Health services research
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Health services research · Jan 1983
Comparative StudyA comparison of alternative medicare reimbursement policies under optimal hospital pricing.
This paper applies and extends the use of a nonlinear hospital pricing model, recently posited in the literature by Dittman and Morey [1]. That model applied a hospital profit-maximizing behavior and studied the effects of optimal pricing of hospital ancillary services on the incidence of payment by private insurance companies and the Medicare trust fund. ⋯ The policies differ according to hospital size and whether cross-subsidies are allowed. We are interested in determining the effects of profit-maximizing and -satisficing behaviors of these three reimbursement policies on the levels of profits received, and on the respective implications for private payors and the Medicare trust fund.
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Health services research · Jan 1982
Quality assurance as a managerial innovation: a research perspective.
Quality assurance is defined and concepts from innovation theory are applied to the study of quality assurance programs. Two distinct although not mutually exclusive perspectives on innovation are considered--the diffusion perspective, focusing on the innovation itself and its implementation, and the adoption perspective, highlighting factors characteristic of the adoption unit (i.e., the organization or individuals within it) that facilitate or impede the adoption process. Directions for future research are suggested.
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A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose.
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Health services research · Jan 1979
Evaluation of emergency ambulance characteristics under several criteria.
A methodology and analysis are presented for evaluating response time characteristics of emergency ambulance systems. The methodology is based on a Monte Carlo simulation technique and a heuristic optimal-seeking technique for locating emergency ambulances under several criteria based on response time distribution. Optimization criteria include minimum mean system response time, minimum system fractile response time and minimum level-loaded response time. ⋯ From these results alternative dispatch polices can be evaluated. Complementing the analysis is a presentation of a sensitivity analysis and an analysis of existing ambulance sites. Unique to the methodology is the adaption of the heuristic optimal-seeking technique to include any of the three criteria and the effectiveness of the methodology for analyzing small or large ambulance systems.