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- All Subjects: healthcare
- Creators: Barrett, The Honors College
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
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
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
This thesis examines how the physical construction of the ooloi Oankali aliens in Octavia Butler's trilogy Lilith's Brood enables the text to explore the limitations of a two-gender construct. It does so by positing the existence of other conscious organic life with a third gender outside the scope of Earth-bound organisms. The ooloi must be understood by a definition of gender that takes into consideration socially constructed and performed roles. The physical bodies of the ooloi have a "boundary-crossing" identity that is unambiguous. Their transformative and healing abilities, physical characteristics, and place in the social structure of the Oankali makes them the targets of disgust and hatred by humans who fear difference. This thesis analyzes how Butler uses the ooloi to demonstrate the possibility that humans living on a future Earth can supersede their innately destructive qualities.
ContributorsBrady, Sarah Rachel (Author) / Hattenhauer, Darryl (Thesis director) / Cook, Paul (Committee member) / Department of English (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This paper explores the complex, multifaceted relationship of science and science fiction. Because of our rapidly evolving, technology-driven world, the question of how science fiction changes, and is changed by, science is more relevant today than ever before. The nuanced relationship of science and science fiction can first be explored by analyzing the influence of science fiction on science with examples such as the XPRIZE Foundation. At the same time that science fiction influences science, changes in science will also resonate in the future of science fiction. New developments like the open-source movement and the success of platforms like Kickstarter, which allow science to be crowdsourced at unprecedented levels, are changing the landscape of scientific development. These changes are causing increased public engagement with science. Based on these changes in the way science and technology are developed, the science fiction genre seems on the cusp of a dramatic shift. Science fiction has long been dominated by dystopian and apocalyptic visions for the future, frequently the result of some catastrophe of our own making. However, because of the changes in science and technology and the public's engagement with those changes, the next generation of science fiction writers and filmmakers is likely to see a more positive outlook for humanity. Based on the interlocked past of science and science fiction, this paper argues that the changing landscape of science and technology will cause a change for the positive in the tonality of popular science fiction.
ContributorsMiller, Hillary Marie (Author) / Finn, Ed (Thesis director) / Swanner, Leandra (Committee member) / School of Film, Dance and Theatre (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
Description
In the future a Community struggles for survival on an uninhabitable Earth. A small faction of rebels, called Villains, put the lives of the entire Community at risk as they fight for domination of their home. Heroes and their Sidekicks rise up from the population to fight the Villains and win back their world. As they complete their training and begin to enter the world of Heroes and Villains, Alyssa begins to struggle with her identity as a Sidekick, her new role in the Community, and whether she can really preserve all that matters most to her. This excerpt from the larger novel, Sidekick, tells the story of Alyssa's struggles to remain true to herself, and her best friend Jeremy, all the while being called to serve the Community and eradicate the threat the Villains pose to her way of life. I conceived Sidekick as a work of speculative fiction because I believe the genre is one of the most powerful tools for education in the present time. By freeing one's mind to wonder, the dull becomes an exciting thought experiment that can (and does) influence how individuals see their world. Reading pieces like Ender's Game and 1984 I have found my ways of thinking challenged and stretched, and ideas from these works of fiction have stuck with and changed me. One major goal of the work was identifying and integrating major academic and life lessons I have learned into the overall work, providing it an intellectual and emotional grounding in reality. Having its foundations in the real world, the setting of Sidekick becomes a stage for a fantastical story as well as the reader's own imagination and introspection.
ContributorsWarren, Taylor Ann (Author) / Finn, Ed (Thesis director) / Bell, Matt (Committee member) / Department of English (Contributor, Contributor, Contributor) / Division of Teacher Preparation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
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