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- All Subjects: healthcare
- Creators: Barrett, The Honors College
- Creators: School of Human Evolution & Social Change
- Creators: School of Human Evolution and Social Change
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
- Resource Type: Text
Description
Establishing a healthcare practice in the U. S. by a Mexican national involves many different steps at federal as well as state levels. The recent implementation of the Patient Protection and Affordable Care Act overhauls some requirements which include increased Medicaid eligibility as well as mandatory health insurance coverage. With these changes taking place over the next few years, the need for healthcare providers will expand. Consequently, I look into the requirements of establishing an urgent care practice in the state of Arizona. Given that Phoenix has a 40.8% Hispanic population and that the Affordable Care Act will increase the coverage of this demographic, it is the city of focus for my analysis. In order to make access to the Arizona healthcare market more impartial and accessible to Mexican entrepreneurs, changes need to be made to the certification process of medical physicians who graduated from Mexican universities. The general disadvantage of Mexican physicians as compared to their U. S. counterparts comes in the form of increased certification times and additional processes. An equal playing field will allow the ease in movement of medical physicians between the U. S. and Mexico which will help meet the increased demand over the next few years. From ownership to taxation and medical billing and coding, this analysis focuses on the many requirements needed to establish an urgent care in Arizona.
ContributorsIbarra, Joseph Anthony (Author) / Carlos, Velez-Ibanez (Thesis director) / Cruz-Torres, Maria (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor)
Created2014-05
Emerging Information Technology, Storage and Evaluation within Healthcare: A Discerning IMT Analysis
Description
The introduction of novel information technology within contemporary healthcare settings presents a critical juncture for the industry and thus lends itself to the importance of better understanding the impact of this emerging "health 2.0" landscape. Simply, how such technology may affect the healthcare system is still not fully realized, despite the ever-growing need to adopt it in order to serve a growing patient population. Thus, two pertinent questions are posed: is HIT useful and practical and, if so, what is the best way to implement it? This study examined the clinical implementation of specific instances of health information technology (HIT) so as to weigh its benefits and risks to ultimately construct a proposal for successful widespread adoption. Due to the poignancy of information analysis within HIT, Information Measurement Theory (IMT) was used to measure the effectiveness of current HIT systems as well as to elucidate improvements for future implementation. The results indicate that increased transparency, attention to patient-focused approaches and proper IT training will not only allow HIT to better serve the community, but will also decrease inefficient healthcare expenditure.
ContributorsMaietta, Myles Anthony (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (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 284 residents of the rural community of Cooper Landing, Alaska are subject to many health risks. Cooper Landing is home to a large population of older adults whom suffer from a disproportionate physician to population ratio. Limited rural health care infrastructure and poor physician to population ratios are not conducive to primary health care implementation. Limited access to primary health care is linked to vast health disparities in rural communities like Cooper Landing. Preventive care and healthy lifestyle incentives have been largely overlooked as viable alternatives to primary health care access. In Cooper Landing, implementation of such incentives has proved to be either underutilized or unsuccessful by the private, public, and nonprofit sectors. To remedy this, the Rural Alaska Wellness Project (RAWP), a nonprofit organization, carries out its mission to promote health and wellness by providing a community resource for preventive care in Cooper Landing, Alaska. RAWP intends to increase the availability of the Cooper Landing School's gymnasium for community use, donate fitness equipment, implement TeleHealth initiatives, and host annual health fairs through grant funding, generous donations, and fundraising activities.
ContributorsNolan, Erin Sachi (Author) / Shockley, Gordon (Thesis director) / Hrncir, Shawn (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Department of Psychology (Contributor)
Created2015-05
Description
Smartphone-based healthcare. It's becoming more real as technology advances, adding value to healthcare and opening the doors to more personalized medicine. The Medical Pal is a smartphone application that can track symptoms and analyze trends in the severity of those symptoms, alerting healthcare providers when there is a significant increase in the symptom severity. This is especially directed to the palliative patient, whose care is focused on managing symptoms and providing comfort. The HIPAA-compliant server used for the smartphone application was Catalyze.io and 40 Mayo Clinic Arizona palliative patients were surveyed on their smartphone usage to test the acceptance of this app in a clinical setting. A trial involving 9 simulated patients was conducted over a two week period to test the functionality of the app. A majority of surveyed patients (85%) expressed favor for the idea of a mobile ESAS, and the app was functioning, with the capability of displaying patient data on a healthcare provider's account. This project is intentionally a door-opener to an open field of opportunity for mobile health, symptom observation, and improvements in healthcare delivery.
ContributorsDao, Lelan Diep (Author) / Cortese, Denis (Thesis director) / Lipinski, Christopher (Committee member) / Fitch, Tom (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor)
Created2015-05
Description
2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.
ContributorsCarson, Anna Elizabeth (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The Performance Based Studies Research Studies Group (PBSRG) at Arizona State University aims to evaluate and provide solutions to problems by using concepts derived from deductive logic. The research group identified that problems in most industries are due to the traditional approach of management, direction and control, and offers a practical contrasting model. The author is a biological sciences major interested in the health care industry. As a volunteer at a local non-profit pregnancy clinic in Tempe, AZ, the author noticed characteristics of the clinic structure that resembled both the traditional approach of management, direction and control and the best value (BV) approach. Although the pregnancy clinic has existed for 30 years and has high patient satisfaction, it faces problems that jeopardize its long term sustainability. This study analyzes the stereotypical structure of non-profit health clinics through literature review and through a case study of a local non-profit pregnancy clinic in Tempe, Arizona. The study identified and analyzed the factors that contribute to inefficiency within non-profit health clinics. The conclusions of the research demonstrate that characteristics of non-profit health clinics that resemble the traditional model perform in a manner that is unsustainable. Recommendations were based on concepts derived from Information Measurement Theory (IMT) and aimed to improve efficiency and effectiveness. The study identifies sources of risks and examines the performance of such organizations; the study concludes that rejection of traditional models and adaptation of the new approach is preferable in improving performance and increasing patient, employee, and volunteer satisfaction.
ContributorsTran, Yvonne Ho (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Healthcare systems and health insurance are both concepts implemented in every country to provide access to the general population. Countries undergo healthcare reforms in order to increase the performance of the system. In 2010, the Affordable Care Act (ACA) was introduced in the United States to increase coverage and create a more inclusive health insurance market. For comparison, the recent reforms in Chile and Singapore were observed as points to determine what concepts work well and what can be implemented in the U.S. system. Unlike the United States, Chile and Singapore completely altered the system that was previously in use. In Chile, the reforms began in the 1970s and made two more major changes in 1973 and early 2000s. Singapore began its reform in the 1960s and created the medical savings account system that is still in use today. To analyze the system further, the medical professions of neurology, physician assistants and optometry were compared in each country. In regards to neurology, the coverage of services in Chile and Singapore are similar in that select medical procedures are covered. In contrast, the United States offers coverage on a case-by-case basis. For physician assistants, such a profession does not exist in Chile or Singapore. In the United States, the profession is rapidly expanding, and coverage is offered for most services provided. Optometry is a stand-alone profession in both the U.S. and Singapore. The services provided by the optometrists are selectively covered by insurance, depending on whether it is considered a medical problem. Chile covers the services often provided by optometrists, however, the ophthalmologist is the provider, as optometry does not exist. This study concluded that the U.S. should continue to provide a more inclusive healthcare system that includes vision and dental care. The U.S., like Singapore, should also adopt a more integrative system. Under this system, patient care would be provided in a way that professionals specializing in the care are included in every step of the process.
ContributorsLa, Jenny (Co-author) / Feruj, Farihah (Co-author) / Morrison, Sarah (Co-author) / Gaughan, Monica (Thesis director) / Essary, Alison (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (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
As technology's influence pushes every industry to change, healthcare professionals must move to a more connected model. The nearly ubiquitous presence of smartphones presents a unique opportunity for physicians to collect and process data from their patients more frequently. The Mayo Clinic, in partnership with the Barrett Honors College, has designed and developed a prototype smartphone application targeting palliative care patients. The application collects symptom data from the patients and presents it to the doctors. This development project serves as a proof-of-concept for the application, and shows how such an application might look and function. Additionally, the project has revealed significant possibilities for the future of the application.
ContributorsGaney, David Howard (Author) / Balasooriya, Janaka (Thesis director) / Lipinski, Christopher (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / Computer Science and Engineering Program (Contributor)
Created2015-05