Empirical Investigations Into The Impact Of Step-Down Unit Admission And Health Information Technology On Patient Outcomes

Simple item page
dc.contributor.advisorChristian Terwiesch
dc.contributor.authorLekwijit, Suparerk
dc.date2023-05-18T01:14:46.000
dc.date.accessioned2023-05-22T17:59:55Z
dc.date.available2001-01-01T00:00:00Z
dc.date.copyright2021-08-31T20:21:00-07:00
dc.date.issued2021-01-01
dc.date.submitted2021-08-31T03:50:43-07:00
dc.description.abstractThis dissertation in operations management studies healthcare operations using large-scale data sets and econometric methods. In chapter one, we examine the benefits of step-down units (SDU), which provide an intermediate level of care for semi-critically ill patients. Using data from 10 hospitals, we estimate the clinical and operational impact of SDU care and find that SDU care significantly improves health outcomes among post-intensive care unit patients. However, its benefits are less certain for patients admitted from the emergency department. In chapter two, we utilize data from a field experiment and examine the efficacy of a connected health system that aimed to reduce readmissions through improved medication adherence. Patients in our study received electronic pill bottles that tracked medication adherence and received different types of feedback when they were non-adherent. We find that patients were more likely to become adherent when receiving high levels of intervention involving personalized feedback and when the intervention is escalated quickly and consistently. We also find that long-term adherence to two crucial heart medications reduces readmission risk. Additionally, we develop a dynamic readmission risk-scoring model and use simulation to show that, when using an intervention strategy that prioritizes high-risk patients, we can significantly reduce readmissions while using the same effort level. In chapter three, we investigate the impact of video visit availability at a large academic medical center on in-system care utilization. Through difference-in-differences, we find that video visit availability is associated with increases in overall care utilization and in-person care utilization within the system. As a whole, this dissertation provides healthcare providers and managers with data-driven insight towards how to maximize effectiveness and efficiency in healthcare delivery through changes in the care structure and health technology adoption.
dc.description.degreeDoctor of Philosophy (PhD)
dc.format.extent145 p.
dc.format.mimetypeapplication/pdf
dc.identifier.urihttps://repository.upenn.edu/handle/20.500.14332/31097
dc.languageen
dc.legacy.articleid5802
dc.legacy.fulltexturlhttps://repository.upenn.edu/cgi/viewcontent.cgi?article=5802&context=edissertations&unstamped=1
dc.provenanceReceived from ProQuest
dc.rightsSuparerk Lekwijit
dc.source.issue4016
dc.source.journalPublicly Accessible Penn Dissertations
dc.source.statuspublished
dc.subject.otherEmpirical Operations Management
dc.subject.otherHealth Information Technology
dc.subject.otherHealthcare Operations Management
dc.subject.otherTelehealth
dc.subject.otherDatabases and Information Systems
dc.subject.otherHealth and Medical Administration
dc.subject.otherOperational Research
dc.titleEmpirical Investigations Into The Impact Of Step-Down Unit Admission And Health Information Technology On Patient Outcomes
dc.typeDissertation/Thesis
digcom.date.embargo2001-01-01T00:00:00-08:00
digcom.identifieredissertations/4016
digcom.identifier.contextkey24594814
digcom.identifier.submissionpathedissertations/4016
digcom.typedissertation
dspace.entity.typePublication
upenn.graduate.groupOperations & Information Management
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Lekwijit_upenngdas_0175C_14612.pdf
Size:
1.73 MB
Format:
Adobe Portable Document Format
Download
Collection
Dissertations and Theses