Healthcare

Using micro data on virtually all of the drugs and diseases of over 500,000 people enrolled in Puerto Rico's Medicaid program, the impact of the vintage (original FDA approval year) of drugs used to treat a patient on the patient's three-year probability of survival, controlling for demographic characteristics (age, sex, and region), utilization of medical services, and the nature and complexity of illness are examined. It is found that people using newer drugs during January-June, 2000, were less likely to die by the end of 2002, conditional on the covariates.

Hospital ambulance diversions are prevalent and increasing nationwide as emergency departments experience growing congestion. Using negative binomial regressions, this paper links the number of acute myocardial infarction (AMI) deaths to the level and extent of diversion in the five boroughs of New York City. The results indicate that both high levels of ambulance diversion and simultaneous diversion across hospitals are associated with increasing numbers of deaths from AMI.

We investigate how making highly consequential, highly undesirable decisions affects emotions and preference for autonomy. We examine individuals facing real or hypothetical decisions to discontinue their infants' life support who either choose personally or have physicians choose for them. Findings from a multidisciplinary approach consisting of a qualitative analysis of in-depth interviews and three laboratory studies reveal that perceived personal causality for making tragic decisions generates more negative feelings than having the same choices externally made.

Due to the increase in diversity of wireless devices, streaming media systems must be capable of serving multiple types of users. Scalable coding allows for adaptations without re-encoding. To account for various viewing capabilities of each user, such as different spatial resolutions, multiple distortion measures are used. In this paper, we examine the question of how to broadcast media packets with multiple distortion measures to multiple users. We cast the problem as a stochastic shortest path problem and use Dynamic Programming to find the optimal policy.

The rate of increase of longevity has varied considerably across U.S. states since 1991. This paper examines the effect of the quality of medical care, behavioral risk factors (obesity, smoking, and AIDS incidence), and other variables (education, income, and health insurance coverage) on life expectancy and medical expenditure using longitudinal state-level data. We examine the effects of three different measures of the quality of medical care. The first is the average quality of diagnostic imaging procedures, defined as the fraction of procedures that are advanced procedures.

This paper presents a general class of dynamic stochastic optimization problems we refer to as Stochastic Depletion Problems. A number of challenging dynamic optimization problems of practical interest are stochastic depletion problems. Optimal solutions for such problems are difficult to obtain, both from a pragmatic computational perspective as also from a theoretical perspective. As such, simple heuristics are desirable.

As the diversity in end-user devices and networks grows, it becomes important to be able to efficiently and adaptively serve media content to different types of users. A key question surrounding adaptive media is how to do Rate-Distortion optimized scheduling. Typically, distortion is measured with a single distortion measure, such as the Mean-Squared Error compared to the original high resolution image or video sequence.

Many primary care offices and other medical practices regularly experience long backlogs for appointments. These backlogs are exacerbated by a significant level of last-minute cancellations or "no-shows," which have the effect of wasting capacity. In this paper, we conceptualize such an appointment system as a single-server queueing system in which customers who are about to enter service have a state-dependent probability of not being served and may rejoin the queue.

The Institute of Medicine identified "timeliness" as one of six key "aims for improvement" in its most recent report on quality. Yet patient delays remain prevalent, resulting in dissatisfaction, adverse clinical consequences, and often, higher costs. This tutorial describes several areas in which patients routinely experience significant and potentially dangerous delays and presents operations research (OR) models that have been developed to help reduce these delays, often at little or no cost.