Prospective screening of diagnostic testing: a valuable tool

The elimination of unneeded services is a key to reducing medical costs and enhancing quality of care. Diagnostic tests have been a target of efforts to reduce costs primarily because they are discretionary and often appear to be unnecessary. Believing that the concept of prior review for many diagnostic tests is a good one, this pilot study sought to evaluate prospectively the propriety of diagnostic tests ordered during the first half of 1989 on individuals insured through a major insurance carrier. A physician review found that 21% of the tests were deemed inappropriate, leading to the conclusion that prospective review can be an effective means of screening inappropriately ordered tests.     

The right cure for health care

An aging population with nearly unlimited access to high-priced doctors and technology is pushing medical costs skyward. Managed care is the best way to bring them down.     

Struggling to save our kids

Many more than ever face the crises of childhood: violence, drugs, bad schools, poverty, divorce, or two parents at work. And no one seems to care.     

The Theory of Socially Embedded Games: Applications and Extensions to Open and Closed Games

An earlier article, drawing on the mathematical theory of rules and rule complexes, extends and generalizes game theory (GGT). The theory has been used to conceptualize and analyze diverse social relationships, roles, and games as particular types of rule complexes.For instance, a social role, as a major basis of a parent's action in a game, consists of at least four key components – which are mathematical objects – in the determination of action: value complex, model of reality (including beliefs and knowledge bases), a repertoire of acts, routines, programs, and strategies, and modality, a role-specific algorithm for determining or generating action in game settings. This article applies and extends GGT in analyses of a market bargaining game (a type of open game) and of the classical game of prisoners' dilemma (a type of closed game). The applications show the concrete effects of social embeddedness on game structuring, game interaction patterns and outcomes, and social equilibria.     

Hölder continuity of the policy function approximation in the value function approximation

We show that given a value function approximation V of a strongly concave stochastic dynamic programming problem (SDDP), the associated policy function approximation is Hölder continuous in V.     

The topography of metropolitan employment: Identifying centers of employment in a polycentric urban area

While it is well recognized that US metropolitan areas are polycentric, there is little consensus as to the appropriate method for identifying concentrations of employment within them. Existing methods suffer from strong assumptions about parametric form, misspecification, or reliance on local knowledge to calibrate model parameters. This paper introduces a new nonparametric method for identifying subcenters. Results indicate that this, more flexible, nonparametric approach yields greater accuracy with regard to both urban and suburban centers compared with other approaches. This approach should provide better data for the numerous topics that depend on the spatial accounting of employment within metropolitan areas.     

Empirical analysis of up-or-out rules for promotion policies

Previous research in the areas of tournaments, human capital, and learning theory have shown that promotion is a function of human capital, experience, ability, and wage growth. These variables were used to estimate a Cox regression using data from a single firm. The survival rates for a Cox regression and an up-or-out regression model are computed. The results suggest that certain up-or-out models are valid even when the firm does not have such a policy and show that an up-or-out procedure predicts the promotion and exit survival rates as well as a Cox regression.     

Legalistic organizational responses to catastrophic illness: The effect of stigmatization on reactions to HIV/AIDS

The HIV/AIDS epidemic has focused increased attention on catastrophic illnesses in the workplace, and because of the stigmas associated with HIV/AIDS, it raises three primary concerns for organizations: (1) organizational avoidance of legal sanctions and litigation; (2) the maintenance of organizational legitimacy; and (3) organizational protection of employee rights. Although many organizations adopt legalistic responses to cope with these concerns, the analysis presented in this article suggests that while legalistic approaches function well to protect organizational interests in terms of both legal liability and legitimacy, the are only partially able to protect employee rights. Drawing upon the limited literature on HIV/AIDS in the workplace, this article presents an agenda for future research on organizational responses to HIV/AIDS.