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 of 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.

Our experience with the procedure found that this new method seems to be as effective in controlling lipidic metabolism and diabetes II as the original version of BPD. As expected, weight loss is only moderate, so that the modified BPD is not suitable for very obese patients.

In this study we describe a stochastic optimization model for the relocation of deployable military hospitals, the reallocation of hospital beds, and the emplacement of tactical medical evacuation assets (medical evacuation helicopters and ground ambulances) during steady-state military combat operations (stability operations). The network model is built around an intuitive objective function, one that is derived from military doctrine. The objective to be minimized is the time traveled, weighted by patient severity, from the evacuation site to the point of injury and onward to the hospital location. The optimal solution also determines the number of air and ground ambulances and the hospital beds of each type required at each selected site. Since future casualty locations, numbers, and severities are uncertain, this information is treated as a number of casualty scenarios with assigned scenario probabilities. The number, location, and severities of casualties can be randomly generated, or provided as part of a planning process. The model then seeks a single set of hospital and vehicle locations, plus the paths the evacuation assets should take in each scenario, which minimize expected travel time over all scenarios. The scenario generator is based on realistic historical data from Operation Iraqi Freedom. Since mobile hospitals provide the primary surgical treatment intervention while dedicated ground and air evacuation assets provide the transportation along evacuation paths, the study objective is important for military medical planners, especially those involved in tactical medical evacuation and treatment planning.

BPD per se does not greatly affect the pharmacokinetic behavior of ranitidine, and therefore a conventional dosage regimen appears adequate for the prophylaxis and therapy of gastric ulcers associated with this operation.