An Agent-Based Fault Tolerance Mechanism for Dependable Medical Systems

Author(s):  
Meriem Zaiter ◽  
Salima Hacini ◽  
Zizette Boufaida

The use of distributed systems and IT is growing, with automation being used more and more to facilitate our daily tasks. The need to remotely monitor a patient has driven one of important results of this growth: domestic medical systems. The latter are able to follow and maintain the condition of a patient in the patient's home. Monitoring is important in terms of saving time and also money. However, the critical nature of this task requires a high level of dependability. The aim of dependability is to satisfy the user's goal, which is that whatever the state and context of the overall system, its ability to control the operation of the medical device and to transmit files reporting the patient's condition (normal, critical, alert, etc.) must be continuously assured. This can be ensured by fault tolerance techniques. The authors' objective in this paper is to present a technique for fault tolerance in a domestic medical system. Briefly, their proposal integrates a smart concept into the system: agents for controlling the operation of the medical system and tolerating the faults that can occur.

Author(s):  
Anqi Yao ◽  
Xingrong Shen ◽  
Jing Chai ◽  
Jing Cheng ◽  
Rong Liu ◽  
...  

Abstract Background This study aimed to identify characteristics and trends in insurance-reimbursed inpatient care (NRIC) for gastric and oesophageal cancers and inform evaluation of medical systems reform. Methods The study extracted routinely collected records of claims for reimbursement from the New Rural Cooperative Medical System (NRCMS) in Anhui Province, China and performed descriptive and regression discontinuity analysis. Results From 2013 to 2017, NRIC in terms of person-time per million people (pmp) increased 5.60 and 20.62 times for gastric and oesophageal cancers, respectively. Total expense per episode for gastric and oesophageal cancers increased from 1130.25 and 22 697.99 yuan to 12 514.98 and 24 639.37 yuan, respectively. The ratio of out-of-pocket expenses per inpatient care episode to annual disposable income per capita was 0.43 for gastric cancer and 0.91 for oesophageal cancer and decreased by 0.17 and 0.47, respectively. Regression discontinuity modelling revealed that, when controlled for disposable income, illiteracy rate and months from start time, the treatment variable was significantly associated with person-times of NRIC pmp (β=0.613, p=0.000), length of stay per 105 people (β=−52.990, p=0.000) and total expenses per NRIC episode (β=2.431, p=0.000). Conclusions The study period witnessed substantial achievements in benefits to patients, inpatient care efficiency and equity. These achievements may be attributed mainly to the recent reforms launched in Anhui province, China.


Sign in / Sign up

Export Citation Format

Share Document