Rural health, long-term care, and chronic disease: Three essays on system design for population health

Yan Li, Purdue University

Abstract

The United States (US) spends more money on health care than any other country in the world. However, the performance of the overall health system is far from satisfactory and falls behind many developed countries. With the hope of reforming the US health care system, the Affordable Care Act of 2010 requires health care delivery organizations to simultaneously reduce costs, improve quality, and ensure patient access. Population health is an important measure of the progress of health reform efforts, but its improvement has been hindered due to increasing health inequity, aging populations, and prevalent chronic conditions. Recognizing the complex and emerging nature of population health, many health organizations, such as the National Institutes of Health, have emphasized the use of systems science tools (e.g., computer simulation and optimization) to improve population health. This dissertation develops innovative systems science models to improve population health from three aspects including rural health, long-term care, and chronic disease. In the first study, we develop a mixed integer programming model to optimally assign physicians and patients in an outpatient care network in order to improve patient access to care in rural areas. In the second study, we develop a profit maximization model combining a migration network and a multi-product newsvendor model to determine the optimal capacity for different care settings in a long-term care network. In the third study, we develop an agent-based simulation model for cardiovascular health and use the model to identify the most effective lifestyle interventions for different populations. We believe these three studies will not only shed light on optimal system design practice in their respective contexts but also add value to the existing literature on methodological advancement in health and systems science.

Degree

Ph.D.

Advisors

Lawley, Purdue University.

Subject Area

Public health|Operations research

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