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Purpose: The main goal of this paper is better understand the risk/return trade-off of investing in socially responsible investment funds (SRIF) and green investment funds (GIF). Design/methodology/approach: To achieve our aim a green investment fund portfolio, a socially responsible investment portfolio and a conventional fund (CF) portfolio from the United States of America (USA) were selected to compare the efficiency of these three different portfolios, by using Value-Based Data Envelopment Analysis (DEA) methodology. Findings: The results point out that SRIF and GIF are more efficient than CF. For five years, the CFs have not outperformed the GIF. Originality/value: The results suggest that there is a growing awareness on the part of investors that sustainable companies are the companies that will allow a better quality of life and a more sustainable environment. It seems that somehow managers and investors are aware that the market will compensate them for thinking about a cleaner and more equitable world. [ABSTRACT FROM AUTHOR]

The article discusses the reconsideration of using buprenorphine as the primary analgesic in non-opioid use disorder (OUD) patients in emergency departments post-X-waiver elimination in 2023. Topics include the historical context of the X-waiver program, the pharmacological profile of buprenorphine, and the need for further U.S.-based research to establish guidelines for its appropriate use as a primary analgesic in emergency settings.

Background: Diabetes poses a serious global challenge, given its increasing prevalence, detrimental effects on public health, and substantial economic burden. Since 1950s, tens of drugs have been approved by the United States (US) Food and Drug Administration (FDA). In the past decade, the medical community and regulatory agencies have moved away from the glucose-centric paradigm and increasingly call for a holistic approach to assess different treatments' benefits and harms., Objective: This study aimed to assess the medication efficiency and technological progress of Type 2 Diabetes (T2D) drugs, by considering their physiological outcomes, including both benefits (i.e., glucose lowering and weight loss) and adverse effects (mortality), relative to dosing frequency., Methods: To derive medication efficiency, this study utilized data from the US FDA and prominent meta-analyses. Given that both the benefits and adverse effects of medications are multidimensional, this study employed a nonparametric frontier method, the data envelopment analysis (DEA) model, to integrate these factors into a measure of medication efficiency. Physiological outcomes could assume both positive and negative values. Adverse effects were regarded undesirable outputs. The DEA model was built under the framework of directional distance function and was able to handle negative and undesirable values which naturally arose in the case of T2D medications., Results: The paper presented a ranking of 20 T2D drugs in terms of medication efficiency. Three of them were able to attain the highest medication efficiency, all of which were in the GLP-1 class, including oral Semaglutide, subcutaneous Semaglutide and Dulaglutide. However, the other two GLP-1 drugs, Lixisenatide and Liraglutide, were less efficient. The average medication efficiency of drugs approved post-2010 was significantly higher than pre-2010 drugs. High dose frequency, low HbA1c reduction and insignificant weight loss were the main driving factors behind inefficiencies. Overall, medication efficiency provided an alternative perspective on treatment effectiveness other than conventional measures such as cost-effectiveness., Competing Interests: The author(s) declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Wang, Xu, Liu, Ban, Liu, Yan and Han.)

Bus rapid transit systems (BRT) have evolved in all shapes and sizes around the world in the last 30 years motivated by providing greater efficiency and value for money than potential alternatives. This paper aims to explore and compare the effectiveness (including its determinants) and revenue potential of 58 BRT systems globally. A key research question for this paper is to what extent there is a trade-off between long term capital expenditure and short term operating cost. The results suggest that BRT systems located in developing countries or countries that have high population densities are successful in generating higher revenues per passenger and unit of input than their conventional bus counterparts but are from a community perspective not more cost effective in doing so. Better BRT standards and hence higher capital expenditure, while significantly increasing patronage and input effectiveness do not have a significant impact on either yields or cost effectiveness. In contrast, public ownership and the number of stations are on average associated with higher cost effectiveness scores. [ABSTRACT FROM AUTHOR]

This paper offers a new perspective on the energy efficiency literature by bringing evidence of political contextual factors as the predictors of energy efficiency. Specifically, we posit that the Democrat administration is more energy-efficient considering the reduction of environmental impact, in contrast, the Republican administration is more efficient considering only financial expenditures leading to the production of economic growth. In addition, we predict that political administration tenure is negatively correlated with green energy efficiency and that political distancing moderates the relationship between political party administration and energy efficiency. This study sheds light on these matters by performing an efficiency analysis of fifty North American states through a bootstrap DEA non-parametric model, followed by Tobit regressions to evaluate our hypotheses concerning the effect of the contextual factors on the calculated efficiency scores. • We investigate the impact of political factors on energy efficiency in the United States. • We perform a two-stage DEA-Tobit bootstrapped regression analysis. • The Democrats consistently demonstrated higher energy efficiency scores. • The political tenure as a feature had mild or mixed impact on energy efficiency. • We confirmed the positive time-passage effect on energy efficiency. [ABSTRACT FROM AUTHOR]

Background: The Controlled Substances Staff of the Center for Drug Evaluation and Research at the US Food and Drug Administration and the Pharmaceutical Research Manufacturers Association (PhRMA) conducted a series of open forum dialog sessions between 2006 and 2016. A Cross Company Abuse Liability Council (CCALC) was formed during the process of this unique collaborative effort between Industry and Federal Regulators whose goals were to establish the development of standards for the preclinical screening of new molecular entities for schedule control actions required as part of every New Drug Application process. The draft guidance document was published and disseminated in 2010, which allowed for alternative approaches to each study protocol requirement needed for NDA review, if the approach satisfied the requirements of the applicable statutes and regulations (i.e., the controlled substance act). In a series of recent pre-study protocol reviews requested by confidential Pharmaceutical Sponsors of MPI Research, the CSS staff appeared to change its policy and set forth to require all drug discrimination study data to be generated under "extinction" test sessions. MPI Research is a Contract Research Organization acting on behalf of pharmaceutical companies and bound under separate confidentiality agreements.Purpose: The purpose of this review is to highlight the data appearing in peer-reviewed scientific journals that do not support the regulatory administrative constraints on one specific testing methodology (extinction) to the exclusion of another (reinforced test sessions).Conclusion: This mind shift represents a restrictive administrative policy by the FDA that is not supported by the published data. [ABSTRACT FROM AUTHOR]

Prescription drug abuse and overdose are rapidly growing problems in the United States. The United States federal Disposal of Controlled Substances Rule became effective 9 October 2014, implementing the Secure and Responsible Drug Disposal Act of 2010 (Disposal Act). These regulations target escalating prescription drug misuse by reducing accumulation of unused controlled substances that may be abused, diverted or accidentally ingested. Clinical areas that can now participate in collecting unused controlled substances include retail pharmacies, hospitals or clinics with an onsite pharmacy, and narcotic treatment programs. Collection methods include placing a controlled substance collection receptacle or instituting a mail-back program. Because prompt onsite destruction of collected items is required of mail-back programs, collection receptacles are more likely to be used in clinical areas. Retail pharmacies and hospitals or clinics with an onsite pharmacy may also place and maintain collection receptacles at long-term care facilities. The Act and Rule are intended to increase controlled substance disposal methods and expand local involvement in collection of unused controlled substances. Potential barriers to participating in controlled substance collection include acquisition of suitable collection receptacles and liners, lack of available space meeting the necessary criteria, lack of employee time for verification and inventory requirements, and program costs. [ABSTRACT FROM AUTHOR]

Synthetic drugs such as Spice and bath salts have been around since the late 1990s, and their use has become widespread around the world. Extensive research into the effects of these drugs is lacking, and health care providers struggle to deal with the increased numbers of patients intoxicated on these substances. Because these drugs are usually labeled “not for human consumption,” it has been difficult to curb them through legal efforts. The fact that these synthetic drugs are continually being revised further complicates the issue. In order to treat individuals effectively, more research must be done, and providers must be educated about the best methods to treat this epidemic of Spice and bath salt users. [ABSTRACT FROM PUBLISHER]

Universities play a critical role in the complex technology transfer process that facilitates technology transformation from pure research activities to commercialization. The literature has recently focused on whether universities are efficient in this process. With a two-stage perspective, this study explores the required capabilities for universities to be efficient in technology transfer process. To explore the efficiencies in different stages of technology transfer, we apply a 2-stage process DEA method. The model considers 2 inputs, 2 intermediate variables, and 3 output variables from the Association of University Technology Management database. These variables represent funding resource, patenting activities, and licensing and entrepreneurships. Technology transfer in the 2-stage perspective includes the research innovation stage and the value creation stage. The results show that achieving efficiency in the 2 technology-transfer stages requires many different innovation capabilities; thus, most efficient universities only perform efficiently in one of the two stages. When mapping the relative site of universities in the reference network, we found that efficient universities in the research innovation stage are in a more centralized location than those in the value creation stage. By contrast, in the value creation stage, efficient universities can be identified as different reference groups for specific inefficient universities. The network visualization also helps to explain that universities must consider their relative advantages and capabilities to reach efficiency goals in different stages. The comparison between the large-scale group and the small-scale group also showed that a resource scale is critical for universities to accumulate different required capabilities for efficiencies in both stages. [ABSTRACT FROM AUTHOR]

Abstract: In this study, a DEA based Malmquist index model was developed to assess the relative efficiency and productivity of U.S. states in decreasing the number of road fatalities. Even though the national trend in fatal crashes has reached to the lowest level since 1949 (Traffic Safety Annual Assessment Highlights, 2010), a state-by-state analysis and comparison has not been studied considering other characteristics of the holistic national road safety assessment problem in any work in the literature or organizational reports. In this study, a DEA based Malmquist index model was developed to assess the relative efficiency and productivity of 50 U.S. states in reducing the number of fatal crashes. The single output, fatal crashes, and five inputs were aggregated into single road safety score and utilized in the DEA-based Malmquist index mathematical model. The period of 2002–2008 was considered due to data availability for the inputs and the output considered. According to the results, there is a slight negative productivity (an average of −0.2 percent productivity) observed in the U.S. on minimizing the number of fatal crashes along with an average of 2.1 percent efficiency decline and 1.8 percent technological improvement. The productivity in reducing the fatal crashes can only be attributed to the technological growth since there is a negative efficiency growth is occurred. It can be concluded that even though there is a declining trend observed in the fatality rates, the efficiency of states in utilizing societal and economical resources towards the goal of zero fatality is not still efficient. More effective policy making towards increasing safety belt usage and better utilization of safety expenditures to improve road condition are derived as the key areas to focus on for state highway safety agencies from the scope of current research. [Copyright &y& Elsevier]

Abstract: This paper applies the -convex model in order to investigate the technical efficiency of a representative sample of US airlines over the period 1998–2010. The results are mixed and reveal that US airlines’ efficiency can be influenced by the size of the airline, mergers and acquisitions, and by time. Policy implications are derived. [Copyright &y& Elsevier]

The escalation of prescription drug abuse in the U.S. has attracted the attention of public health and safety officials as well as others puzzled by how such a tightly regulated enterprise could so easily be breached by those seeking controlled substances for nonmedical use. Prescribers and patients who use, misuse, or, in some cases, redistribute or divert these drugs have figured prominently in government strategies aimed at addressing this issue. This review departs from this paradigm and focuses on wholesale drug distributors, a highly efficient and largely behinds-the-scene link in the supply chain of controlled substances. By law, distributors are required to identify and report to the Drug Enforcement Administration (DEA) orders for controlled substances that are suspicious and may indicate drug diversion. Ten cases are examined in which distributors were each charged with failing to prevent the diversion of millions of doses of controlled substances. Special attention is given to a payment system employed by the industry that may encourage this unlawful commerce. Court records, agency and industry reports, and other published sources are used to document referenced cases and their disposition, and recommendations are offered for improving distributors' compliance with the law. [ABSTRACT FROM AUTHOR]

This article measures efficiency of the top 50 business schools in the United States in 2006, using the Data Envelopment Analysis (DEA) method. We use peer assessment (to represent school quality) and average Graduate Management Admission Test (GMAT) scores (to represent student ability) as inputs and average starting salary and the percent of graduates employed upon graduation as outputs. The 50 business schools consist of 27 private schools and 23 public schools, and their efficiency scores are compared. We find that although technical efficiencies of private and public schools are both high, scale and overall efficiencies of the public schools are lower than those of the private schools. And most public schools exhibit Increasing Returns To Scale (IRTS). The returns to scale in this article refers to increases in the output measures - starting salary and the employment rates - in response to increases in the quality of inputs - peer assessment and the average GMAT scores. Hence, schools that exhibit IRTS will experience more than proportionate increases in starting salary and the employment rates by raising the quality of inputs. The policy implication is that for many public schools, efficiency will be improved if they could improve school and student quality levels. [ABSTRACT FROM AUTHOR]

The prescribing and dispensing of controlled substances within long-term care facilities is an important and complex issue from both the clinical and the public policy perspectives. This article reviews the regulatory background and clinical concerns regarding the enforcement of the Controlled Substances Act by the Drug Enforcement Administration within the institutional pharmacies serving long-term care facilities. The article argues that the processes implemented since 2009 in response to concerns about Drug Enforcement Administration enforcement are suboptimal at many levels. A robust solution that meets the needs of all parties involved will require multiple levels of collaboration and respect for several legitimate agendas pertinent to this issue. The comprehensive solution must address at least 4 concerns. It must ensure that (1) residents and patients of long-term care facilities receive appropriate and timely administration of controlled substances when they are part of their individualized plans of care; (2) long-term care facilities have rigorous processes in place to prevent diversion of controlled substances; (3) required processes for prescribing controlled substances are reasonable and not overly burdensome to the clinicians caring for this population; and (4) all parties are in compliance with statutory and regulatory requirements. The solution, however, will likely require legislative amendments to the Controlled Substances Act and regulatory revisions for optimal outcomes. The debate surrounding the enforcement of the Controlled Substances Act within long-term care facilities is ongoing and the parameters are in flux. This article provides a historical perspective and policy framework for understanding the topic, reviews various proposed solutions, and suggests a collaborative process for resolution. [Copyright &y& Elsevier]

The Drug Enforcement Administration (DEA) is issuing this statement of policy to provide guidance under existing law regarding the proper role of a duly authorized agent of a DEA-registered individual practitioner in connection with the communication of a controlled substance prescription to a pharmacy. [ABSTRACT FROM AUTHOR]

The Drug Enforcement Administration (DEA) has in recent years engaged in flip-flopping over important policy decisions. The most recent example involved whether a pharmacist can correct a written schedule II prescription upon verification with the prescriber. For several years the DEA's policy permitted this practice. Then the DEA issued a conflicting policy statement in 2007 in the preamble to the multiple schedule II prescription regulation, causing a series of subsequent contradictory statements ending with the policy that pharmacists should follow state law or policy until the Agency issues a regulation. It is doubtful that the DEA's opinion in the preamble would in itself constitute legal authority, or that the Agency would try to enforce the opinion. Nonetheless, these flip-flop opinions have confused pharmacists, caused some pharmacies to have claims rejected by third party payors, and most likely have inconvenienced patients. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates productivity growth, technical progress, and efficiency change for a group of the 56 largest CPA firms in the US from the period 1996–1999 through the period 2003–2006, where the former preceded, and the latter followed, enactment of the Sarbanes–Oxley Act (SOX). Data envelopment analysis (DEA) is used to calculate Malmquist indices of three measures of interest: productivity growth, technical progress, and efficiency change. Results indicate that CPA firms, on average, experienced a productivity growth of approx. 17% from the pre- to post-SOX period. Consistent with the finding of Banker et al. [Banker RD, Chang H, Natarajan R. Productivity change, technical progress and relative efficiency change in the public accounting industry. Management Science 2005;51:291–304], this productivity gain can be attributed primarily to technical progress rather than a change in relative efficiency. In addition, results indicate that the “Big 4” firms underperformed their non-Big 4 counterparts in both productivity growth and technical progress. [Copyright &y& Elsevier]

Excess capacity can be viewed as wasteful (an unnecessary cost) or as prudential (a ready source of supply). The role of excess capacity is an important issue at the individual firm level as well as at the community level. In this paper we explore hospital capacity for a sample hospitals operating in the 15 largest standard metropolitan statistical areas (SMSAs) in the U.S. during 2002. Using Johanson’s (, Production Functions and the Concept of Capacity, Namur, Belgium, Recherches Récentes sur le Fonction de Production (Collection, Economie Mathematique et Econometrie no. 2). [Reprinted in Finn R. Førsund (ed) (1987) The Collected Works of Leif Johanson, vol 1. Amsterdam, North-Holland, pp 350–282]) notion of capacity as the maximum rate of output possible from fixed inputs (i.e., without restrictions on variable inputs), we measure capacity in a frontier setting using directional distance functions. Rather than attempt to determine the “optimal” level of hospital capacity, we instead quantify capacity and capacity utilization rates at both the individual hospital and, by aggregating, the SMSA levels. After determining capacity and capacity utilization rates, we then introduce a model that calculates the changes in variable inputs that would be needed to utilize excess capacity. Finally, we introduce a simulation model that is used to examine whether each SMSA has enough “excess” hospital capacity to accommodate the loss of one of its five largest hospitals. The approach developed in this study should be of value to decision makers and planners in a variety of fields. [ABSTRACT FROM AUTHOR]

The 1990s were tumultuous times for the US Real Estate Investment Trusts (REITs) industry. Significant structural changes occurred during the decade, especially after the 1993 Revenue Reconciliation Act, which tremendously boosted the flow of funds into the system by allowing the participation of institutional investors in REITs. As a result, the industry experienced remarkable asset growth during the decade, with a large number of initial public offerings and substantial increases in market capitalization. Employing the Data Envelopment Analysis-type Malmquist index approach, this paper explores the impact of such environmental changes on productivity growth, efficiency change, and technological progress of REITs. Our results indicate that while efficiency of the REITs significantly increased, their average productivity declined and technology regressed during this decade. It appears that the typical REIT has failed to improve technically, but exerted substantial effort to catch up with the best practice ones relying mainly on aggressive growth strategies. However, our empirical results indicate that they might have overextended themselves as most began to suffer from diseconomies of scale. [ABSTRACT FROM AUTHOR]

This study uses the directional output distance function from economic productivity theory as an alternative approach to environmental index construction. We use the directional output distance function to aggregate multiple environmental objectives into one measure of environmental performance. We apply this method to a set of watershed data and compare our results to the existing U.S. Environmental Protection Agency (EPA) index values. When modeling the same set of objectives, the directional output distance function and the existing EPA index yield similar measures of environmental performance. We discuss the mathematical properties of both indices using the axioms of economic index theory, and explore the possible advantages to our approach. The mathematical properties of the directional output distance function are well established and this approach provides a nonparametric way to aggregate individual characteristics. This advances the standard use of a priori-weighted summation, and circumvents the often contentious selection of index weights. [Copyright &y& Elsevier]

Prescribing opioid analgesic medications brings with it a risk of regulatory oversight. A Florida Physician, Dr. Andrew Nguyen, was arrested in 2000 for allegedly violating controlled substance laws. The allegation was that Dr. Nguyen had not conducted a physical examination of a patient for whom controlled substances were prescribed. The allegation was untrue, and the charges against Dr. Nguyen were dismissed. Dr. Nguyen successfully sued the local law enforcement authorities, but a companion lawsuit against the Drug Enforcement Agency (DEA) was dismissed. The United States Court of Appeals has now reinstated Dr. Nguyen's lawsuit against the DEA. The reinstatement of the lawsuit corrects a moral hazard that produces imbalanced regulatory perspectives on the enforcement of controlled substance laws. [ABSTRACT FROM AUTHOR]

The authors compared the cohort group of the top-10 MBA programs in the United States with their lower-ranking counterparts on their value-added efficiency. The findings reveal that the top-10 MBA programs in the United States are associated with statistically higher average technical and scale efficiency and scale efficiency, but not with a statistically higher average pure technical efficiency. By calculating the efficiency measures, the proper decision variables of the MBA programs can be identified and improvements to their efficiency can be made. In addition, the findings can assist prospective students in selecting the best MBA programs for their educational investment. [ABSTRACT FROM AUTHOR]

Abstract: This paper analyzes the United Nations Organization''s Kyoto Protocol nations to address two questions. First, what are the environmental production efficiency rankings of these nations? Second, is there a relationship between a nation''s ratification status and its environmental production efficiency ranking? Our findings suggest that the nations that have ratified the Kyoto Protocol are more likely to be environmentally production efficient as compared to the nations that have not ratified the Protocol. [Copyright &y& Elsevier]

The federal notice and comment rulemaking process is described and illustrated with the recent multiple-copy prescription controversy. Impact assessment, balance in controlled substance regulation, and informing balanced decision making are discussed. Examples of regulations that may warrant patient impact assessment scrutiny are provided and the need for caution in applying these is described. [ABSTRACT FROM AUTHOR]

Multiple same-day prescriptions for Schedule II medications offer the flexibility to provide continuous access to necessary medication without requiring that stabilized patients unnecessarily visit their prescriber on a monthly basis. The federal Drug Enforcement Administration recently promulgated a new regulation that specifically authorizes the use of multiple prescriptions. This is a change in policy within the agency. Health care professionals must communicate to each other that this useful practice is now recognized as being completely legal. [ABSTRACT FROM AUTHOR]

The article presents an analysis on the relationship between quality and efficiency in hospital care industry. It provides an effective approach to measuring cost and quality of hospital care in the United States, as the federal government attempts to realign health care resources to other community needs. It is mentioned that effective allocation of resources and development of high-performance work processes are important to improve quality of care.

On January 18, 2005, DEA published in the Federal Register a solicitation of comments on the subject of dispensing controlled substances for the treatment of pain. Many of the comments that DEA received asked the agency to elaborate on the legal requirements and agency policy relating to this subject. This document provides such information. [ABSTRACT FROM AUTHOR]

The United States Court of Appeals for the 4th Circuit has ruled that a jury considering charges of drug trafficking against a pain management physician should be instructed that the defendant's good faith is a defense to the charges. The court rejected a subjective standard of good faith, and instead ruled that the good faith of the defendant must be evaluated from an objective perspective. This objective standard requires that the jury determine whether the defendant was practicing in accordance with the standard generally recognized and accepted in the United States. General recognition and acceptance are determined on a case-by-case basis, within the context of a defendant's practice. Simply because a physician's practice is out of the norm for many physicians does not mean it can't be generally recognized and accepted within the standard of medical practice. Expert witness testimony of pain management physicians will assist juries in the application of this standard for good faith in prescribing. [ABSTRACT FROM AUTHOR]

Productivity growth of the catfish-processing sector in the United States was measured over the time period of 1986 through 2005. The analysis evaluated the efficiency with which products are produced by catfish processing plants. The Malmquist index is employed to decompose the total factor productivity into growth associated with technical efficiency change and technological progress. The relationship between Farrell's measure of technical efficiency and the Shepard's distance function provides the theoretical foundation for estimating the Malmquist production index using data envelopment analysis. The results indicate that, between 1986 and 2005, there was no technical progress or adoption of new techniques with significant impact on catfish processing. Technical efficiency change, which is associated with input use efficiency, varied with type of fish size processed. It decreased from 1985 to 1995 as the industry struggled to establish the most efficient fish size to process. Between 1995 and 2005 the fluctuation continued but at a higher mean. Productivity growth and long-term competitiveness are likely to result from adoption of new processing innovations by the catfish-processing sector. [ABSTRACT FROM AUTHOR]

A consensus document on frequently asked questions, answers and references relating to the use and abuse of prescription analgesics was released to the public in August 2004 by the Drug Enforcement Administration, Last Acts Partnership, and the Pain & Policies Study Group of the University of Wisconsin. This document provides clear answers to common questions and is intended for primary care clinicians and drug enforcement and regulatory personnel. It clearly states that police and regulatory personnel should not interfere with medical practice and that clinicians have an obligation to practice in a legal manner. Topics addressed include risk assessment, how opioid treatment works, patient behavior, abuse, addiction, rules and laws, and clear descriptions of how and why the DEA may prosecute a clinician. [ABSTRACT FROM AUTHOR]

The structural transformation of agriculture in recent decades has raised serious concerns about the future of the family farm. This study examines the economic performance of U.S. farms, to explore the potential of smaller farms to compete with larger entities, and ultimately to survive in this rapidly changing environment. We use deterministic and stochastic frontier methods and survey data to measure and evaluate factors underlying scale economies (SEC) and efficiency (SEF) of corn-belt farms for 1996-2001. Our results suggest that family farms are both scale and technically inefficient. Potential for the exploitation of significant scale and scope economies, and some greater technical efficiency, seem to be driving trends toward increased farm size and dwindling competitiveness of the small family farm. [ABSTRACT FROM AUTHOR]

This study evaluates the technical efficiency of federal hospitals in the United States using a variable returns to scale, input-oriented, data envelopment analysis (DEA) methodology. Hospital executives, health care policy-makers, taxpayers, and other stakeholders, benefit from studies that improve the efficiency or federal hospitals. Data for 280 federal hospitals in 1998 and 245 in 2001 were analyzed using DEA to measure hospital efficiency. Results indicate overall efficiency in federal hospitals improved from 68% in 1998 to 79% in 2001. However, based upon 2001 spending of $42.5 billion for federal hospitals potential savings of $2.0 billion annually are possible through more efficient management of resources. From a policy perspective, this study highlights the importance of establishing more specific policies to address inefficiency in the federal health care industry. [ABSTRACT FROM AUTHOR]

Insurers, health plans, and individual physicians in the United States are facing increasing pressures to reduce costs while maintaining quality. In this study, motivated by our work with a large managed care organization, we use readily available data from its claims database with data envelopment analysis (DEA) to examine physician practices within this organization. Currently the organization evaluates primary care physicians using a profile of 16 disparate ratios involving cost, utilization, and quality. We employed these same factors along with indicators of severity to develop a single, comprehensive measure of physician efficiency through DEA. DEA enabled us to identify a reference set of “best practice” physicians tailored to each inefficient physician. This paper presents a discussion of the selection of model inputs and outputs, the development of the DEA model using a “stepwise” approach, and a sensitivity analysis using superefficiency scores. The stepwise and superefficiency analyses required little extra computation and yielded useful insights into the reasons as to why certain physicians were found to be efficient. This paper demonstrates that DEA has advantages for physician profiling and usefully augments the current ratio-based reports. [Copyright &y& Elsevier]

Data envelopment analysis (DEA) is a mathematical technique used to determine the relative inefficiency of decision making units (DMUs). Results from DEA analysis yield important information regarding the optimal operating capabilities of each unit. This paper discusses two studies applying DEA to medical clinics, and provides a comprehensive explanation of the results. Data for the first study comes from 51 independent civilian clinics in the United States. The second study consists of data received from a set of clinics at a military base in the United States. The studies provide insight into the usage and capabilities of DEA. [Copyright &y& Elsevier]

China's dairy product import volume and output continue to grow rapidly, and to a certain extent, it will form a substitute for the Chinese dairy market. Therefore, it is necessary to study the impact of the import of dairy products on the technological progress of raw milk production in China. Using the data from 2005 to 2017, this paper uses the DEA model and the input-output model to analyze the impact of China's dairy product imports on the technological progress of raw milk production. The model results show that: (1) there are differences in the technological content of dairy products from different importing countries; (2) The total technological content of imported dairy products hinders the improvement of the technological progress index of small, medium and large-scale production of raw milk in China, and has the most prominent negative impact on the technological progress of large-scale raw milk production in China; (3) The technological content of dairy products imports from New Zealand, Australia, Germany, the Netherlands and other countries can help improve the technological progress index of China's moderate-scale production of raw milk, while importing countries from the United States, Canada and other countries hinder it.

DEA (data envelopment analysis) is a technique for determining the efficiency frontier (the envelope) to the inputs and outputs of a collection of individual corporations or other productive units. DEA is here employed to estimate the intertemporal productive efficiency of U.S. computer manufacturers, using financial data brought from earnings statements and balance sheets. The results indicate that a few corporations, including Apple Computer Inc., Compaq Computer Corp., and Seagate Technology were able to stay at the productivity efficiency frontier throughout the time period investigated. But not all successful corporations did; sometimes subefficiency (=disequilibrium) actually goes together with very rapid growth. A new Malmquist type productivity index is calculated for each corporation, measuring shifts of the estimated intenemporal efficiency frontier. [ABSTRACT FROM AUTHOR]

The theoretical industrial organization literature cites varying factors which might influence the degree of technical efficiency achieved under different ownership structures in the US hospital industry. Unfortunately, this literature offers no consensus regarding the net direction and magnitude of these various effects. This study analyzes the four types of ownership structure in the US hospital industry--private nonprofit, private for-profit, federal, and state and local government. Distance functions are used to measure technical efficiency of hospitals producing multiple outputs relative to other hospitals in the sample, allowing comparisons among the different ownership types. [ABSTRACT FROM AUTHOR]

To address the dual public health imperatives of enhanced pain management and decreased abuse and diversion of prescription medications, the U.S. Drug Enforcement Administration (DEA) recently adopted regulations to allow practitioners to issue multiple prescriptions for a Schedule II controlled substance on the same day, to be dispensed sequentially. Public feedback suggested there was concern that practitioners could interpret the initially proposed language as limiting the quantity of prescribed medication and establishing an ambiguous practice standard. The DEA later explicitly confirmed that they did not intend to impose undue limits on practice. Rather, if implemented appropriately, the new regulation can be considered an important mechanism to control medication diversion while maintaining access for legitimate medical purposes and patient care. [ABSTRACT FROM AUTHOR]

All new molecular entities that enter the CNS and exert an activity in the brain must be assessed for abuse liability prior to a New Drug Application approval by the US Food and Drug Administration. One element of the screening process is the assessment of the reinforcing properties of the drug candidate using the regulatory-preferred species, the rat. We describe one method of data review from the standard rat IV SA study design that can be used to conclude the relative abuse liability of the new drug entity. While we do not claim the process as the only way to review or interpret the data, we believe the steps described highlight a process that the pharmaceutical development team can use as a starting point for a discussion during study protocol development., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This paper discusses and empirically analyses the implications of efficiency and innovation offsets for the management of non-point source pollution from agriculture. If efficiency improvements and green innovation indeed combine environmental advantages with economic advantages, these offsets would offer a free lunch adjustment to environmental regulations. A theoretical model of the farm is developed where pollution is a joint output of production, where inefficiency in production prevails and environmental innovations are available. We discuss whether education about environmentally friendlier farming practices is effective in such a context. The empirical analysis addresses pesticide use in conventional and genetically modified cotton production in North Carolina, USA. The conceptual model was implemented by means of the non-parametric directional distance function approach in Data Envelopment Analysis (DEA). [ABSTRACT FROM AUTHOR]