Health Insurance,Health Conditions,and Veteran Health Care Utilization

Abstract

The utilization of health care services by veterans has received much attention in recent years. However, the impact of the large array of factors affecting the veterans’ demand for health care services remains understudied. These factors include individual socio-demographic and economic characteristics, the availability of various sources of health insurance, and the prevalence of medical conditions. We use public data to analyze how veterans’ utilization of health care services varies with these factors. We also analyze how the reliance on VA services varies when alternative sources of health insurance are available to veterans. Based on the estimated relationships, we use a micro-simulation model to forecast future health care utilization, both inside and outside of VA.     

Server scheduling on parallel dedicated machines with fixed job sequences

We consider server scheduling on parallel dedicated machines to minimize the makespan. Each job has a loading operation and a processing operation. The loading operation requires a server that serves all the jobs. Each machine has a given set of jobs to process, and the processing sequence is known and fixed. We design a polynomial‐time algorithm to solve the two‐machine case of the problem. When the number of machines is arbitrary, the problem becomes strongly NP‐hard even if all the jobs have the same processing length or all the loading operations require a unit time. We design two heuristic algorithms to treat the case where all the loading times are unit and analyze their performance.     

A game with distorted information

This article considers a two-person game in which the first player has access to certain information that is valuable but unknown to the second player. The first player can distort the information before it is passed on to the second player. The purpose in distorting the information is to render it as useless as possible to the second player. Based on the distorted information received, the second player then maximizes some given objective. In certain cases he may still be able to use the distorted information, but sometimes the information has been so badly distorted that it becomes completely useless to him. © 1993 John Wiley & Sons, Inc.     

General models for the supplier's all-unit quantity discount policy

The purpose of this article is to investigate some managerial insights related to using the all-unit quantity discount policies under various conditions. The models developed here are general treatments that deal with four major issues: (a) one buyer or multiple buyers, (b) constant or price-elastic demand, (c) the relationship between the supplier's production schedule or ordering policy and the buyers' ordering sizes, and (d) the supplier either purchasing or manufacturing the item. The models are developed with two objectives: the supplier's profit improvement or the supplier's increased profit share analysis. Algorithms are developed to find optimal decision policies. Our analysis provides the supplier with both the optimal all-unit quantity discount policy and the optimal production (or ordering) strategy. Numerical examples are provided. © 1993 John Wiley & Sons. Inc.     

Scheduling jobs with piecewise linear decreasing processing times

We study the problems of scheduling a set of nonpreemptive jobs on a single or multiple machines without idle times where the processing time of a job is a piecewise linear nonincreasing function of its start time. The objectives are the minimization of makespan and minimization of total job completion time. The single machine problems are proved to be NP‐hard, and some properties of their optimal solutions are established. A pseudopolynomial time algorithm is constructed for makespan minimization. Several heuristics are derived for both total completion time and makespan minimization. Computational experiments are conducted to evaluate their efficiency. NP‐hardness proofs and polynomial time algorithms are presented for some special cases of the parallel machine problems. © 2003 Wiley Periodicals, Inc. Naval Research Logistics 50: 531–554, 2003     

Estimating the probability that a simulated system will be the best

Consider a stochastic simulation experiment consisting of v independent vector replications consisting of an observation from each of k independent systems. Typical system comparisons are based on mean (long‐run) performance. However, the probability that a system will actually be the best is sometimes more relevant, and can provide a very different perspective than the systems' means. Empirically, we select one system as the best performer (i.e., it wins) on each replication. Each system has an unknown constant probability of winning on any replication and the numbers of wins for the individual systems follow a multinomial distribution. Procedures exist for selecting the system with the largest probability of being the best. This paper addresses the companion problem of estimating the probability that each system will be the best. The maximum likelihood estimators (MLEs) of the multinomial cell probabilities for a set of v vector replications across k systems are well known. We use these same v vector replications to form v^k unique vectors (termed pseudo‐replications) that contain one observation from each system and develop estimators based on AVC (All Vector Comparisons). In other words, we compare every observation from each system with every combination of observations from the remaining systems and note the best performer in each pseudo‐replication. AVC provides lower variance estimators of the probability that each system will be the best than the MLEs. We also derive confidence intervals for the AVC point estimators, present a portion of an extensive empirical evaluation and provide a realistic example. © 2002 Wiley Periodicals, Inc. Naval Research Logistics 49: 341–358, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/nav.10019     

A trajectory for homeland ballistic missile defense

The Ground-based Midcourse Defense system is intended to protect the US homeland against limited attacks from intermediate- and long-range ballistic missiles. It has succeeded in intercepting target missiles and can engage a threat launched from North Korea or the Middle East, targeting any point in the USA. Nevertheless, high-profile struggles and program changes related to homeland ballistic missile defense (BMD) continue to make headlines. The most significant struggle has been a string of three straight intercept test failures over five years, followed by the recent successful intercept test in June 2014. This article first briefly reviews the current threats of concern. It then examines homeland BMD policy objectives, followed by the current major technical issues in supporting these objectives and, then, the likelihood of negating a warhead. Finally, it highlights major considerations that should be part of the trajectory the US government takes moving forward.     

Preemptive parallel‐machine scheduling with a common server to minimize makespan

We consider parallel‐machine scheduling with a common server and job preemption to minimize the makespan. While the non‐preemptive version of the problem is strongly NP‐hard, the complexity status of the preemptive version has remained open. We show that the preemptive version is NP‐hard even if there is a fixed number of machines. We give a pseudo‐polynomial time algorithm to solve the case with two machines. We show that the case with an arbitrary number of machines is unary NP‐hard, analyze the performance ratios of some natural heuristic algorithms, and present several solvable special cases. © 2017 Wiley Periodicals, Inc. Naval Research Logistics 64: 388–398, 2017