When outsourcing fragments: customer creativity and technological transmutations

One of the most fundamental decisions made in firms is about what functions or activities the firm should perform within its own hierarchy, and which of these it should rely on the market to perform. Outsourcing is ‘an agreement in which one company contracts out a part of their existing internal activity to another company’. However, this article contends that outsourcing has changed, and is changing in ways that make the application of neat, legal and technically correct definitions hard to use, and even harder to apply in strategy. Under the new outsourcing paradigm, technology is not a passive ‘substance’, rather it is an active ‘force’. We aim to look at the ways in which technologies are re-shaped and transmuted by consumers. Through this analysis, we add the consumer activity to the conventional definition of outsourcing. We focus on one of the most highly anticipated and influential new products of 2007 – the Apple iPhone.     

Erectile dysfunction is a marker for obstructive sleep apnea

Purpose: To investigate the prevalence of erectile dysfunction (ED) in patients with obstructive sleep apnea (OSA) with and without any other comorbidities.

Methods: The patient group was newly diagnosed as having OSA (apnea–hypopnea index [AHI]?>?5/h) using a polysomnographic examination. A group of subjects with simple snoring were included into the control group. Clinically relevant comorbidities were systematically assessed in face-to-face interviews. All patients were asked to complete the 15-item International Index of Erectile Function (IIEF-15) questionnaire for the evaluation of ED. The patients with OSA and ED were evaluated according to these comorbidities.

Results: Of the 94 patients, 39 patients were excluded because of severe diseases. OSA was observed in 38 (69.1%) of the 55 patients. ED was seen in 24 (63.2%) patients with OSA, and in 8 (47.1%) patients without OSA (p?>?0.05). There were no statistical differences between the groups’ ages, IIEF scores, and body mass index (BMI) scores. There were statistically significant differences between the groups’ AHI scores (p?p?Conclusion: The rate of ED was higher in patients with OSA who had no other comorbidities. Therefore, ED can be a sensitive marker of OSA.     

On the Use of the Concentration Function in Medical Fraud Assessment

We propose a simple, but effective, tool to detect possible anomalies in the services prescribed by a health care provider (HP) compared to his/her colleagues in the same field and environment. Our method is based on the concentration function that is an extension of the Lorenz curve widely used in describing uneven distribution of wealth in a population. The proposed tool provides a graphical illustration of a possible anomalous behavior of the HPs and it can be used as a prescreening device for further investigations of potential medical fraud.     

Overpayment models for medical audits: multiple scenarios

Comprehensive auditing in Medicare programs is infeasible due to the large number of claims, therefore, the use of statistical sampling and estimation methods is crucial. We introduce super-population models to understand the overpayment phenomena within the claims population. The zero- and one-inflated mixture-based models can capture various overpayment patterns including the fully legitimate or fraudulent cases. We compare them with the existing models for symmetric and mixed payment populations that have different overpayment patterns. The distributional fit between the actual and estimated overpayments is assessed. We also provide comparisons of models with respect to their conformance with Centers for Medicare and Medicaid Services (CMS) guidelines. In addition to estimating the dollar amount of recovery, the proposed models can help the investigators to detect overpayment patterns.