Management and efficiency have a fundamental impact on the performance of public hospitals, as well as on their philanthropic mission. Various studies have shown that the financial weaknesses of these entities affect the planning, setting of goals and objectives, monitoring, evaluation and feedback necessary to improve health systems and guarantee accessibility as an inalienable right. This study aims to analyze the management and efficiency of third-level and/or high-complexity hospitals in Colombia, through a statistical model that uses financial analysis and key performance indicators (KPIs) such as ROA, ROE and EBITDA. A non-experimental cross-sectional design is used, with an analytical-synthetic, documentary, exploratory and descriptive approach. The results show financial deficiencies in the hospitals evaluated; hence it is recommended to make adjustments in the operating cycle to increase efficiency rates. In addition, the use of the KPIs ROA and ROE under adjusted models is suggested for a more precise analysis of the financial ratios, since these adequately explain the variability of each indicator and are appropriate to evaluate hospital management and efficiency, but not in EBITDA ratio, hence the latter is not recommended to evaluate hospital efficiency reliably. This study provides relevant information for public health policy makers, hospital managers and researchers, in order to promote the efficiency and improvement of health services.

Every production day in Nigeria, and in other oil producing countries, millions of barrels of produced water is generated. Being very toxic, remediation of the produced water before discharge into environment or re-use is very essential. An eco-friendly and cost effective approach is hereby reported for remediative pre-treatment of produced water (PW) obtained from Nigerian oilfield. In this approach, Telfairia occidentalis stem extract-silver nanoparticles (TOSE-AgNPs) were synthesized, characterized and applied as bio-based adsorbent for treating the PW in situ. The nanoparticles were of average size 42.8 nm ± 5.3 nm, spherical to round shaped and mainly composed of nitrogen and oxygen as major atoms on the surface. Owing to the effect of addition of TOSE-AgNPs, the initially high levels (mg/L) of Total Dissolved Solids (TDS), Biological Oxygen Demand (BOD) and TSS of 607, 3.78 and 48.4 in the PW were reduced to 381, 1.22 and 19.6, respectively, whereas DO and COD improved from 161 and 48.4 to 276 and 19.6 respectively, most of which fell within WHO and US-EPA safe limits. Particularly, the added TOSE-AgNPs efficiently removed Pb (II) ions from the PW at temperatures between 25 ℃ to 50 ℃. Removal of TOSE-AgNPs occurred through the adsorption mechanism and was dependent contact time, temperature and dose of TOSE-AgNPs added. Optimal remediation was achieved with 0.5 g/L TOSE-AgNPs at 30 ℃ after 5 h contact time. Adsorption of Pb (Ⅱ) ions on TOSE-AgNPs was spontaneous and physical in nature with remediation efficiency of over 82% of the Pb (Ⅱ) ions in solution. Instead of discarding the stem of Telfairia occidentalis, it can be extracted and prepared into a new material and applied in the oilfield as reported here for the first time.

Since 2013, the state has introduced a number of policies to strictly control the number and scale of public hospitals and to control the rapid expansion of public hospitals. After the introduction of this series of policies, the number of public hospitals in China did not continue to grow, but the number of beds in public hospitals continued to grow. This paper uses difference-in-difference (DID) method to analyze the number of public hospitals with the corresponding data of the development of private hospitals after the introduction of the policy, and the results proves that the introduction of relevant policies has an impact on the number of public hospitals, but has a limited impact on the expansion of the scale of public hospitals. At the end of the article, positive policy suggestions are given to the development of hospitals in China, such as controlling the expansion of public hospitals, strictly controlling the number of beds in public hospitals, and vigorously developing private hospitals. Promoting the development of private hospitals is an important economic supplement to China’s health care.