Improving care delivery in integrated health care systems
Abstract/Contents
- Abstract
- In this dissertation, I leverage datasets drawn from administrative and clinical records of two large integrated health care systems to study the management of chronic health conditions at the population level. I use a combination of simulation modeling and econometric methods to provide insights around clinical decision-making and care delivery improvement, as well as contemporary evidence of screening effectiveness. The first two chapters focus on the treatment of opioid use disorder (OUD) within the Veterans Health Administration (VA). In Chapter 1, I develop a simulation model of Veterans seen for OUD and use calibrated model parameters to characterize treatment durations for which elevated mortality risks during transitions into and out of treatment are balanced by mortality reductions during stable treatment. Chapter 2 extends this modeling analysis to inform the prioritization of efforts to improve care and reduce opioid-related and all-cause mortality among Veterans with OUD. It projects future diagnosis and treatment trends in the absence of additional system intervention by the VA, as well as the effects of hypothetical policies to increase treatment uptake. Chapter 3 takes a retrospective approach to assess the effectiveness of preventive screening in population health management. Using an instrumental variables approach, I evaluate the clinical outcomes of a screening program for abdominal aortic aneurysms (AAA) implemented by a large integrated healthcare system in Northern California.
Description
| Type of resource | text |
|---|---|
| Form | electronic resource; remote; computer; online resource |
| Extent | 1 online resource. |
| Place | California |
| Place | [Stanford, California] |
| Publisher | [Stanford University] |
| Copyright date | 2021; ©2021 |
| Publication date | 2021; 2021 |
| Issuance | monographic |
| Language | English |
Creators/Contributors
| Author | Ching, Jack Horn-Yu |
|---|---|
| Degree supervisor | Owens, Douglas K |
| Thesis advisor | Owens, Douglas K |
| Thesis advisor | Goldhaber-Fiebert, Jeremy D |
| Thesis advisor | Salomon, Joshua A |
| Degree committee member | Goldhaber-Fiebert, Jeremy D |
| Degree committee member | Salomon, Joshua A |
| Associated with | Stanford University, Program in Health Policy |
Subjects
| Genre | Theses |
|---|---|
| Genre | Text |
Bibliographic information
| Statement of responsibility | Jack Horn-Yu Ching. |
|---|---|
| Note | Submitted to the Program in Health Policy. |
| Thesis | Thesis Ph.D. Stanford University 2021. |
| Location | https://purl.stanford.edu/qf475dz9851 |
Access conditions
- Copyright
- © 2021 by Jack Horn-Yu Ching
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
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