Graduation Semester and Year
2016
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Industrial Engineering
Department
Industrial and Manufacturing Systems Engineering
First Advisor
Shernette R Kydd
Second Advisor
Erick C Jones
Abstract
Hospital Closures occur from time to time. Several rural hospitals were closed in the U.S recently in an unprecedented manner and hundreds of others are at the risk of closing. The Patient Protection and Affordable Care Act (PPACA) which was amended in 2010, has brought sea of changes in the healthcare industry right from changing the way how hospitals receive reimbursements by introducing several new programs targeting hospitals’ quality of care to expanding health insurance for millions of poor and underprivileged populations in the country. The goal of this study is to understand the closure of rural hospitals in line with the recent reform changes and identifying counter measures to prevent further closures in the future. The first section of the research identifies and evaluates the factors behind the closures by creating a binary logistic model to predict closures of hospitals. Three models were created, first using patient and market characteristics factors (Financial Importance), second using hospitals core measure processes (Operational Importance) and a final model combining the above both models. The second section of the research identifies and evaluates process improvement initiatives by deploying Lean Six Sigma projects in the hospitals. A Hospital Enterprise System (HES) which encompass three hospitals is used for the study. A 0-1 Integer Linear Programming method (Knapsack Method) is proposed for the selection of projects. Two scenarios are created in which the first scenario optimizes the cost savings by selecting projects among three hospitals. In the second scenario, one among the three hospitals are assumed to be present in a disadvantaged location and few core measure projects are mandatorily implemented to improve the performance of processes to avoid penalties, reimbursement cuts and achieve cost savings to prevent closures in the future.
Keywords
Rural hospitals, Lean Six Sigma, Hospital closures, Healthcare, Medicare, Six Sigma
Disciplines
Engineering | Operations Research, Systems Engineering and Industrial Engineering
License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Balasubramanian, Soma Sekar, "EVALUATING INCREASING HOSPITAL CLOSURE RATES IN U.S: A MODEL FRAMEWORK AND A LEAN SIX SIGMA DEPLOYMENT APPROACH FOR QUALITY IMPROVEMENT INITIATIVES TO PREVENT FURTHER CLOSURES IN RURAL AND DISADVANAGED LOCATIONS" (2016). Industrial, Manufacturing, and Systems Engineering Dissertations. 162.
https://mavmatrix.uta.edu/industrialmanusys_dissertations/162
Comments
Degree granted by The University of Texas at Arlington