quality, speed, and cost efficiency. The thesis identifies critical factors such as the alignment of the international manufacturing configurations with operational strategy and the importance of agility in production systems.The proposed framework offers practical recommendations for multinational corporations to optimize their ramp-up processes, thereby ensuring quicker market entry and better product quality. This research provides valuable insights for manufacturing firms looking to enhance their global production strategies, ultimately leading to improved competitiveness and market responsiveness. / Den globala tillverkningsindustrin genomgår sedan en tid tillbaka en omfattande förändring där nya krav på effektivare processer och rutiner ställs. Detta, tillsammans med en förändrlig omvärld, tvingar företag att anpassa sig för att bibehålla konkurrenskraft och marknadsposition. Rapporten diskuterar metoder för effektiv produktionsökning presenterade av Slamanig and Winkler (2011) och Schuh et al. (2005) vilka sätts i relation till olika typer av internationella produktionsnätverk (IMN) enligt Abele et al. (2008). Det huvudsakliga målet är att identifiera ett ramverk för strategier som lämpar sig för effektiv ökning av produktion, så kallad upprampning, av nya produkter i en global kontext. Vidare bygger det strategiska ramverket på att visa möjliga alternativ samt att guida operativa val. Målsättningen är att tydliggöra hur verksamheten kan styras mot en effektiv integrering av produktions-konfigurationer och design av aktiviteter för uppstart eller signifikant ökning av produktion. Rapporten består av en litteraturstudie, medverkan i workshops och studiebesök samt en kvalitativ undersökning i form av intervjuer med utvalda intressenter där Atlas Copcos nyligen lanserade system för skruvmatning används som fallstudie. Baserat på litteraturstudien och den empiriska undersökningen identifieras kriterier som utgör grunden till det strategiska ramverket. Analysen leder till strategiska rekommendationer för att uppnå mål för produktionsvolym, kundanpassning, kvalité och produktivitet. I rapporten diskuteras också vikten av att produktion och tillverkning behöver överensstämma med företagets befintliga operativa strategi. Det framgår att etablerade flexibla och robusta produktionssystem i kombination med integration av tillämplig teknik, är en förutsättning för effektiv och snabb ökning av produktion. Ramverket ger sammanfattningsvis både praktiska rekommendationer för globala multinationella organisationer för att säkerställa en effektiv produktionsökning, samt vägledning för att öka produktion och uppnå ökade marknadsandelar. Rapporten visar att detta kan möjliggöras samtidigt som högre produktionskvalité kan uppnås genom utnyttjandet av organisationens befintliga kunskap och produktionsstruktur.