We present a two‐period model of remanufacturing in the face of competition. In our model, an original equipment manufacturer (OEM) competes with a local remanufacturer (L) under many reverse logistics configurations for the returned items. After establishing the Nash Equilibrium in the second period sub‐game, we use numerical experiments for comparative statics. OEM wants to increase L'S remanufacturing cost. Surprisingly, while L competes in the sales market, she has incentives to reduce oem's remanufacturing cost. A social planner who wants to increase remanufacturing can give incentives to the OEM to increase the fraction available for remanufacturing, or reduce his remanufacturing costs.
This paper considers network supply chains with price dependent demand by modelling them as large acyclic networks. Such large networks are common in the automobile and apparel industries. We develop a model to analyze the effect of these large-scale problems involving long sequences of contracts, and show that contract leadership, as well as leader position in the network, affect the performance of the entire supply chain. We generalize Spengler (Spengler, J. 1950. Vertical integration and anti-trust policy. J. Political Econom. 58 347-352) to a game on a "contract tree" for a particular supply chain and extend the concept of double marginalization so that it can be applied in the form of a transformation to each contract that is offered by one member to another in the "contract tree." We construct an algorithm to find the equilibrium solution, and derive the optimal location of the leader ("optimal" being the leader location that maximizes total supply chain profits). Our work formalizes many intuitive insights; for example, member profits are determined by systemwide rather than individual costs. Finally, we model Cournot competition between competing supply chains (both two heterogeneous trees and multiple identical trees) and show the effect of changes in leader position as well as cost structure on the equilibrium.Stackelberg game, double marginalization, vertical and horizontal competition, noncooperative games, supply chains, Cournot competition
Background: The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessment, primary care providers (PCP) and diagnostic audiologists in the identification of 'red flag' conditions (those conditions that may require medical consultation and/or intervention). Methods: Six primary care practices will implement one of three screening strategies (2 practices per strategy) with 660 patients (220 per strategy) ages 65-75 years with no history of hearing aid use or diagnosis of hearing loss. Strategies differ on the location and use of PCP encouragement to complete a telephone-based hearing screen (tele-HS). Group 1: instructions for tele-HS to complete at home and educational materials on warning signs and consequences of hearing loss. Group 2: PCP counseling/encouragement on importance of hearing screening, instructions to take the tele-HS from home, educational materials. Group 3: PCP counseling/encouragement, inoffice tele-HS, and educational materials. Patients from all groups who fail the tele-HS will be referred for diagnostic audiological testing and medical evaluation, and complete a self-assessment of red flag conditions at this follow-up appointment. Due to the expected low incidence of ear disease in the PCP cohort, we will enroll a complementary population of patients (N = 500) from selected otolaryngology head and neck surgery clinics in a national practicebased research network to increase the likelihood of occurrence of medical conditions that might contraindicate hearing aid fitting. The primary outcome is the proportion of patients who complete the tele-HS within 2 months of the PCP appointment comparing Group 3 (PCP encouragement, in-office tele-HS, education) versus Groups 2 and 1 (education and tele-HS at home, with and without PCP encouragement, respectively). The several secondary outcomes include direct and indirect costs, patient, family and provider attitudes of hearing healthcare, and accuracy of red flag condition evaluations compared with expert medical assessment by an otolaryngology provider.
Background Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, governments, and policy makers. Although low-cost hearing screening (HS) is widely available, most older adults are not asked about hearing during health care visits. A promising approach to addressing unmet needs in hearing health care is HS in primary care (PC) clinics; most PC providers (PCPs) do not inquire about hearing loss. However, no cost assessment of HS in community PC settings has been conducted in the United States. Thus, this study conducted a cost-effectiveness analysis of HS using results from a pragmatic clinic trial that compared three HS protocols that differed in the level of support and encouragement provided by the PC office and the PCPs to older adults during their routine visits. Two protocols included HS at home (one with PCP encouragement and one without) and one protocol included HS in the PC office. Methods Direct costs of the HS included costs of: (1) educational materials about hearing loss, (2) PCP educational and encouragement time, and (3) access to the HS system. Indirect costs for in-office HS included cost of space and minimal staff time. Costs were tracked and modeled for each phase of care during and following the HS, including completion of a diagnostic assessment and follow-up with the recommended treatment plan. Results The cost-effectiveness analysis showed that the average cost per patient is highest in the patient group who completed the HS during their clinic visit, but the average cost per patient who failed the HS is by far the lowest in that group, due to the higher failure rate, that is, rate of identification of patients with suspected hearing loss. Estimated benefits of HS in terms of improvements in quality of life were also far greater when patients completed the HS during their clinic visit. Conclusions Providing HS to older adults during their PC visit is cost-effective and accrues greater estimated benefits in terms of improved quality of life. Trial registration: clinicaltrials.gov (Registration Identification Number: NCT02928107).
I n thi~ pape~, we stu~y multi-stage serial supply chains with price depen~ent deterministic demand and mcreasmg margmal costs. We analyze the effect of contract leadershIp (i.e., the ability to offer wholesale price and two-part tariff contracts) on supply chain performance and use that as a basis to study coordi~ation ~nd .cooper~t~on. There is stro.ng. eviden~e of firs~-mover advantage in wholesale price contractmg whIch IS amplIfied when the cham IS coord mated usmg two-part tariff contracts. We analyze cooperation and the impli~ati?ns of lea~er location in uncoordinated chains. Our results demonstrate the importance of considenng the entIre sequence of successive contracts when assessing the performance of a supply chain. We find that in some cases an inefficient supply chain may have a natural tendency to reduce inefficiency through cooperation between non-leader members.
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