Factors associated with geographic variation in cost per episode of care for three medical conditions

Objective: To identify associations between market factors, especially relative reimbursement rates, and the probability of surgery and cost per episode for three medical conditions (cataract, benign prostatic neoplasm, and knee degeneration) with multiple treatment options. Methods: We use 2004–2006 Medicare claims data for elderly beneficiaries from sixty nationally representative communities to estimate multivariate models for the probability of surgery and cost per episode of care as a function local market factors, including Medicare physician reimbursement for surgical versus non-surgical treatment and the availability of primary care and specialty physicians. We used Symmetry’s Episode Treatment Groups (ETG) software to group claims into episodes for the three conditions (n = 540,874 episodes). Results: Higher Medicare reimbursement for surgical episodes and greater availability of the relevant specialists are significantly associated with more surgery and higher cost per episode for all three conditions, while greater availability of primary care physicians is significantly associated with less frequent surgery and lower cost per episode. Conclusion: Relative Medicare reimbursement rates for surgical vs. non-surgical treatments and the availability of both primary care physicians and relevant specialists are associated with the likelihood of surgery and cost per episode

GPU enabled real-time optical frequency comb spectroscopy and photonic readout

We describe a GPU-enabled approach for real-time optical frequency comb spectroscopy in which data is recorded, Fourier transformed, normalized, and fit at data rates up to 2.2 GB/s. As an initial demonstration we have applied this approach to rapidly interrogate the motion of an optomechanical accelerometer through the use of an electro-optic frequency comb. However, we note that this approach is readily amenable to both self-heterodyne and dual comb spectrometers for molecular spectroscopy as well as photonic readout where the approach's agility, speed, and simplicity are expected to enable future improvements and applications

Agile chip-scale electro-optic frequency comb spectrometer with millivolt drive voltages

Here, we present an on-chip spectrometer that leverages an integrated thin-film lithium niobate modulator to produce a frequency-agile electro-optic frequency comb for interrogating chip-scale temperature and acceleration sensors. The low half-wave voltage, $V_{\pi}$, of the modulators and the chirped comb process allows for ultralow radiofrequency drive voltages, which are as much as seven orders of magnitude less than the lowest found in the literature and are generated using a chip-scale, microcontroller-driven direct digital synthesizer. The on-chip comb spectrometer is able to simultaneously interrogate both the on-chip temperature sensor and an off-chip, microfabricated optomechanical accelerometer with cutting-edge sensitivities of $\approx 5 {\mu} \mathrm{K} \cdot \mathrm{Hz} ^{-1/2}$ and $\approx 130 {\mu}\mathrm{m} \cdot \mathrm{s}^{-2} \cdot \mathrm{Hz}^{-1/2}$, respectively. Notable strengths of this platform include the frequency agility of the optical frequency combs, ultralow radiofrequency power requirements and compatibility with a broad range of existing photonic integrated circuit technologies.Comment: 11 pages, 5 figure