Cost containment in health care: a model for management research.

Cost containment is a dominant problem in the health care field, but it has not been addressed from a comprehensive management perspective. To fill this gap, we have developed an inclusive model of the cost containment process. The model has implications for management research in several areas: cost containment baselines, incentive systems, organization structures, cost/quality trade-offs, and cost containment constraints.     

Will oil markets tighten again? A survey of policies to manage possible oil supply disruptions

The effects of an oil supply disruption on the U.S. economy are analyzed along with the various policy options. Part of the analysis is based on a computerized model of the U.S. economy and the world oil market. Micro as well as macroeconomic issues are considered. The paper argues against the use of price controls and allocations and also against a disruption tariff used as a stand-alone measure. It advocates the use of some stabilizing macroeconomic measures and a temporary producer tax similar to the windfall profits tax.     

Consideration of Background Exposures in the Management of Hazardous Waste Sites: A New Approach to Risk Assessment

The current approach to health risk assessment of toxic waste sites in the U.S. may lead to considerable expenditure of resources without any meaningful reduction in population exposure. Risk assessment methods used generally ignore background exposures and consider only incremental risk estimates for maximally exposed individuals. Such risk estimates do not address true public health risks to which background exposures also contribute. The purpose of this paper is to recommend a new approach to risk assessment and risk management concerning toxic waste sites. Under this new approach, which we have called public health risk assessment, chemical substances would be classified into a level of concern based on the potential health risks associated with typical national and regional background exposures. Site assessment would then be based on the level of concern for the particular pollutants involved and the potential contribution of site contaminants to typical background human exposures. While various problems can be foreseen with this approach, the key advantage is that resources would be allocated to reduce the most important sources of human exposure, and site remediation decisions could be simplified by focussing on exposure assessment rather than questionable risk extrapolations.     

Small-sample results for maximum-likelihood estimation in branching processes

In this article, small sample properties of the maximum-likelihood estimator (m.l.e.) for the offspring distribution (pk) and its mean m are considered in the context of the simple branching process. A representation theorem is given for the m.l.e. of (Pk) from which the m.l.e. of m is obtained. The case where p0 + p1 + p2 = 1 is studied in detail: numerical results are given for the exact bias of these estimators as a function of the age of the process; a curve fitting analysis expresses the bias of m? as a function of the mean and the variance of the offspring distribution and finally an “approximate m.l.e.” for (pk) is given.     

Learning about radon's risk

This article reports the results of an evaluation of the effectiveness of different types of information materials in communicating the risk from exposure to radon, a naturally occurring indoor air pollutant. The study involved a panel of 2300 homeowners who actually experienced risks from radon, and the information program used to explain these risks. The analysis considered information transfer and performance on specific tasks requiring information on the risk from radon to measure learning. The results suggest a systematic learning process, but indicate that the process can be influenced by how risk information is presented.     

The decision to add a second system producer

Typically in the United States only one contractor (the developer or first producer) makes a weapon system because it is too expensive or for some other reason infeasible to develop a second source. Congress and higher headquarters are constantly challenging the Armed Services to add other sources who can competitively make their systems. This paper describes a method of analyzing this complex problem which often has very large monetary and other significant impacts. Procedures and a case study are presented which consider cost and other criteria which might be used to make the second source decision.