Are Medical Prices Declining?

We address long-standing problems in measuring health care prices by estimating two medical care price indices. The first, a Service Price Index, prices specific medical services, as does the current CPI. The second, a Cost of Living Index, measures the net valuation of treating a health problem. We apply these indices to heart attack treatment between 1983 and 1994. Because of technological change and increasing price discounts, the current CPI overstates a chain-weighted price index by three percentage points annually. For plausible values of an additional life-year, the real Cost of Living Index fell about 1 percent annually.

Pricing Heart Attack Treatments

In this paper, we estimate price indices for heart attack treatments, demonstrating the techniques that are currently used in official price indices and presenting some alternatives. We consider two types of price indices, a Service Price Index, which prices specific treatments provided, and a Cost of Living Index, which prices the health outcomes of patients. Both indices are complicated by price measurement issues: list prices and transactions prices are fundamentally different in the medical care field. The development of new or modified medical treatments further complicates the comparison of like' goods over time. And the Cost of Living Index is hampered by the need to determine how much of health improvement results from medical treatments in comparison to other factors. We describe methods to address each of these obstacles. We conclude that whereas traditional price indices when applied to heart attack treatments are rising at roughly 3 percent per year above general inflation, a corrected service price index is rising at perhaps 1 to 2 percent per year above general inflation, and the cost of living index is falling by 1 to 2 percent per year relative to general inflation. We discuss the implications of these results for official price index calculations.

How well do Car-Parrinello simulations reproduce the Born-Oppenheimer surface ? Theory and Examples

We derive an analytic expression for the average difference between the forces on the ions in a Car-Parrinello simulation and the forces obtained at the same ionic positions when the electrons are at their ground state. We show that for common values of the fictitious electron mass, a systematic bias may affect the Car-Parrinello forces in systems where the electron-ion coupling is large. We show that in the limit where the electronic orbitals are rigidly dragged by the ions the difference between the two dynamics amounts to a rescaling of the ionic masses, thereby leaving the thermodynamics intact. We study the examples of crystalline magnesium oxide and crystalline and molten silicon. We find that for crystalline silicon the errors are very small. For crystalline MgO the errors are very large but the dynamics can be quite well corrected within the rigid-ion model. We conclude that it is important to control the effect of the electron mass parameter on the quantities extracted from Car-Parrinello simulations.Comment: Submitted to the Journal of Chemical Physic

Ab initio molecular dynamics using density based energy functionals: application to ground state geometries of some small clusters

The ground state geometries of some small clusters have been obtained via ab initio molecular dynamical simulations by employing density based energy functionals. The approximate kinetic energy functionals that have been employed are the standard Thomas-Fermi $(T_{TF})$ along with the Weizsacker correction $T_W$ and a combination $F(N_e)T_{TF} + T_W$. It is shown that the functional involving $F(N_e)$ gives superior charge densities and bondlengths over the standard functional. Apart from dimers and trimers of Na, Mg, Al, Li, Si, equilibrium geometries for $Li_nAl, n=1,8$ and $Al_{13}$ clusters have also been reported. For all the clusters investigated, the method yields the ground state geometries with the correct symmetries with bondlengths within 5\% when compared with the corresponding results obtained via full orbital based Kohn-Sham method. The method is fast and a promising one to study the ground state geometries of large clusters.Comment: 15 pages, 3 PS figure

Modeling Cluster Production at the AGS

Deuteron coalescence, during relativistic nucleus-nucleus collisions, is carried out in a model incorporating a minimal quantal treatment of the formation of the cluster from its individual nucleons by evaluating the overlap of intial cascading nucleon wave packets with the final deuteron wave function. In one approach the nucleon and deuteron center of mass wave packet sizes are estimated dynamically for each coalescing pair using its past light-cone history in the underlying cascade, a procedure which yields a parameter free determination of the cluster yield. A modified version employing a global estimate of the deuteron formation probability, is identical to a general implementation of the Wigner function formalism but can differ from the most frequent realisation of the latter. Comparison is made both with the extensive existing E802 data for Si+Au at 14.6 GeV/c and with the Wigner formalism. A globally consistent picture of the Si+Au measurements is achieved. In light of the deuteron's evident fragility, information obtained from this analysis may be useful in establishing freeze-out volumes and help in heralding the presence of high-density phenomena in a baryon-rich environment.Comment: 31 pages REVTeX, 19 figures (4 oversized included as JPEG). For full postscript figures (LARGE): contact [email protected]

Out of Equilibrium Thermal Field Theories - Finite Time after Switching on the Interaction - Wigner Transforms of Projected Functions

We study out of equilibrium thermal field theories with switching on the interaction occurring at finite time using the Wigner transforms (in relative space-time) of two-point functions. For two-point functions we define the concept of projected function: it is zero if any of times refers to the time before switching on the interaction, otherwise it depends only on the relative coordinates. This definition includes bare propagators, one-loop self-energies, etc. For the infinite-average-time limit of the Wigner transforms of projected functions we define the analyticity assumptions: (1) The function of energy is analytic above (below) the real axis. (2) The function goes to zero as the absolute value of energy approaches infinity in the upper (lower) semiplane. Without use of the gradient expansion, we obtain the convolution product of projected functions. We sum the Schwinger-Dyson series in closed form. In the calculation of the Keldysh component (both, resummed and single self-energy insertion approximation) contributions appear which are not the Wigner transforms of projected functions, signaling the limitations of the method. In the Feynman diagrams there is no explicit energy conservation at vertices, there is an overall energy-smearing factor taking care of the uncertainty relations. The relation between the theories with the Keldysh time path and with the finite time path enables one to rederive the results, such as the cancellation of pinching, collinear, and infrared singularities, hard thermal loop resummation, etc.Comment: 23 pages + 1 figure, Latex, corrected version, improved presentation, version accepted for publication in Phys. Rev.

Effect of hydrogen on ground state structures of small silicon clusters

We present results for ground state structures of small Si$_{n}$H (2 \leq \emph{n} \leq 10) clusters using the Car-Parrinello molecular dynamics. In particular, we focus on how the addition of a hydrogen atom affects the ground state geometry, total energy and the first excited electronic level gap of an Si$_{n}$ cluster. We discuss the nature of bonding of hydrogen in these clusters. We find that hydrogen bonds with two silicon atoms only in Si$_{2}$H, Si$_{3}$H and Si$_{5}$H clusters, while in other clusters (i.e. Si$_{4}$H, Si$_{6}$H, Si$_{7}$H, Si$_{8}$H, Si$_{9}$H and Si$_{10}$H) hydrogen is bonded to only one silicon atom. Also in the case of a compact and closed silicon cluster hydrogen bonds to the cluster from outside. We find that the first excited electronic level gap of Si$_{n}$ and Si$_{n}$H fluctuates as a function of size and this may provide a first principles basis for the short-range potential fluctuations in hydrogenated amorphous silicon. Our results show that the addition of a single hydrogen can cause large changes in the electronic structure of a silicon cluster, though the geometry is not much affected. Our calculation of the lowest energy fragmentation products of Si$_{n}$H clusters shows that hydrogen is easily removed from Si$_{n}$H clusters.Comment: one latex file named script.tex including table and figure caption. Six postscript figure files. figure_1a.ps and figure_1b.ps are files representing Fig. 1 in the main tex

Nuclear Clusters as a Probe for Expansion Flow in Heavy Ion Reactions at 10-15AGeV

A phase space coalescence description based on the Wigner-function method for cluster formation in relativistic nucleus-nucleus collisions is presented. The momentum distributions of nuclear clusters d,t and He are predicted for central Au(11.6AGeV)Au and Si(14.6AGeV)Si reactions in the framework of the RQMD transport approach. Transverse expansion leads to a strong shoulder-arm shape and different inverse slope parameters in the transverse spectra of nuclear clusters deviating markedly from thermal distributions. A clear ``bounce-off'' event shape is seen: the averaged transverse flow velocities in the reaction plane are for clusters larger than for protons. The cluster yields --particularly at low $p_t$ at midrapidities-- and the in-plane (anti)flow of clusters and pions change if suitably strong baryon potential interactions are included. This allows to study the transient pressure at high density via the event shape analysis of nucleons, nucleon clusters and other hadrons.Comment: 38 pages, 9 figures, LaTeX type, eps used, subm. to Phys. Rev.

Quantum Tunneling in the Wigner Representation

Time dependence for barrier penetration is considered in the phase space. An asymptotic phase-space propagator for nonrelativistic scattering on a one - dimensional barrier is constructed. The propagator has a form universal for various initial state preparations and local potential barriers. It is manifestly causal and includes time-lag effects and quantum spreading. Specific features of quantum dynamics which disappear in the standard semi-classical approximation are revealed. The propagator may be applied to calculation of the final momentum and coordinate distributions, for particles transmitted through or reflected from the potential barrier, as well as for elucidating the tunneling time problem.Comment: 18 pages, LATEX, no figure