Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
Displaying 1 - 10 of 15
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- All Subjects: healthcare
- Creators: School of Molecular Sciences
- Creators: Department of Supply Chain Management
Description
Thesis Abstract: Cygnal The healthcare market plays a vital role in how our team worked with innovation space to design a product that fit user needs and could be a sustainable business. Whatever product we design is going to be dictated based off of how the insurance market will pay for it and how much we can charge for our product and services. In fact, the healthcare market is so incredibly unclear with outdated regulations that all of these fraud schemes and inflammatory prices are bound to happen. Stronger government involvement in this instance, I believe would help the issue. In reality, there are so many people taking advantage of the system that you cannot put the blame on anyone exploiting the system. What is clear though, is that they are taking advantage of a system that looks like it was set up to allow them to do so, and in that sense, Medicare is responsible for allowing this market to become warped. The healthcare industry played a vital role in our team for Innovation Space is completing our project. If we do not have a firm understanding on how the insurance market works, how much wheelchair companies are pricing chair components for, and how easily customers can see a financial benefit in switching to our product, it will not survive in the market place. That is why I as the business student am dedicating a lot of time in the final months of our project to make sure that our pricing is accurate, and feasible. The health insurance market, even if it is dysfunctional, will be ultimately paying for our product, and in business if you do not truly know your customer, you are bound to lose him. This paper uncovers why this market is warped and how to do business within it.
ContributorsMefford, Michael James (Author) / Peck, Sidnee (Thesis director) / Boradkar, Prasad (Committee member) / Barrett, The Honors College (Contributor) / Department of Economics (Contributor) / Department of Supply Chain Management (Contributor) / W. P. Carey School of Business (Contributor)
Created2015-05
Description
Objective: To assess and quantify the effect of state’s price transparency regulations (hereafter, PTR) on healthcare pricing.
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.
ContributorsSabol, Joshua Lawrence (Author) / Reiser, Mark (Thesis director) / Ketcham, Jonathan (Committee member) / Dassanayake, Maduranga (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Department of Supply Chain Management (Contributor)
Created2015-05
Description
This article summarizes exploratory research conducted on private and public hospital systems in Australia and Costa Rica analyzing the trends observed within supply chain procurement. Physician preferences and a general lack of available comparative effectiveness research—both of which are challenges unique to the health care industry—were found to be barriers to effective supply chain performance in both systems. Among other insights, the ability of policy to catalyze improved procurement performance in public hospital systems was also was observed. The role of centralization was also found to be fundamental to the success of the systems examined, allowing hospitals to focus on strategic rather than operational decisions and conduct value-streaming activities to generate increased cost savings.
ContributorsBudgett, Alexander Jay (Author) / Schneller, Eugene (Thesis director) / Gopalakrishnan, Mohan (Committee member) / Barrett, The Honors College (Contributor) / Department of Supply Chain Management (Contributor) / Department of English (Contributor)
Created2015-05
Description
The healthcare industry is currently facing significant changes. One of the changes in the industry is a movement towards patient-focused care, which considers the patient as a person and the impact of care on the person. Patient experience is part of patient-focused care, and has similarities to the marketing term customer experience, which contributes to happier customers and long-term financial growth and success for businesses. This thesis defines current issues in patient experience as it relates to hospital manager decision making. Through secondary research, this thesis demonstrates what patient experience is, the role it plays in healthcare and hospital settings, the pressures on hospitals to increase patient experience performance, how patient experience performance is measured, and what strategies or action drive improvements under current performance measurements. Many studies and articles exist examining each of these issues individually. However, these sources do not comprehensively define patient experience in hospitals with perspective on how this influences hospital strategy and decision-making. Previous works on patient experience from the perspective of hospital strategy do not include considerations for recent industry shifts, most notably the Patient Protection and Affordable Care Act. The collected definitions in this thesis provide guidance of relevant concerns hospital managers consider when formulating organization-wide strategy related to patient experience. This thesis explains how patient experience contributes to the success of hospitals in the short-term, medium-term, and long-term and how patient experience may shift its focus over time. Short-term concerns include specific regulations and definitions from the Centers for Medicare and Medicaid services, responsible for over half of all payments to hospitals. Conforming to CMS standards is a matter of survival for most hospitals in the short-term. Hospitals are adjusting to rules and payment models not in existence just two years ago. First, hospitals will adapt, and then hospitals will strive to optimize under new standards as well as respond to adjustments in the rules over the next several years. After patient experience standards are well established, certain aspects of patient experience will be part of long-term differentiation and success for hospitals. Responding comprehensively to the shift towards improving patient experience is a critical aspect for hospitals to weather the many changes in the healthcare industry. Patient experience will provide better care to patients and better financial health to the hospitals that perform above patient experience standards.
ContributorsWilton, Kara Alexandra (Author) / Ketcham, Jonathan (Thesis director) / Ostrom, Amy (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Supply Chain Management (Contributor) / Department of Marketing (Contributor)
Created2014-05
Description
As of March 2020, there were over 112,400 patients actively waiting on the United States national organ transplant waitlist with only about 3,300 donors1. Although transplantation is an effective treatment for end-stage organ failure, the access to a procedure will vary depending on national regulations, cost of health care, extensive screening processes, and the availability of organs2. Organ shortage is a worldwide problem, and the growing insufficiency has resulted patients becoming too for ill or dying while waiting3. Due to the varying wait times and costs of procedures, some patients have begun to outsource their own transplantation through international transactions, also known as transplant tourism2. The 2004 World Health Assembly resolution recognized these trades as a significant health policy issue, while also acknowledging the inability of national health care systems to meet the needs of patients4. To address this issue, a proposal will be made such that all live kidney and liver donors will be compensated $22,500 and $12,150 respectively through a cost-neutral scheme based on annual healthcare expenditures per organ that would be eliminated by a transplant. With this proposal, it is suggested that the organ transplant waitlist would not only be significantly reduced, but potentially eliminated, and the crisis of organ shortage would be defeated.
ContributorsMartin, Starla (Author) / Kingsbury, Jeffrey (Thesis director) / Edmonds, Hallie (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
In 2017 alone, over 250,00 patients died due to medical errors and is the 3rd leading cause of death in America. These errors attributed to incorrect diagnosis and treatment of illnesses can be preventable. The solution to this major issue is the creation of an app called HealthKeep. Primary market research done during the first semester of the study included the creation of a school-wide survey across all ASU campuses that consisted of key questions for people of all ages in regards to their healthcare. These questions include how often patients of specific age ranges visit the doctor, their overall experience during appointments, and their attitudes towards the creation of a mobile health application that would be able to tabulate all your medical information neatly and securely. The overwhelming response stated that patient’s from all ranges would be open to the idea of having such an application. Further development included the creation of a business plan and application storyboard used when interviewing potential customers about the application. All of these tools aided in the first entry for Venture Devils in the first semester leading to the disappointing failure of winning funding. However, the feedback on the website created, executive summary, expanded pitch deck, and market research aided in the successful key revisions of the venture during this second semester and has resulted in placement in the final round of Pitch Playoffs where funding can be awarded.
ContributorsSiraj, Salim (Co-author) / Undrill, Grayson (Co-author) / Ott, Madison (Co-author) / Smith, Keaton (Co-author) / Byrne, Jared (Thesis director) / Sebold, Brent (Committee member) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
This study aims to examine how the use of consensus-based transactions, smart contracts,and interoperability, provided by blockchain, may benefit the blood plasma industry. Plasmafractionation is the process of separating blood into multiple components to garner benefitsof increased lifespan, specialized allocation, and decreased waste, thereby creating a morecomplex and flexible supply chain. Traditional applications of blockchain are developed onthe basis of decentralization—an infeasible policy for this sector due to stringent governmentregulations, such as HIPAA. However, the trusted nature of the relations in the plasmaindustry’s taxonomy proves private and centralized blockchains as the viable alternative.Implementations of blockchain are widely seen across pharmaceutical supply chains to combatthe falsification of possibly afflictive drugs. This system is more difficult to manage withblood, due to the quick perishable time, tracking/tracing of recycled components, and thenecessity of real-time metrics. Key attributes of private blockchains, such as digital identity,smart contracts, and authorized ledgers, may have the possibility of providing a significantpositive impact on the allocation and management functions of blood banks. Herein, we willidentify the economy and risks of the plasma ecosystem to extrapolate specific applications forthe use of blockchain technology. To understand tangible effects of blockchain, we developeda proof of concept application, aiming to emulate the business logic of modern plasma supplychain ecosystems adopting a blockchain data structure. The application testing simulates thesupply chain via agent-based modeling to analyze the scalability, benefits, and limitations ofblockchain for the plasma fractionation industry.
ContributorsVallabhaneni, Saipavan K (Author) / Boscovic, Dragan (Thesis director) / Kellso, James (Committee member) / Department of Information Systems (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
The purpose of this thesis is to gain a more nuanced understanding of what research is currently going on in the academic realm of supply chain management. This thesis is composed of two parts. The first part contains summaries and personal takeaways from four different supply chain management seminars that were put on by professors who were visiting the ASU campus. These seminars include general topics such as RFID readability, supply chain cash conversion cycles, risk management within the healthcare supply chain, and building trust and trustworthiness in global business. The second part of the thesis will then use a literature review to expand upon the topic of risk management within the healthcare supply chain, and to explore how previous research ties into the current happenings of the industry, as well as its future implications.
ContributorsHemzacek, Noah (Author) / Printezis, Antonios (Thesis director) / Choi, Thomas (Committee member) / Department of Finance (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The purpose of this project is to develop a risk assessment tool for the University of California, Riverside (UCR). UCR is health enterprise that manages operations under an environment of innate and uncontrollable risks. Therefore, a risk assessment tool is highly advisable under California State Laws and federal laws. In the case of overlapping laws, federal law will always prevail unless State law explicitly states otherwise. California Health Information Privacy Manual states that California must follow numerous state guidelines and a federal set of guidelines called HIPAA (Health Insurance Portability and Accountability Act of 1996). HIPAA is put in place to protect and serve as an organizational tool to develop a stronger and more secure infrastructure of security measures within healthcare enterprises. Under HIPAA is a Security and Privacy Rule that was implemented by The U.S. Department of Health and Human Services (HHS) and will serve as the basis for the risk assessment tool I developed. The Security and Privacy Rule's main goal is to set a national standard of how electronic protected health information (ePHI) will be appropriately used and disclosed by organizations subject to this rule, also known covered entities. Covered entities include health plans, health care providers and health care clearinghouses unless specifically stated otherwise. Permitted uses and disclosures of PHI or ePHI are outlined in detail and covered entities are expected to follow all aspects of it that pertain to their role within a healthcare system. Under HHS, the Office of Civil Rights (OCR) strictly enforces the Security and Privacy Rules and can issue civil money penalties and/or other major consequences making this a sizable and critical issue in healthcare environments. Each risk and impact must be assessed to determine an overall risk score. This score will then determine what risks need to be immediately addressed and which risks are most critical to UCR. To do this, potential impacts were determined for each section. The impact score can be decided by using a chart that will be discussed in the development section. The likeliness of the risk can be determined by a UCR professional via the provided chart and an overall risk score can be assigned. From here, an action plan can be set and carried out to eliminate possible hazards and imminent risks. Once a Risk Assessment tool is developed, potential risks can be indentified and dealt with appropriately in regard to level of impact and the likelihood of the risk occurring. By reducing risk, a healthcare enterprise can gain greater financial stability, decrease loss and protect vital information that is critical to the success organization.
ContributorsAustin, Hannah N. (Author) / Riley, William (Thesis director) / Hackman, Paul (Committee member) / School of Molecular Sciences (Contributor) / W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
This research will focus on identifying healthcare disparities among different groups of people in Maricopa County, with a focus on the Phoenix area. It takes form in a combination of a review of previously existing data, surveying pregnant women about their health insurance situations before their pregnancies, and surveying college students in Maricopa County about their past and current health insurance situations. The pregnant women who were interview were part of a study called Metabolism Tracking During Pregnancy through the School of Nutrition and Health Promotion at Arizona State University. College students who were interviewed were recruited online and all participants were choosing to respond. This research paper will focus on policies currently in place to try to address healthcare disparities and establishing the presence of healthcare disparities that are preexisting, and using individual responses from a small sample size of minorities and women to represent the larger Phoenix population. Differences in healthcare spending for different groups of people will also be analyzed in order to establish disparities present. This research is significant because if healthcare equality is the goal, then spending distribution to each should be proportional to the size of each subpopulation.
ContributorsGeiser, Rachel (Author) / Reifsnider, Elizabeth (Thesis director) / Cortese, Denis (Committee member) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor) / School of Politics and Global Studies (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05