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Thomas R. Sexton

Bio: Thomas R. Sexton is an academic researcher from Stony Brook University. The author has contributed to research in topics: Data envelopment analysis & Inefficiency. The author has an hindex of 21, co-authored 57 publications receiving 2992 citations. Previous affiliations of Thomas R. Sexton include State University of New York System.


Papers
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TL;DR: In this paper, the authors show how to compute offsets related to the historical performance of the utility itself in the typical PCF, and show that the price cap formulas that are employed often do not include firm-specific productivity or efficiency differentials.

15 citations

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TL;DR: When used to treat patients who had acute pain states, 60 mg of IM ketorolac produced analgesia similar to that produced by 100mg of IM meperidine; however, the ketorlac produced fewer subjective side effects and less sedation than did the me peridine.
Abstract: Objective: To compare the pain relief, sedation, and common side effect profiles of ketorolac tromethamine and meperidine for the management of acute pain in the emergency department (ED). Methods: A prospective, double-blind, randomized clinical trial was conducted over a 12-month period using consecutive adult patients presenting to a university teaching hospital ED (annual census: 32,000), who required IM analgesia for acute pain. Adult patients with acute pain of various etiologies were randomly assigned to receive a single fixed IM dose of ketorolac (60 mg) or meperidine (100 mg). Results: Ninety-three patients were enrolled in the study; 46 were randomized to meperidine and 47 to ketorolac. Using a visual analog scale, there was no difference in pain relief between the ketorolac and meperidine groups even after adjusting for baseline pain level. Ketorolac caused significantly (p < 0.005) less sedation than did meperidine at one hour. Rescue analgesia was required for seven of the 46 (15.2%) patients receiving meperidine and five of the 47 (10.6%) patients receiving ketorolac (p = NS). Seventeen of 45 (38%) patients receiving meperidine experienced side effects compared with eight of the 47 (17%) patients receiving ketorolac (p = 0.0452). Conclusions: When used to treat patients who had acute pain states, 60 mg of IM ketorolac produced analgesia similar to that produced by 100 mg of IM meperidine; however, the ketorolac produced fewer subjective side effects and less sedation than did the meperidine.

15 citations

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TL;DR: It is found that among respondents who were not college graduates, HCWs were more likely to have a personal physician than non-HCWs, an association absent among graduates, and female HCWs older than 50 years were less likely to adhere to the guidelines of having a mammogram within the past 2 years.
Abstract: lute rates of adverse behaviors were low, such as HIV risk behaviors, most Americans adhere to public health recommendations, and the lack of difference between HCWs and other Americans is reassuring. Perhaps most surprisingly, female HCWs older than 50 years were less likely to adhere to the guidelines of having a mammogram within the past 2 years. Other studies have also observed this paradoxical, unexplained finding. Among respondents who were not college graduates, HCWs were more likely to have a personal physician than non-HCWs, an association absent among graduates. If confirmed, working in health care may improve access preferentially among individuals at greatest risk for not having a regular provider. Specific limitations should be mentioned. The BRFSS is limited to self-reported information, which cannot be externally confirmed. Because HCWs did not report their specific positions, we cannot differentiate between physicians, nurses, aides, and other HCWs. In conclusion, HCWs adhered variably to healthy life choices, often no differently and, for mammography, even less than other Americans. Interventions directed toward HCWs or their employers may improve overall adherence rates. Despite serving as role models, HCWs frequently do not “practice what they preach.”

15 citations

Journal ArticleDOI
TL;DR: In this paper, the authors proposed an efficiency-based mechanism for state funding of public colleges and universities using data envelopment analysis, which provides incentives to institution administrators to eliminate wasteful spending and increase positive outcomes while maintaining educational quality and research productivity.
Abstract: We propose an efficiency-based mechanism for state funding of public colleges and universities using data envelopment analysis. We describe the philosophy and the mathematics that underlie the approach and apply\break the proposed model to data from 362 U.S. public four-year colleges and universities. The model provides incentives to institution administrators to eliminate wasteful spending and increase positive outcomes while maintaining educational quality and research productivity. The institutions in our study spent $96.74 billion, and states would reimburse $88.02 billion. Thus efficiency-based funding would reduce state government expenditures on these institutions by $8.72 billion, or approximately 9.0 percent. Efficiency-based funding is politically viable, as demonstrated by North Carolina’s successful use of this approach in pupil transportation operations since 1994. The model will be of interest to state legislators, state education officials, and others who are concerned with funding...

14 citations

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TL;DR: This work proposes a two-stage efficiency-based multicriteria decision model to guide an ASC in identifying its optimal procedure mix and demonstrates the approach using a data set based in part on data from an actual ASC.
Abstract: Ambulatory surgery centers (ASCs) provide a low-cost alternative to traditional inpatient care In addition, with health care reform imminent, it is likely that many currently uninsured people will soon acquire health care coverage, significantly increasing the demand for health services ASCs are among the providers that can expect to see a substantial amount of this new pent-up demand and, therefore, ASCs are likely to continue their current growth into the foreseeable future Those ASCs that plan accordingly by optimizing procedure mix and volume will benefit most from the increased demand We propose a two-stage efficiency-based multicriteria decision model to guide an ASC in identifying its optimal procedure mix The first stage uses Data Envelopment Analysis (DEA) to calculate the efficiency of each procedure based on the resources required to perform the procedure, the revenue it generates, and its risk of complications The second stage uses the DEA factor efficiency scores in a bottleneck program to optimize the mix of procedures while satisfying the ASC's resource and operational constraints The criteria are to (1) maximize reimbursement while (2) minimizing the total number of complications We demonstrate the approach using a data set based in part on data from an actual ASC

13 citations


Cited by
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Journal ArticleDOI
TL;DR: This paper considers the design and analysis of algorithms for vehicle routing and scheduling problems with time window constraints and finds that several heuristics performed well in different problem environments; in particular an insertion-type heuristic consistently gave very good results.
Abstract: This paper considers the design and analysis of algorithms for vehicle routing and scheduling problems with time window constraints. Given the intrinsic difficulty of this problem class, approximation methods seem to offer the most promise for practical size problems. After describing a variety of heuristics, we conduct an extensive computational study of their performance. The problem set includes routing and scheduling environments that differ in terms of the type of data used to generate the problems, the percentage of customers with time windows, their tightness and positioning, and the scheduling horizon. We found that several heuristics performed well in different problem environments; in particular an insertion-type heuristic consistently gave very good results.

3,211 citations

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TL;DR: In this paper, a coherent data-generating process (DGP) is described for nonparametric estimates of productive efficiency on environmental variables in two-stage procedures to account for exogenous factors that might affect firms’ performance.

2,915 citations

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TL;DR: A sketch of some of the major research thrusts in data envelopment analysis (DEA) over the three decades since the appearance of the seminal work of Charnes et al. is provided.

1,390 citations

Journal ArticleDOI
TL;DR: The relational model developed in this paper is more reliable in measuring the efficiencies and consequently is capable of identifying the causes of inefficiency more accurately.

1,112 citations

Journal ArticleDOI
TL;DR: A slacks-based network DEA model is proposed, called Network SBM, that can deal with intermediate products formally and evaluate divisional efficiencies along with the overall efficiency of decision making units (DMUs).

954 citations