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Biomedical subjects

G Diehr

Publications and source records attributed to G Diehr.

2 recordsLinked to original sources
PubMed1989

Linear programming models for cost reimbursement.

Tamura, Lauer, and Sanborn (1985) reported a multiple regression approach to the problem of determining a cost reimbursement (rate-setting) formula for facilities providing long-term care (nursing homes). In this article we propose an alternative approach to this problem, using an absolute-error criterion instead of the least-squares criterion used in regression, with a variety of side constraints incorporated in the derivation of the formula. The mathematical tool for implementation of this approach is linear programming (LP). The article begins with a discussion of the desirable characteristics of a rate-setting formula. The development of a formula with these properties can be easily achieved, in terms of modeling as well as computation, using LP. Specifically, LP provides an efficient computational algorithm to minimize absolute error deviation, thus protecting rates from the effects of unusual observations in the data base. LP also offers modeling flexibility to impose a variety of policy controls. These features are not readily available if a least-squares criterion is used. Examples based on actual data are used to illustrate alternative LP models for rate setting.

Computer Simulation↗
PubMed1982

Cluster analysis to determine headache types.

Cluster analysis was used to separate 726 headache patients into clusters of patients with similar symptoms. This was done to answer two questions: what "naturally occurring' groups of patients can be found? And how do these groups correspond to traditional headache types? When only two clusters were required, the best two clusters were tension and migraine-like. However, eight clusters could also be distinguished, and the migraine group then became very small. The clusters were tested for clinical interpretability by having 12 physicians name and prescribe treatment for the clusters. The suggested treatment was similar to what patients had actually received in about 2/3 of the cases but was rather different for the remainder. Further, the outcomes associated with different treatments appeared to vary by cluster. This suggests that the current method for classifying and treating headaches may not be optimal.

Adult↗