Doing more with less: smart stockroom management equals great service.

As manufacturers compete for a larger share of a shrinking market, cries for a better way of doing business can be heard resounding throughout the business community. Many companies are now looking toward these principles for help: working smarter, doing more with less, and supplying superior service. One area in which they can be applied successfully is stockroom management. Their implementation can result in positive, cost-effective changes. This article describes how a materiel control organization was able to meet the call for change and in the process increase accuracy, reduce cycle time, and enhance its commitment to providing "great service" to both internal and external customers.     

Women in cabinet and public health spending: evidence across countries

This article studies the effect of women’s cabinet representation on public health policy outcomes. Based on a large sample of countries in the year 2000, the analysis shows that an increase in the share of women in cabinet is associated with an increase in public health spending. There is also an indication of a decrease in the gender gap in life expectancies in places with higher cabinet representation of women. The endogeneity of women’s cabinet representation is accounted for by using the share of daughters that a national leader parents as an instrument.     

Managerial expertise,learning potential and dynamic incentives: get more for less?

In this paper the impact of ability and learning potential on incentive contracts is analyzed. A central feature of the model is that the true ability will not be revealed. The learning potential of an agent is modeled as the magnitude of impact on the agent's expected ability that learning‐by‐doing has in a given task. Absent a managerial labor market, depending on an agent's learning potential, a monotone or non‐monotone pay structure may be optimal. The second important result is that using agents' ability distributions as inputs to information systems, higher learning potentials lead to less costly information systems, i.e. actions can be implemented at lower costs. Additionally, it is proven that the criteria cost minimization and value maximization are equivalent in the model's context. Copyright © 2007 John Wiley & Sons, Ltd.     

SIPP and health care issues.

There are three major areas in health care policy which can be addressed by the data elements in the Survey of Income and Program Participation (SIPP): (1) health insurance coverage and the stability of insurance over time; (2) health disability and its relationship to socioeconomic variables, including unemployment, over time; and (3) health care utilization. The survey does not, however, include information on health care expenditures or on details of visits to providers.     

The health care employee with an "attitude"

Health care managers may encounter employees who seem to have an "attitude." The employee may have a pattern of ingrained, inflexible, maladaptive responses to anxiety indicative of a personality disorder. When the employee has a pervasive sense of self-importance, is preoccupied with fantasies of unlimited success, and requires excessive admiration, a narcissistic personality disorder or traits may be present. Although this individual can cause havoc in the workplace, an alert manager who uses specific management techniques can enable the narcissistic employee to be productive and to be an asset in the work setting. This article provides a look at the etiology, symptoms, and management of the narcissistic employee. When the employee is willing to be assisted, the behavior can be modified and the necessary level of adaptation can occur. This can result in a more productive, less chaotic workplace.     

Quality in health care: possibilities and limitations of quantitative research instruments among health care users

Quality in health care has traditionally been dominated by medical profession, where patients’ opinions were labelled as lay evaluation. Patients’ views and opinions are important because they give us an insight into dimensions of quality that are not evaluated by medical profession and often seem to be more important. In health care quantitative methodology is often used to address these quality dimensions and introduce patients’ views and opinions. There are various benefits using quantitative research instruments, such as a detailed analysis of the importance of various quality dimensions for patients and an analysis of factors influencing patients’ satisfaction. On the other hand serious deficiencies can be tackled too, that are usually dealt with qualitative research instruments, because they go deeper into people’s motives and feelings. However, health care service is specific—it is very important to patients (health is one of the most important values), but their participation in health care service is rather low. They also don’t always say and do what they mean. In such a context combination of quantitative and qualitative research instrument does not give satisfactory answers. The importance of complaints is stressed and rewards for taking them seriously and acting upon them is discussed.     

A model for dual health care market with congestion differentiation

The French market for specialist physician care has a dual legal structure: physicians must exclusively work in sector 1 and charge regulated fees or in sector 2, where they can freely set their fees. Patient out-of-pocket payments in sector 2 are partially covered by private insurance. The primary differentiating factor between both sectors is the number of patients per specialist, which in turn directly affects the overall quality of the service provided. We built an equilibrium model to analyze both specialists' decisions about which sector to work in, and patients' choice of physician and therefore sector. More specifically, the model allowed us to study the effect of changes in prices and economy-wide patient-to-specialist ratios on profits and patients' utility associated with the services provided in each sector.     

Network position and health care worker infections

We use a newly collected data set coupled with an agent-based model to study the spread of infectious disease in hospitals. We estimate the average and marginal infections created by various worker groups in a hospital as a function of their network position in order to identify groups most crucial in a hospital-based epidemic. Surprisingly, we find that many groups with primary patient care responsibilities play a small role in spreading an infectious disease within our hospital data set. We also demonstrate that the effect of different network positions can be as important as the effect of different transmission rates for some categories of workers.     

A more flexible joint latent model for longitudinal and survival time data

In this article, a more flexible and easily explained joint latent model with time-varying coefficients is used to characterize time-dependent responses and a failure time. The dependence within time-dependent responses and between time-dependent responses and a failure time, and the heterogeneity in both processes are established through partially non-parametric latent variables. Based on longitudinal and survival time data, an estimation procedure is proposed for the parameter functions of the joint latent model. In our estimation, the approximated likelihood is constructed via substituting the basis function expansions for parameter functions. The expectation and maximization (EM) algorithm is then implemented to obtain the maximizer of the approximated likelihood function, and, hence, the estimated parameter functions. The validity of the considered joint latent model enables us to derive the asymptotic properties of the estimated functions. Moreover, the corresponding finite sample properties and the usefulness of our methods are demonstrated through a Monte Carlo simulation and the AIDS Clinical Trials Group (ACTG) 175 data. A possible extension of our joint latent model and some additional topics of interest are also discussed herein.     

Improving home care: Knowledge creation through engagement and design

In this paper, we apply a design science approach to help a Northern European city improve the efficiency of its home care delivery system. Our proposed solution emerges as a synthesis of applying Goldratt's Theory of Constraints and the principles of variable-demand inventory replenishment. The improved system exhibits both more level resource utilization and higher productivity due to more efficient capacity utilization. In addition to improving system efficiency, we gain insights into how authentic operations management problems can be addressed through design research. A crucial aspect of empirically-rooted practical problems is that they always involve multiple stakeholders with only partially overlapping preferences. Consequently, one must not assume or ascribe an a priori system objective, instead, it must arise from explicit empirical analysis of the relevant stakeholders. Another characteristic of authentic problems is that they are always embedded in an institutional context that sets significant boundary conditions to the feasibility of solutions. These boundary conditions are an important reminder of the complexity of empirically-rooted managerial problems.     

Efficiency and productivity change in Ukrainian health care

The study analyses technical efficiency and efficiency change of 193 community hospitals and polyclinics across Ukraine, for the years 1997–2001. These facilities are a subset of the medical institutions in rural Ukraine; they are identical w.r.t. their function in the health system and share the same departmental structure. The data comprise the number of beds in the hospitals, the number of staff employed in the hospitals as well as the polyclinics connected to the hospitals, the number of inpatient and outpatient admissions as well as the number of surgical procedures, lab tests, X-rays performed and the number of deaths and deaths after surgery. Because of the known sensitivity of traditional nonparametric frontier estimators to outlier observations, we employ an order-m estimator, a robust technique, to assess the efficiency of these health care providers as well as changes of their productivity time. The efficiency scores are calculated with an output-oriented model; they are close to unity for hospitals whereas polyclinics seem somewhat less efficient. The Malmquist-indices averaged over all observations are close to unity indicating that productivity does not change over during our observation period. But, depending on the period and the region, substantial deviations from unity can be observed.

High-risk clients and mental health care management.

A framework characterizing high-risk psychiatric patients by their probability of hospitalization and lengthy stay is introduced. Risk curves are then developed for each patient showing the potential impact of mental health case management on patient risk. Preliminary empirical analysis reveals that although most patients benefit from the case management intervention, some 30% of the client population may face an increase in risk of hospitalization and lengthy stay.     

E-retailer's dynamic inventory and pricing policy with price-protection services

This paper investigates a coordinated inventory and pricing problem with the e-retailer's price-protection service over multiple periods. By solving a stochastic dynamic programming in the two-dimensional state space, the optimal policy is fully characterized. Specifically, the inventory policy is a previous price-dependent base-stock policy. The pricing policy: as the previous price increases, the optimal current price stays unchanged first, then increases, and finally decreases. Numerical results indicate that with the impact of the price-protection service increasing, the base-stock level and current price rise under some conditions. Moreover, the price-protection service benefits the e-retailer when its impact is large enough.     

Joint inventory and transshipment decisions with consumer behavioral heterogeneity

Transshipment is an effective method for reducing mismatches between supply and demand among retailers. Consumers attempting to purchase out-of-stock items may wait for transshipment, purchase at another store, or choose not to buy. In this paper, the consumer behavioral heterogeneity is characterized using the transshipment request rate and consumer switching rate. It affects the replenishment and transshipment decisions, as well as the system profits. The inventory replenishment and transshipment decisions are studied in both centralized and decentralized two-location inventory systems with consumer behavioral heterogeneity. We characterize optimal replenishment decisions in a centralized system, prove the existence of a unique Nash equilibrium in a decentralized system with a specific demand distribution, and determine the coordinating transshipment price for some decentralized systems. In numerical studies, the performance of various systems is analyzed for consumers with identical (symmetric) or differing (asymmetric) behavior between retailers. For scenarios with symmetric consumers, a higher transshipment request rate and consumer switching rate resulted in increased total profit in all systems. For scenarios with asymmetric consumers, the retailer with the higher consumer switching rate should reduce ordering in a centralized system but increase ordering in a decentralized system. Moreover, the retailer with the higher transshipment request rate reduces ordering to increase profit, whereas the other retailer increases order quantity yet earns less profit.