We develop a theoretical model about how organizations cope with the bullwhip effect created by consumer demand uncertainty through product modularity and information sharing across the supply chain. Unpredictability of consumer demand is likely to accentuate inventory flows in the supply chain. Information sharing and product modularity can be used by organizations to mediate the impact of unc...

OBJECTIVES This study aims to compare the organisation of primary care (PC) systems in Estonia, Latvia and Lithuania, focusing on the structure and process of service delivery, and to discuss the suitability of the PHAMEU instrument for international comparison of PC systems. METHODS The data were collected in the framework of PHAMEU project during 2009-2010. The selected indicators were used...

OBJECTIVE To assess the degree to which the Chinese people are protected from catastrophic household expenditure and impoverishment from medical expenses and to explore the health system and structural factors influencing the first of these outcomes. METHODS Data were derived from the Fourth National Health Service Survey. An analysis of catastrophic health expenditure and impoverishment from...

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline ...

OBJECTIVE To calculate the abandonment rate of oral oncolytic medications and identify factors that may affect likelihood of abandonment. STUDY DESIGN Cross-sectional cohort study using administrative claims data. METHODS We analyzed a nationally representative pharmacy claims database and identified 10,508 patients with Medicare and commercial insurance for whom oral oncolytic therapy was ...

Rural-urban differences in the supply of nursing home services are hypothesized to be jointly affected by competitive and regulatory forces, government pohcies, and the cost structure. Study findings indicate that rural services are slightly less accessible and lower in quality. A translog cost share function reveals no difference in the operating cost structure of rural and urban homes. Cost s...

Common sense suggests that networks are not random mazes of purposeless connections, but that these connections are organized so that networks can perform their functions well. One function common to many networks is targeted transport or navigation. Here, using game theory, we show that minimalistic networks designed to maximize the navigation efficiency at minimal cost share basic structural ...

A consumer-driven health plan (CDHP), also known as a consumer-directed health plan, is a health insurance plan design increasingly prevalent in the United States. CDHPs are a specific type of high-deductible health plan generally including a health savings account (HSA) or a health reimbursement arrangement (HRA). Compared to traditional commercial health plans—such as a health maintenance org...

BACKGROUND Rates of nonadherence to aromatase inhibitors (AIs) among Medicare beneficiaries with hormone receptor-positive early breast cancer are high. Out-of-pocket drug costs appear to be an important contributor to this and may be addressed by eliminating copayments and other forms of patient cost sharing. The authors estimated the incremental cost-effectiveness of providing Medicare benefi...

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteri...