Health Care Manag Sci
September 2022
The COVID-19 pandemic hastened hundreds of thousands of deaths in the United States. Many of these excess deaths are directly attributed to COVID-19, but others stem from the pandemic's social, economic, and health care system disruptions. This study compares provisional mortality data for age and sex subgroups across different time windows, with and without COVID-19 deaths, and assesses whether mortality risks are returning to pre-pandemic levels.
View Article and Find Full Text PDFHealth Care Manag Sci
December 2021
COVID-19 has disrupted society and health care systems, creating a fertile environment for deaths beyond the virus. The year 2020 will prove to be the most deadly year on record in the United States. Direct deaths due to COVID-19 have been well documented and reported.
View Article and Find Full Text PDFRecent mass killings, such as those in Newtown, Connecticut, and Aurora, Colorado, have brought new attention to mass killings in the United States. This article examines 323 mass killings taking place between January 1, 2006, and October 4, 2016, to assess how they are distributed over time. In particular, we find that they appear to be uniformly distributed over time, which suggests that their rate has remained stable over the past decade.
View Article and Find Full Text PDFThe objective of this paper is to estimate the impact of county-level public transit usage on obesity prevalence in the United States and assess the potential for public transit usage as an intervention for obesity. This study adopts an instrumental regression approach to implicitly control for potential selection bias due to possible differences in commuting preferences among obese and non-obese populations. United States health data from the 2009 Behavioral Risk Factor Surveillance System and transportation data from the 2009 National Household Travel Survey are aggregated and matched at the county level.
View Article and Find Full Text PDFPurpose Of Review: Traveling by automobile rather than walking or cycling can encourage obesity by eliminating physical activity. As national obesity rates in the USA have reached 37.9% in 2014, understanding the connections between obesity and transportation choices can help policymakers in the public health community propose effective obesity interventions at the national level.
View Article and Find Full Text PDFThis paper provides an alternative policy for Ebola entry screening at airports in the United States. This alternative policy considers a social contact tracing (SCT) risk level, in addition to the current health risk level used by the CDC. The performances of both policies are compared based on the scenarios that occur and the expected cost associated with implementing such policies.
View Article and Find Full Text PDFExpert Rev Vaccines
April 2015
Pediatric immunization programs in the USA are a successful and cost-effective public health endeavor, profoundly reducing mortalities caused by infectious diseases. Two important issues relate to the success of the immunization programs, the selection of cost-effective vaccines and the appropriate pricing of vaccines. The recommended childhood immunization schedule, published annually by the CDC, continues to expand with respect to the number of injections required and the number of vaccines available for selection.
View Article and Find Full Text PDFWe explored market factors that affect pediatric combination vaccine uptake in the US public-sector pediatric vaccine market. We specifically examined how Pediarix and Pentacel earned a place in the 2009-2012 lowest overall cost formulary. Direct competition between Pediarix and Pentacel is driven by the indirect presence of the Merck Haemophilus influenzae type b vaccine and the Recommended Childhood Immunization Schedule requirement for a hepatitis B birth dose.
View Article and Find Full Text PDFObjective: The objective of this study is to assess the association between average adult body mass index (BMI), automobile travel, and caloric intake in the US in order to predict future trends of adult obesity.
Methods: Annual BMI data (1984-2010) from the Behavioral Risk Factor Surveillance System (BRFSS), vehicle miles traveled data (1970-2009) from the Federal Highway Administration, licensed drivers data (1970-2009) from the Federal Highway Administration, and adult average daily caloric intake data (1970-2009) from the US Department of Agriculture were collected. A statistical model is proposed to capture multicollinearity across the independent variables.
This paper analyzes pricing strategies for US pediatric combination vaccines by comparing the lowest overall cost formularies (i.e., formularies that have the lowest overall cost).
View Article and Find Full Text PDFA critical component of aviation security consists of screening passengers and baggage to protect airports and aircraft from terrorist threats. Advancements in screening device technology have increased the ability to detect these threats; however, specifying the operational configurations of these devices in response to changes in the threat environment can become difficult. This article proposes to use Fisher information as a statistical measure for detecting changes in the threat environment.
View Article and Find Full Text PDFThis paper analyzes pricing strategies for pediatric combination vaccines and their impact on the United States pediatric vaccine market. Three pharmaceutical companies compete pairwise with each other over the sale of vaccines containing two or three antigens per injection. Specific emphasis is placed on examining the competition between two pentavalent vaccines: GlaxoSmithKline's Pediarix (DTaP-HepB-IPV) and Sanofi Pasteur's Pentacel (DTaP-IPV/Hib).
View Article and Find Full Text PDFHealth Care Manag Sci
December 2008
The growing-complexity of the United States Recommended Childhood Immunization Schedule has resulted in as many as five required injections during a single well-baby office visit. To reduce this number, vaccine manufacturers have developed combination vaccines that immunize against several diseases in a single injection. At the same time, a growing number of parents are challenging the safety and effectiveness of vaccinating children.
View Article and Find Full Text PDFJ Am Med Inform Assoc
January 2010
This article describes the motivation, development, and implementation of a software tool, www.vaccineselection.com, introduced to assist health care professionals and public health administrators in managing pediatric vaccine purchase decisions and making economically sound formulary choices.
View Article and Find Full Text PDFExpert Rev Vaccines
December 2007
Vaccine distribution and delivery has become an issue of significant interest, given the threat of a pandemic influenza outbreak and the resulting need for coordinated efforts to distribute and deliver pandemic influenza vaccines into the hands of healthcare workers responsible for administering them. This review provides an overview of the issues that are most relevant to vaccine distribution and delivery, including routine pediatric immunization, combination vaccines, vaccine shortages and stockpiling, seasonal influenza vaccines and, of most current interest, a discussion on pandemic influenza outbreak issues and a list of future distribution and delivery challenges that may be faced during such an event.
View Article and Find Full Text PDFIn 2002, several factors resulted in pediatric vaccine manufacturers not being able to produce a sufficient number of vaccines to vaccinate all the children in the United States according to the Recommended Childhood Immunization Schedule. The resulting vaccine supply shortage resulted in thousands of children not being fully immunized according to this schedule, and hence, created an unnecessary risk for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention responded to this crisis by using pediatric vaccine stockpiles to mitigate the impact of future shortages.
View Article and Find Full Text PDFThe terrorist attacks of September 11, 2001 have resulted in dramatic changes in aviation security. As of early 2003, an estimated 1,100 explosive detection systems (EDS) and 6,000 explosive trace detection machines (ETD) have been deployed to ensure 100% checked baggage screening at all commercial airports throughout the United States. The prohibitive costs associated with deploying and operating such devices is a serious issue for the Transportation Security Administration.
View Article and Find Full Text PDFIn recent years, several factors have led to pediatric vaccine manufacturers experiencing vaccine production interruptions that resulted in vaccine supply shortages. One unfortunate consequence of such events is that not all children in the United States could be vaccinated on time, as set forth by the Recommended Childhood Immunization Schedule, and hence, created the potential for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention (CDC) have responded to such events by releasing vaccine supplies from the national pediatric vaccine stockpiles, which were designed to mitigate the impact of vaccine production interruptions.
View Article and Find Full Text PDFHealth Care Manag Sci
February 2005
Combination vaccines for pediatric immunization have become an effective means to reduce the number of separate injections required to immunize children according to the United States Recommended National Childhood Immunization Schedule. This paper reports the results of using operations research methodologies to analyze the price and value of two pentavalent combination vaccines for pediatric immunization: diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated polio (DTPa-HBV-IPV) and diphtheria-tetanus-acellular pertussis, Haemophilus influenzae type B, inactivated polio (DTPa-HIB-IPV). These two combination vaccines are analyzed both individually and head-to-head, as a function of the cost of administering (or avoiding) an injection and the number of doses of the vaccine required to be in the lowest overall cost vaccine formulary.
View Article and Find Full Text PDFPediatric immunization is an important factor in providing protection against numerous common preventable diseases. The success of the pharmaceutical industry in developing new pediatric vaccines has resulted in a crowded recommended immunization schedule requiring several clinic visits over the first 12 years of life. Operations research models have been developed and used to make economically sound procurement choices from among a growing number of competing vaccine products.
View Article and Find Full Text PDFDetermining how to effectively operate security devices is as important to overall system performance as developing more sensitive security devices. In light of recent federal mandates for 100% screening of all checked baggage, this research studies the trade-offs between screening only selectee checked baggage and screening both selectee and non-selectee checked baggage for a single baggage screening security device deployed at an airport. This trade-off is represented using a cost model that incorporates the cost of the baggage screening security device, the volume of checked baggage processed through the device, and the outcomes that occur when the device is used.
View Article and Find Full Text PDFThe National Immunization Program, housed within the Centers for Disease Control and Prevention in the USA, has identified several challenges that must be faced in childhood immunization programs to deliver and procure vaccines that immunize children from the plethora of childhood diseases. The biomedical issues cited include how drug manufacturers can combine and formulate vaccines, how such vaccines are scheduled and administered and how economically sound vaccine procurement can be achieved. This review discusses how operations research models can be used to address the economics of pediatric vaccine formulary design and pricing, as well as how such models can be used to address a new set of pediatric formulary problems that will surface with the introduction of pediatric combination vaccines into the US pediatric immunization market.
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