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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

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.
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
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Description
The areas of cloud computing and web services have grown rapidly in recent years, resulting in software that is more interconnected and and widely used than ever before. As a result of this proliferation, there needs to be a way to assess the quality of these web services in order

The areas of cloud computing and web services have grown rapidly in recent years, resulting in software that is more interconnected and and widely used than ever before. As a result of this proliferation, there needs to be a way to assess the quality of these web services in order to ensure their reliability and accuracy. This project explores different ways in which services can be tested and evaluated through the design of various testing techniques and their implementations in a web application, which can be used by students or developers to test their web services.
ContributorsHilliker, Mark Paul (Author) / Chen, Yinong (Thesis director) / Nakamura, Mutsumi (Committee member) / Computer Science and Engineering Program (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description

Pelvic Circumferential Compression Devices (PCCDs), an important medical device when caring for patients with pelvic fractures, play a crucial role in the stabilization and reduction of the fracture. During pelvic fracture cases, control of internal bleeding through access to the femoral artery is of utmost importance. Current designs of PCCDs

Pelvic Circumferential Compression Devices (PCCDs), an important medical device when caring for patients with pelvic fractures, play a crucial role in the stabilization and reduction of the fracture. During pelvic fracture cases, control of internal bleeding through access to the femoral artery is of utmost importance. Current designs of PCCDs do not allow vital access to this artery and in attempts to gain access, medical professionals and emergency care providers choose to cut into the PCCDs or place them in suboptimal positions with unknown downstream effects. We researched the effects on surface pressure and the overall pressure distribution created by the PCCDs when they are modified or placed incorrectly on the patient. In addition, we investigated the effects of those misuses on pelvic fracture reduction, a key parameter in stabilizing the patient during critical care. We hypothesized that incorrectly placing or modifying the PCCD will result in increased surface pressure and decreased fracture reduction. Our mannequin studies show that for SAM Sling and T-POD, surface pressure increases if a PCCD is incorrectly placed or modified, in support of our hypothesis. However, opposite results occurred for the Pelvic Binder, where the correctly placed PCCD had higher surface pressure when compared to the incorrectly placed or modified PCCD. Additionally, pressure distribution was significantly affected by the modification of the PCCDs. The cadaver lab measurements show that modifying or incorrectly placing the PCCDs significantly limits their ability to reduce the pelvic fracture. These results suggest that while modifying or incorrectly placing PCCDs allows access to the femoral artery, there are potentially dangerous effects to the patient including increased surface pressures and limited fracture reduction.

ContributorsRyder, Madison Taylor (Co-author) / Conley, Ian (Co-author) / Vernon, Brent (Thesis director) / Bogert, James (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description

Pelvic Circumferential Compression Devices (PCCDs), an important medical device when caring for patients with pelvic fractures, play a crucial role in the stabilization and reduction of the fracture. During pelvic fracture cases, control of internal bleeding through access to the femoral artery is of utmost importance. Current designs of PCCDs

Pelvic Circumferential Compression Devices (PCCDs), an important medical device when caring for patients with pelvic fractures, play a crucial role in the stabilization and reduction of the fracture. During pelvic fracture cases, control of internal bleeding through access to the femoral artery is of utmost importance. Current designs of PCCDs do not allow vital access to this artery and in attempts to gain access, medical professionals and emergency care providers choose to cut into the PCCDs or place them in suboptimal positions with unknown downstream effects. We researched the effects on surface pressure and the overall pressure distribution created by the PCCDs when they are modified or placed incorrectly on the patient. In addition, we investigated the effects of those misuses on pelvic fracture reduction, a key parameter in stabilizing the patient during critical care. We hypothesized that incorrectly placing or modifying the PCCD will result in increased surface pressure and decreased fracture reduction. Our mannequin studies show that for SAM Sling and T-POD, surface pressure increases if a PCCD is incorrectly placed or modified, in support of our hypothesis. However, opposite results occurred for the Pelvic Binder, where the correctly placed PCCD had higher surface pressure when compared to the incorrectly placed or modified PCCD. Additionally, pressure distribution was significantly affected by the modification of the PCCDs. The cadaver lab measurements show that modifying or incorrectly placing the PCCDs significantly limits their ability to reduce the pelvic fracture. These results suggest that while modifying or incorrectly placing PCCDs allows access to the femoral artery, there are potentially dangerous effects to the patient including increased surface pressures and limited fracture reduction.

ContributorsConley, Ian Patrick (Co-author) / Ryder, Madison (Co-author) / Vernon, Brent (Thesis director) / Bogert, James (Committee member) / Harrington Bioengineering Program (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description

Many would contend that the United States healthcare system should be moving towards a state of health equity. Here, every individual is not disadvantaged from achieving their true health potential. However, a variety of barriers currently exist that restrict individuals across the country from attaining equitable health outcomes; one of

Many would contend that the United States healthcare system should be moving towards a state of health equity. Here, every individual is not disadvantaged from achieving their true health potential. However, a variety of barriers currently exist that restrict individuals across the country from attaining equitable health outcomes; one of these is the social determinants of health (SDOH). The SDOH are non-medical factors that influence the health outcomes of an individual such as air pollution, food insecurity, and transportation accessibility. Each of these factors can influence the critical illnesses and health outcomes of individuals and, in turn, diminish the level of health equity in affected areas. Further, the SDOH have a strong correlation with lower levels of health outcomes such as life expectancy, physical health, and mental health. Despite having influenced the United States health care system for decades, the industry has only begun to address its influences within the past few years. Through exploration between the associations of the SDOH and health outcomes, programming and policy-making can begin to address the barrier to health equity that the SDOH create.

ContributorsWaldman, Lainey (Author) / Zhou, Hongjuan (Thesis director) / Zicarelli, John (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Economics Program in CLAS (Contributor)
Created2023-05
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Description
The objective of this paper is to find and describe trends in the fast Fourier transformed accelerometer data that can be used to predict the mechanical failure of large vacuum pumps used in industrial settings, such as providing drinking water. Using three-dimensional plots of the data, this paper suggests how

The objective of this paper is to find and describe trends in the fast Fourier transformed accelerometer data that can be used to predict the mechanical failure of large vacuum pumps used in industrial settings, such as providing drinking water. Using three-dimensional plots of the data, this paper suggests how a model can be developed to predict the mechanical failure of vacuum pumps.
ContributorsHalver, Grant (Author) / Taylor, Tom (Thesis director) / Konstantinos, Tsakalis (Committee member) / Fricks, John (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Description
In 2022, the revenue generated from accounting services hit an all-time high of 119.48 billion USD (“Accounting Services in the US - Market Size”, 2022). On top of this, research has shown that 45% of all accounting professionals would like to automate something about their workflow (Thomas, 2020). Indeed, a

In 2022, the revenue generated from accounting services hit an all-time high of 119.48 billion USD (“Accounting Services in the US - Market Size”, 2022). On top of this, research has shown that 45% of all accounting professionals would like to automate something about their workflow (Thomas, 2020). Indeed, a lot of bookkeeping accountancy has been phased out by simple automation. However, larger accounting tasks like business mergers still require a team of accountants despite being a largely iterative process. This project chronicles one such attempt at automating accounting events or transactions that are performed by businesses both large and small. With the help of accounting students Madeline Stolper and Heddie Liu we were able to build a fully-functioning website to automate accounting transactions. For this project, we used industry-standard software frameworks React and Express to build the site with dynamic accounting applications. These applications were built with reusable components, making the development of future applications very simple. We also leveraged cutting-edge technological solutions from Amazon Web Services to make the website available on the Internet with rapid response times. Lastly, we incorporated an agile approach to project management and communication, in order to create functionality in the most efficient and organized manner possible. On a large scale, something like this has never been attempted and TurboIFRS/GAAP represents a revolutionary leap in accounting automation.
ContributorsForde, Jakob (Author) / Roth, Ryder (Co-author) / McLemore, Benjamin (Co-author) / Chen, Yinong (Thesis director) / Hunt, Neil (Committee member) / Barrett, The Honors College (Contributor) / Computer Science and Engineering Program (Contributor) / School of Music, Dance and Theatre (Contributor) / School of Mathematical and Statistical Sciences (Contributor)
Created2022-05
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Description

This study was conducted in order to better understand the ways in which social and environmental justice curriculum would suit engineers. In particular, it focuses on how social and environmental justice are valued in engineering and the internal and external barriers engineers face in pursuing it. The research first discusses

This study was conducted in order to better understand the ways in which social and environmental justice curriculum would suit engineers. In particular, it focuses on how social and environmental justice are valued in engineering and the internal and external barriers engineers face in pursuing it. The research first discusses the role of engineering in social and environmental justice, followed by common engineering ideologies and existing interactions between engineers and justice. The results in this paper presents the findings of qualitative data analysis of transcriptions of interviews conducted with engineers regarding social and environmental justice. The responses of interviewees were organized into different categories of value and obstacles were identified, analyzed, and discussed. The interpretations presented in this paper are tentative and are a part of an ongoing study that will be released at a later date.

ContributorsTon, Kathie (Author) / Karwat, Darshan (Thesis director) / McMeekin, Mike (Committee member) / Barrett, The Honors College (Contributor) / Chemical Engineering Program (Contributor) / School of Mathematical and Statistical Sciences (Contributor)
Created2022-05
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Description

The United States spends far more on healthcare than other developed countries, and it is increasing at a rapid pace that places intense financial pressure on the American public. The high levels of spending are not attributable to increased quality of care or a healthier general population. Rather, the culprits

The United States spends far more on healthcare than other developed countries, and it is increasing at a rapid pace that places intense financial pressure on the American public. The high levels of spending are not attributable to increased quality of care or a healthier general population. Rather, the culprits are a combination of uniquely American social and cultural factors that increase the prevalence of chronic illness coupled with a large and complex healthcare industry that has a multitude of stakeholders, each with their own motivations and expense margins that inflate prices. Additionally, rampant lack of transparency, overutilization and low-quality care contribute to unnecessarily frequent and expensive payments. Public and private institutions have implemented legislation and programs that provide temporary relief, but powerful lobbying efforts by healthcare-related organizations and a general American aversion to high government involvement have prevented the United States from creating effective, long-lasting reform.

ContributorsPetit, Lea (Author) / Milovanovic, Jelena (Thesis director) / Zicarelli, John (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor)
Created2022-05
Description
For this study, my overarching goal was to understand the possibilities of humanity’s future in space exploration. Addressing the future of space exploration not only opens doors for a multitude of discoveries but may answer questions that can be essential to our survival on Earth. This study, more specifically, aimed

For this study, my overarching goal was to understand the possibilities of humanity’s future in space exploration. Addressing the future of space exploration not only opens doors for a multitude of discoveries but may answer questions that can be essential to our survival on Earth. This study, more specifically, aimed to determine how college students at Arizona State University, engineering and astronomy students in particular, visualize the future of space exploration, as in the future, they will become the leading experts at the forefront of all space-related developments. The method through which I have conducted this study is a short survey, consisting of a variety of questions, designed to encourage students to develop their own unique interpretations of space exploration and ultimately, its imminent future. The results ultimately demonstrated that most participants in the study believed that political obstacles were the most prevalent concern in the further development of space exploration. There also appeared to be a moderate outlook on the future success and vitality of space exploration among student scientists and engineers. From a statistical standpoint, there appeared to be no alarming difference of opinion between these two ASU student groups.
ContributorsMontano, Sebastian (Author) / Voorhees, Matthew (Thesis director) / Aganaba, Timiebi (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / School of Earth and Space Exploration (Contributor)
Created2023-12