Mohammed Khayum

Benchmarking patient improvement in physical therapy with data envelopment analysis

PURPOSE The purpose of this article is to present a case study that documents how management science techniques (in particular data envelopment analysis) can be applied to performance improvement initiatives in an inpatient physical therapy setting. DESIGN/METHODOLOGY/APPROACH The data used in this study consist of patients referred for inpatient physical therapy following total knee replacement surgery (at a medium-sized medical facility in the Midwestern USA) during the fiscal year 2002. Data envelopment analysis (DEA) was applied to determine the efficiency of treatment, as well as to identify benchmarks for potential patient improvement. Statistical trends in the benchmarking and efficiency results were subsequently analyzed using non-parametric and parametric methods. FINDINGS Our analysis indicated that the rehabilitation process was largely effective in terms of providing consistent, quality care, as more than half of the patients in our study achieved the maximum amount of rehabilitation possible given available inputs. Among patients that did not achieve maximum results, most could obtain increases in the degree of flexion gain and reductions in the degree of knee extension. RESEARCH LIMITATIONS/IMPLICATIONS The study is retrospective in nature, and is not based on clinical trial or experimental data. Additionally, DEA results are inherently sensitive to sampling: adding or subtracting individuals from the sample may change the baseline against which efficiency and rehabilitation potential are measured. As such, therapists using this approach must ensure that the sample is representative of the general population, and must not contain significant measurement error. Third, individuals who choose total knee arthroplasty will incur a transient disability. However, this population does not generally fit the World Health Organization International Classification of Functioning, Disability and Health definition of disability if the surgical procedure is successful. Since the study focuses on the outcomes of physical therapy, range of motion measurements and circumferential measurements were chosen as opposed to the more global measures of functional independence such as mobility, transfers and stair climbing. Applying this technique to data on patients with different disabilities (or the same disability with other outcome variables, such as Functional Independence Measure scores) may give dissimilar results. PRACTICAL IMPLICATIONS This case study provides an example of how one can apply quantitative management science tools in a manner that is both tractable and intuitive to the practising therapist, who may not have an extensive background in quantitative performance improvement or statistics. ORIGINALITY/VALUE DEA has not been applied to rehabilitation, especially in the case where managers have limited data available.

The Impact of Service Sector Growth on Intersectoral Linkages in the United States

This article examines the impact of service sector growth on intersectoral linkages in the US economy since the 1940s. Input-output tables are used to determine direct and total back-ward linkages for a six-sector aggregation of the economy. The results show that the service sector ranks fifth in terms of the size of these linkage indicators. An added feature is the construction of economy-wide indexes of sectoral interdependence which are weighted averages of each sectors linkage effect, with the weights determined as each sectors share of national income. The main finding is that the combined effect of service sector growth and a pattern of low linkage effects associated with the service sector has led to a reduction in the degree of overall intersectoral linkage in the US economy over time. A major implication is that the pace of economic growth may be considerably lower in the future as a rising share of expenditures is accounted for by service-producing activities.

Characteristics of the information content in business sentiment surveys

The purpose of this manuscript is to quantify exactly how much information and/or predictive content is contained in business sentiment surveys. This paper uses techniques drawn from information theory econometrics, and more specifically the theory of information entropy, to characterize the predictive content of business sentiment surveys. The authors apply these techniques to publicly available information obtained from various editions of the Federal Reserve Bank of New Yorks Empire State Manufacturing Survey, one of the most popular business sentiment surveys conducted in the USA. Parametric and non-parametric statistical analyses are used to examine differences in the quantity of predictive content across various questions in the survey. The results suggest that business sentiment surveys contain a reasonably high degree of informative content. However, the amount of informative content varies considerably from question to question in the survey. Questions that are more general in nature and ask about current perceptions (as opposed to future expectations) contain more informative content. Business sentiment surveys are a practical, low-cost method to assess the current and expected future state of local and regional economies. However, the value of these surveys is questionable if they do not contain much information. This research finds that such surveys do contain a large amount of information, and are worth administering. However, specific types of survey items convey more information that others, which also suggests that business sentiments surveys can be further revised to maximize the amount of content gained from respondents.

Composite forecasts of inflation: An improvement in forecasting performance

This study investigates the performance of a composite forecast of inflation for the period 1969:I–1992:IV. This composite forecast is generated by combining the forecasts of four methods commonly used to measure expected inflation. Initially, the results of conditional efficiency tests suggest that a composite forecast can improve performance by encompassing a wider information set. The evidence, from the comparison of various forecast series, shows that the composite forecast improves on the performance of the four individual forecasts and an alternative composite forecast in terms of accuracy and rationality criteria.

The role of the university in accelerated learning and innovation as a regional ecosystem integrator

Purpose The purpose of this paper is to present an adaptation of a program that is at the intersection of two dynamic force fields. The first relates to imperatives impinging upon and inherent in higher education. The second ties to the concept of ecosystems as spaces for aligning actors and resources to create value. Design/methodology/approach Tables I-III present pre-test and post-test means and p-values for the paired sample t-tests for the measures. Findings As expected, post-test means are consistently significantly higher (or lower depending on item wording) for a shift in beliefs away from self-censoring and prejudging ideas during ideation and more toward greater openness in the ideation process. Originality/value The paper examines the outcome of an educational program.