Health Care Management Science
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Risk adjusting capitation: Applications in employed and disabled populations
Health Care Management Science - Tập 3 - Trang 101-109 - 2000
Risk adjustment may be a sensible strategy to reduce selection bias because it links managed care payment directly to the costs of providing services. In this paper we compare risk adjustment models in two populations (public employees and their dependents, and publicly-insured low income individuals with disabilities) in Washington State using two statistical approaches and three health status me......
Keeping pace with the ebbs and flows in daily nursing home operations
Health Care Management Science - Tập 22 - Trang 350-363 - 2018
Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent nursing home departments of a single Dutch nursing home. This demand data is used as input for an optimiz......
Improving the quality of the coding of primary diagnosis in standardized discharge summaries
Health Care Management Science - Tập 11 - Trang 147-151 - 2008
We propose to design and test an information-processing model to participate in appraising the quality and the consistency of the coding, for billing, of Standardized Discharge Summaries (SDSs). We designed a model using both symbolic knowledge extracted from the NLM’s UMLS and statistical knowledge. The aim is to retrieve from the ICD-10 terms recorded in a SDS the Principal Diagnosis (PD) at the......
Towards Decision Support for Waiting Lists: An Operations Management View
Health Care Management Science - Tập 4 - Trang 133-142 - 2001
This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare – national, regional, hospital and process – that each contributes......
An open source software project for obstetrical procedure scheduling and occupancy analysis
Health Care Management Science - Tập 14 - Trang 56-73 - 2010
Increases in the rate of births via cesarean section and induced labor have led to challenging scheduling and capacity planning problems for hospital inpatient obstetrical units. We present occupancy and patient scheduling models to help address these challenges. These patient flow models can be used to explore the relationship between procedure scheduling practices and the resulting occupancy on ......
Effect of individual protective behaviors on influenza transmission: an agent-based model
Health Care Management Science - - 2015
Computer-aided auditing of prescription drug claims
Health Care Management Science - Tập 17 - Trang 203-214 - 2013
We describe a methodology for identifying and ranking candidate audit targets from a database of prescription drug claims. The relevant audit targets may include various entities such as prescribers, patients and pharmacies, who exhibit certain statistical behavior indicative of potential fraud and abuse over the prescription claims during a specified period of interest. Our overall approach is co......
Impact of e-detailing on the number of new prescriptions
Health Care Management Science - Tập 13 - Trang 101-111 - 2009
The recent trend of e-detailing in the pharmaceutical industry aims to increase the effectiveness of promotion of prescription products to physicians at a less expensive way than traditional detailing. In the proposed promotion response model, the effect of e-detailing on new prescriptions is accounted for in the presence of traditional face-to-face detailing and a host of product-specific factors......
Performance of Number-Between g-Type Statistical Control Charts for Monitoring Adverse Events
Health Care Management Science - Tập 4 - Trang 319-336 - 2001
Alternate Shewhart-type statistical control charts, called “g” and “h” charts, have been developed for monitoring the number of cases between hospital-acquired infections and other adverse events, such as heart surgery complications, catheter-related infections, surgical site infections, contaminated needle sticks, medication errors and other care induced concerns. This article investigates the st......
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