Locating social service centres using interactive graphics

The paper explores the feasibility of using interactive graphic based solution procedures in location problems with discrete choices. It compares solutions generated through interactive graphics with those generated through optimization for a problem context where service centres had to be located in rural India. The comparison demonstrates the feasibility of generating near optimal solutions for problems with a certain dimensionality. Broad features of the graphic software are described. The paper also highlights other advantages and limitations of the interactive graphic procedure.     

The Impact of Population,Contact, and Spatial Heterogeneity on Epidemic Model Predictions

Our objective was to evaluate the effect that complexity in the form of different levels of spatial, population, and contact heterogeneity has in the predictions of a mechanistic epidemic model. A model that simulates the spatiotemporal spread of infectious diseases between animal populations was developed. Sixteen scenarios of foot‐and‐mouth disease infection in cattle were analyzed, involving combinations of the following factors: multiple production‐types (PT) with heterogeneous contact and population structure versus single PT, random versus actual spatial distribution of population units, high versus low infectivity, and no vaccination versus preemptive vaccination. The epidemic size and duration was larger for scenarios with multiple PT versus single PT. Ignoring the actual unit locations did not affect the epidemic size in scenarios with multiple PT/high infectivity, but resulted in smaller epidemic sizes in scenarios using multiple PT/low infectivity. In conclusion, when modeling fast‐spreading epidemics, knowing the actual locations of population units may not be as relevant as collecting information on population and contact heterogeneity. In contrast, both population and spatial heterogeneity might be important to model slower spreading epidemic diseases. Our findings can be used to inform data collection and modeling efforts to inform health policy and planning.     

A model for national planning policies

This paper attempts to develop a multiobjective model to help policy-makers choose the most appropriate mix of economic policies concurrent with the elimination of serious gaps. Each individual policy attempts to achieve a specific goal or a set of subgoals; but it may hinder the achievement of some other subgoals. To differentiate between the importance of different objectives, the analyst assigns different priorities to each of the given set of subgoals. Three sets of results are provided by three separate computer runs of this model. Each set of results corresponds to one of the three priority structures, and each run indicates quite differing underachievements or over-achievements of individual subgoals. A detailed explanation for each of these deviations (gaps) from the targeted subgoals is attempted in an overall framework and some interactions between various gaps (savings gaps, foreign exchange gap, domestic growth gap, GNP gap, etc.) are also identified.     

What's ahead on quality: the managed care perspective

Without question, the most important processes occurring in managed care that can be expected to affect quality are accreditation and the effort to obtain and compare uniform information on quality of care across health care organizations, in short, to create "report cards." For both processes, 1993 was an extremely productive year, and 1994 promises to be even more so. These two processes fit hand-in-glove--one is designed to determine that managed care organizations are equipped to serve the public and to implement better health care programs, while the other is designed to help them understand and improve their own performance. Although, in the short run, managed care organizations may view both these efforts as additional costs, in the long run, both should lead to a better industry and to better care for the public.     

Long-term solution to malpractice crises: reduce harm to patients

Physician executives need to lead the charge and actually reduce harm to patients. Simply capping malpractice awards or changing the rules of litigation is not enough.     

Managing aging men in Asia: a strategic approach

We have established a comprehensive diagnostic paradigm for the management of aging men which seeks to evaluate the various determinants of the aging process in five major health areas: cardio-health, bone health, sex health, general health and endocrine state. This paradigm appears to be useful for the management of the problem of aging in our local population. It could be used for the management of individuals as well as for population research. When combined with the establishment of evidence-based management modalities, it will provide a useful tool for the holistic management of aging in Asia.