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- Creators: Department of Supply Chain Management
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
- Resource Type: Text
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 purpose of this thesis will be to compare and contrast films made by German and American directors about World War II and the Vietnam War, respectively. First, we will provide a list of the films including a brief summary and the reasons why that specific film was chosen for this analysis. Next, we will give background information about the two wars and the time period in the respective nations. The next steps are the actual project. First, we will list the criteria for analysis and why we chose those specific items to focus on. Lastly, we will provide an analysis of each film individually; going through the criteria previously provided. After reading the thesis the reader will be able to understand how filmmaking can show the feelings and sentiments of a nation during a specific time period, like war.
ContributorsRen, Haimo (Co-author) / Ahern, Jared (Co-author) / Bradley, Christopher (Thesis director) / Forss, Brennan (Committee member) / Barrett, The Honors College (Contributor) / School of Accountancy (Contributor) / Department of Supply Chain Management (Contributor) / W. P. Carey School of Business (Contributor) / School of Politics and Global Studies (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
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 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
The purpose of this research was to identify various problems within value analysis teams as well as provide solutions that will help to better align the agents involved in the value analysis process. As healthcare costs continue to rise, and hospital reimbursements fall, value analysis teams will play an even more pivotal role in the success of healthcare organizations. Also, the industry trend toward value-based care is highlighting the importance of these teams. However, interdisciplinary value analysis teams bring to light the underlying agency issue that exists between physicians and hospital administrators, and the general misalignment of values between the participants. In order for these teams to function properly, it is inherent that all of the professionals involved align their incentives. For this study, I studied relevant literature pertaining to value analysis, attended relevant speakers, and then performed interviews with several different professionals involved in healthcare value analysis. I organized and coded this data using the Grounded Theory approach, and was able to identify the underlying issues within these teams. I then created a typology of value analysis teams, based on my respondents, where I segment them into four tiers based on their utilization of data, and their level of physician involvement. Finally, I identified three distinct strategies for developing value analysis teams to implement in order to increase their efficiency and overall success.
ContributorsLindgren, Thomas John (Author) / Schneller, Eugene (Thesis director) / Choi, Thomas (Committee member) / Department of Supply Chain Management (Contributor) / Department of Economics (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Humans have traveled since the dawn of humanity over 200,000 years ago. As time progressed and technology increased, so too did human motivations and drivers for travel. This thesis aims to understand these human motivations and drivers, ultimately answering the question, "Why Travel?" To answer this question, this research starts from the earliest of humans, classifying groups of individuals across time into respective buckets based on a similar motivation. In doing so, four traveler segments were identified: the Survivors, the Inventors, the Adventurers, and the Colonists. Each segment describes an era in time of a specific group of humans, each distinctly aligning with a specific reason for travel. In the early 1800s, the advent of commercial travel altered the future of travel. This began with the invention of the locomotive and was followed by the airplane and automobile. With this onset of commercial travel, transportation arrives to its current state in 2018 with a new type of traveler: the Modern Traveler. This is a turning point in the history of travel, as prior to commercial travel, groups of individuals could be grouped under one specific reason. Post commercial travel, human motivations and drivers become diverse and discrete, with no two individuals sharing the same motivations. To further understand this human desire for travel in a modern sense, a survey was administered to uncover these drivers. The findings revealed one broad reason: humans travel for the experience. With this overarching view of travel, five drivers were also apparent. First, humans travel to visit friends and family. Secondly, family vacations are an important factor in the motivation to travel. Third, humans desire the ability to experience a culture different than their own. Fourth, humans are intrigued by new places and can be motivated to travel by the ability to have new experiences. Fifth and finally, rest and relaxation are a key driver in human travel. With a greater understanding as to "why humans travel," and the drivers behind the "experience" individuals seek through travel, such understandings could be used to segment these individuals into distinct traveler profiles. These segments, the Backpacker, the Solo-Traveler, the Groupie, the Cultural Traveler and the Party Lover, were used to better group motivations for travel. One conclusion can be drawn from this research: travel is diverse and so are travelers. One reason cannot define the motivations of a modern traveler, rather today's traveler is bound by multiple. However, segmenting an individual provides valuable insights into their own diverse traveler persona.
ContributorsCheney, Elizabeth Marie (Author) / Eaton, John (Thesis director) / Mokwa, Michael (Committee member) / Department of Supply Chain Management (Contributor) / Department of Marketing (Contributor) / School of Film, Dance and Theatre (Contributor) / W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
In the sixty-seven years following the end of World War II, West Germany and Japan underwent a remarkable series of economic and social changes that irrevocably altered their respective ways of life. Formerly xenophobic, militaristic and highly socially stratified societies, both emerged from the 20th Century as liberal, prosperous and free. Both made great strides well beyond the expectations of their occupiers, and rebounded from the overwhelming destruction of their national economies within a few short decades. While these changes have yielded dramatic results, the wartime period still looms large in their respective collective memories. Therefore, an ongoing and diverse dialectical process would engage the considerable popular, official, and intellectual energy of their post-war generations. In West Germany, the term Vergangenheitsbewältigung (VGB) emerged to describe a process of coming to terms with the past, while the Japanese chose kako no kokufuku to describe their similar historical sojourns. Although intellectuals of widely varying backgrounds in both nations made great strides toward making Japanese and German citizens cognizant of the roles that their militaries played in gruesome atrocities, popular cinematic productions served to reiterate older, discredited assertions of the fundamental honor and innocence of the average soldier, thereby nurturing a historically revisionist line of reasoning that continues to compete for public attention. All forms of media would play an important role in sustaining this “apologetic narrative,” and cinema, among the most popular and visible of these mediums, was not excluded from this. Indeed, films would play a unique recurring role, like rhetorical time capsules, in offering a sanitized historical image of Japanese and German soldiers that continues to endure in modern times. Nevertheless, even as West Germany and Japan regained their sovereignty and re-examined their pasts with ever greater resolution and insight, their respective film industries continued to “reset” the clock, and accentuated the visibility and relevancy of apologetic forces still in existence within both societies. However, it is important to note that, when speaking of “Germans” and “Japanese,” that they are not meant to be thought of as being uniformly of one mind or another. Rather, the use of these words is meant as convenient shorthand to refer to the dominant forces in Japanese and German civil society at any given time over the course of their respective post- war histories. Furthermore, references to “Germany” during the Cold War period are to be understood to mean the Federal Republic of Germany, rather than their socialist counterpart, the German Democratic Republic, a nation that undertook its own coming to terms with the past in an entirely distinct fashion.
ContributorsPiscopo, Michael (Author) / Benkert, Volker (Thesis director) / Moore, Aaron (Committee member) / Machander, Sina (Committee member) / Barrett, The Honors College (Contributor) / College of Liberal Arts and Sciences (Contributor)
Created2012-12
Description
At the outset it may seem as if fields of business and history are two irreconcilable fields. However, careful study of both reveals that the two are far from dissimilar. After all, one cannot expect to conquer the world without impeccable logistics, and no organization succeeds without a competent culture. Two great civilizations rose to prominence because their supply chains and methodologies outstripped their contemporaries. The first is the Romans. Once a small village situated on the Italian Peninsula, Rome’s empire grew to encompass the entirety of the Mediterranean world during the first century CE. The second is the Mongols, nomadic horseman who formed the largest contiguous empire in history roughly twelve hundred years later. At its height, the Mongol civilization spanned from the Pacific Ocean in the east to the forests of Europe in the west.
Both great civilizations achieved their empires due to their innovative supply chains, organizational tactics, and culture. Each, however, presented their own unique solutions to the problem of world conquest by capitalizing on their respective strengths. For the Romans, this meant placing an emphasis on infrastructure, adopting and modifying the technologies of other peoples, and instituting a culture that emphasized achievement and resilience among an aristocratic elite. The Mongol’s, however, focused on their force’s mobility rather than infrastructure, emphasized recruiting of outsiders to supplement their weakness, and developed a meritocratic system largely free of aristocratic structure. Both empires, however, emphasized the importance of each soldier as a self-sufficient unit to ease the strain of the overall supply chain.
These two civilizations therefore provide valuable insight for two diametrically opposed business environments. The first being manufacturing companies, with the need for rigid processes and investments in infrastructure not unlike the Romans. The second being startups with their need for speed and flexibility much like the Mongols. Thus, by examining the past modern companies gain valuable insights in how to structure their organizations for the future.
Both great civilizations achieved their empires due to their innovative supply chains, organizational tactics, and culture. Each, however, presented their own unique solutions to the problem of world conquest by capitalizing on their respective strengths. For the Romans, this meant placing an emphasis on infrastructure, adopting and modifying the technologies of other peoples, and instituting a culture that emphasized achievement and resilience among an aristocratic elite. The Mongol’s, however, focused on their force’s mobility rather than infrastructure, emphasized recruiting of outsiders to supplement their weakness, and developed a meritocratic system largely free of aristocratic structure. Both empires, however, emphasized the importance of each soldier as a self-sufficient unit to ease the strain of the overall supply chain.
These two civilizations therefore provide valuable insight for two diametrically opposed business environments. The first being manufacturing companies, with the need for rigid processes and investments in infrastructure not unlike the Romans. The second being startups with their need for speed and flexibility much like the Mongols. Thus, by examining the past modern companies gain valuable insights in how to structure their organizations for the future.
ContributorsCurtis, Alexander (Author) / Kellso, James (Thesis director) / Brettle, Adrian (Committee member) / Department of Supply Chain Management (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