Medical Service Industry Research Articles

Antitrust Enforcement in the Medical Services Industry: What Does It All Mean?

Before 1975, federal antitrust authorities neglected the health care sector, thereby allowing the entrenchment of many anticompetitive practices and institutions that seemed not only "natural," but also beneficial to the quality and professionalism of doctor-patient relations. While antitrust enforcement shares the usual physician preference for free enterprise, prosecutorial discretion is often feared as eroding professional discretion and even well-intentioned reform. However, strengthened competition in the health services industry offers a way to bring some stability to health policy, and to resolve some of the conflicts between advocates of institutional status quo and enthusiasts for increased government regulatory power.

Introduction to the Special Issue on Managing Knowledge in Organizations: Creating, Retaining, and Transferring Knowledge

Interest in the issues of organizational learning and knowledge management on the part of academics and practitioners increased dramatically in recent years. On the practical side, changes in technology and modes of organizing work, globalization, and increased competition brought the issues of organizational learning and knowledge management to center stage for organizations. New developments in computing and information technology enabled the retention and transfer of information in organizations on a larger scale than was once possible. Shifts to more distributed modes of organizing work made knowledge transfer a priority for firms. The greater prevalence of the multiunit organizational form, such as a franchise or chain (Baum and Greve 2001), and the greater frequency of interorganizational relationships (Powell et al. 1996) also increased the importance of knowledge transfer for firms. Parallel to the surge in interest among practitioners, academic interest in organizational learning and knowledge management also grew considerably, as evidenced by the proliferation of books and articles recently published on the subject.1 In addition, a

Staying healthy in a wired world

Our medical records store some of our most valuable information. Quick, reliable access to this information can make the difference between life and death. Yet, despite these stakes, we have accepted the risks of our current paper-based system. Storing medical records online is one of the first steps toward improving many aspects of health care. Whereas you have limited access to your current paper record, you can browse your online record from anywhere and at any time. Having our records online will enable a new medical service industry. Online medical records will also facilitate statistical medical research. High-quality World Wide Web sites offer wide-ranging medical information presented in terms that the layman can understand. Medical information represents one of our most private kinds of information, and so moving our records online poses major concerns. Fortunately, we have already surmounted many of the technological barriers of maintaining privacy. Effectively using the Internet to improve our health care will require infrastructure development and cooperation among many resources. Starting with online medical records, the Internet promises to help us stay healthier. With easier access to our medical history and valuable medical references, patients will be empowered to take more of their well-being into their own hands, doctors will be able to deliver better care, and researchers will make new medical breakthroughs.

Incorporating Patient Travel Times in Decisions about Size and Location of Dialysis Facilities

This report demonstrates the power and usefulness of mathematical optimization as a decision support tool in the medical services industry by presenting an application to dialysis service planning. Models to predict the number of dialysis beds in a given region are usually population-based. Dialysis planners and providers have found a need to accommodate sparsely populated regions by making some allowance for patient travel times. A formal approach to incorporating travel times into dialysis planning, based on the formulation and solution of a mixed-integer programming model, is presented. The development of a method for dialysis planning serves as a platform to demonstrate the use of integer programming to support decision making. Major modeling principles are presented; output interpretation and sensitivity analysis are illustrated by examples; and computational requirements are discussed.

A Computer-based Safety Assessment for Flight Evacuation: SAFE

Recently, the U.S. emergency medical services (EMS) industry has received a great deal of negative publicity concerning its safety record. It has been noted that the EMS industry has an accident rate that is five times that of the rest of the helicopter industry (Harvey and Jensen, 1987; Harvey, 1986. While it is true that during 1987 and early 1988 the safety record has improved, the industry cannot become complacent. The National Transportation and Safety Board recently conducted a study of the EMS industry and returned specific recommendations for the FAA and NASA. One of the critical factors in EMS missions is the pilot's decision accept or reject a mission. This can often be influenced by such factors as the urgency of the care required. This, along with other factors, may prompt a pilot to accept a mission of unacceptable risk. The present paper presents a computer- based decision aid, based upon earlier work by the Army and Coas Guard, to assist the pilot in objective assessment of the probable risk of an EMS mission. Data for validation of this technique will be collected at an EMS operator and from the EMS Safety Reporting Service.

Antitrust Enforcement in the Medical Services Industry: What Does It All Mean?

Antitrust Enforcement in the Medical Services Industry: What Does It All Mean?

One Life—One Physician: An Inquiry Into the Medical Profession's Performance in Self-Regulation

The medical service industry, as nation's second largest enterprise, could not long escape probing by Ralph Nader. One Life—One Physician is report of a self-styled nonexpert group which has examined the medical profession's performance in self regulation. The verdict is, total inadequacy—the profession does not merit trust which public places in it! The study is largely a review of existing literature reinforced by a few questionnaires. The evidence of competent medical practice is taken to be recorded histories, many laboratory tests, and accessory examinations. Experience, in lieu of expensive cookbook addenda, is given no place. The naivete of report, from viewpoint of practicing physician, is inconsequential. Rather, it should be noted that probers have run into same frustrations which have beset profession for lo these many years. Doctors can scarcely fault novices for proposing yardsticks such as 70%