Managing magnetic resonance imaging machines: support tools for scheduling and planning

We devise models and algorithms to estimate the impact of current and future patient demand for examinations on Magnetic Resonance Imaging (MRI) machines at a hospital radiology department. Our work helps improve scheduling decisions and supports MRI machine personnel and equipment planning decisions. Of particular novelty is our use of scheduling algorithms to compute the competing objectives of maximizing examination throughput and patient-magnet utilization. Using our algorithms retrospectively can help (1) assess prior scheduling decisions, (2) identify potential areas of efficiency improvement and (3) identify difficult examination types. Using a year of patient data and several years of MRI utilization data, we construct a simulation model to forecast MRI machine demand under a variety of scenarios. Under our predicted demand model, the throughput calculated by our algorithms acts as an estimate of the overtime MRI time required, and thus, can be used to help predict the impact of different trends in examination demand and to support MRI machine staffing and equipment planning.     

The impact of competition among health care financing authorities on market yields and issuer interest expenses

The main source of capital for non-for-profit health care organizations is tax-exempt municipal bonds. The tax-exempt nature of this debt requires that they be issued through financing authorities, which are run by, or affiliated with, state or local government agencies. In some states, all tax-exempt health care bonds must be issued through a single financing authority, but in other states the issuing health care organization has a choice of multiple authorities. Using a Herfindahl index of issuer concentration, prior research has found that greater competition among authorities results in lower interest costs to the issuing health care organization. We pick up where this earlier study left off, examining the links between authority competition, the interest expenses to the issuer, and the yield to the market investor. Although our analysis of all hospital bonds issued between 1994 and 2002 corroborates earlier findings with regard to interest expenses to the issuing health care organization, we also find market yield is lower for statewide authorities where issuer concentration is lower. Thus, authority competition is good from the issuers' point of view, but holds no favor in the investors' eyes. On the other hand, the lower market yield associated with statewide authorities does not make its way down to the issuer in the form of lower interest costs. To help sort through this paradox, we explore our findings through interviews of executives in state issuing authorities.     

Pregnancy (im)possibilities: identifying factors that influence sexual minority women’s pregnancy desires

ABSTRACT

Sexual minority women (SMW) face both increased risk for unintended pregnancy and barriers to achieving wanted pregnancy, but little research investigates SMW’s pregnancy desires. To fill this gap, we conducted five focus groups and 11 in-depth interviews with 20-30-year-old SMW in three US cities. Findings highlight that the heteronormative pregnancy planning paradigm lacks salience for SMW. While some SMW clearly wish to avoid pregnancy, many others are unsure, and factors influencing this uncertainty include relationship context, anticipating logistical barriers, and discord between queer identity and pregnancy.     

Disparities in Health Insurance Coverage and Access to Care for Children By Mother’s Sexual Orientation

Maternal and Child Health Journal - Few population-based studies have examined the health care experiences of children with sexual minority parents. The purpose of this study was to compare health...     

Postmastectomy/postlumpectomy pain in breast cancer survivors

Few studies have focused on careful assessment of postmastectomy pain (PMP); a chronic neuropathic pain syndrome that can affect women postlumpectomy or postmastectomy for breast cancer (BC). Study aims were to determine the prevalence of PMP in an outpatient sample of breast cancer survivors (BCS), describe subjective and objective characteristics of PMP, and examine the relationship between PMP and quality of life. Breast cancer survivors (n = 134) participated in telephone interviews, and those reporting PMP (n = 36) were invited to a pain center for further evaluation and treatment. Results show PMP is a distinct, chronic, pain syndrome affecting 27% of BCS. Findings support the need for clinical trials evaluating the effectiveness of nonpharmacological or cognitive behavioral therapies in alleviating mild to moderate PMP.