Health plan auditing: 100-percent-of-claims vs. random-sample audits.

The objective of this study was to examine the relative efficacy of two different methodologies for auditing self-funded medical claim expenses: 100-percent-of-claims auditing versus random-sampling auditing. Multiple data sets of claim errors or 'exceptions' from two Fortune-100 corporations were analysed and compared to 100 simulated audits of 300- and 400-claim random samples. Random-sample simulations failed to identify a significant number and amount of the errors that ranged from $200,000 to $750,000.

The 2002 PhRMA Code and Pharmaceutical Marketing: did anybody bother to ask the reps?

After marketing tactics resulted in $1.2 billion fines, the 2002 PhRMA Code attempted to standardize marketing and sales practices. Self-regulation had varied success by other industries and by pharmaceutical industries in other countries.

Afghanistan, poppies, and the global pain crisis.

The World Health Organization has reported that somewhere between 30-86 million people suffer from moderate to severe pain due to cancer, HIV/AIDS, burns, wounds and other illnesses annually and do not have access to proper opiate anesthetics to control the pain [1]. The vast majority of these people live in poor nations where medicinal opiates are either too expensive or not readily available. In this paper, it is argued that access to adequate healthcare is a human right and that adequate healthcare includes management of pain.

Quality of life in people with insomnia.

Objective: To determine whether subjects with insomnia report greater reductions in quality of life (QoL) than subjects without insomnia when assessed with self-report instruments.

Methods: Questionnaires were completed by individuals recruited through media advertisements and screened with a structured telephone interview. Data obtained from 261 individuals with insomnia (INS group) were compared with those of 101 individuals with no sleep complaint, or controls (CTL group).

Forecasting the adoption of new medical technology using the Bass model.

A mathematical model, the Bass model, was used to forecast the adoption of new medical technology based on durable equipment. When the model was applied to five successful medical technologies, actual unit sales were predicted for three. The technologies investigated are computed tomography (CT scan), magnetic resonance imaging (MRI), ultrasound, hemodialysis, and lithotripsy.