UMD Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/1903/3

New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a given thesis/dissertation in DRUM.

More information is available at Theses and Dissertations at University of Maryland Libraries.

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Subject: search.filters.subject.Health Sciences, Health Care Management

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    Applications of Operations Research Models to Problems in Health Care
    (2009) Price, Carter Claiborne; Golden, Bruce; Applied Mathematics and Scientific Computation; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This dissertation is divided into two parts. In the first portion, we study inflection points in biobjective variants of the traveling salesman problem (TSP) related to health care applications. In the second portion, we use a variety of techniques from operations research to improve hospital efficiency. We used a TSP variant that prioritizes the ability to return to the depot, in addition to the standard distance, to study the collection of blood from remote collection sites. In an application related to emergency response, we looked into behavior of tours generated using the target visitation problem, a TSP variant that also includes node priority in the objective function. Working with the University of Maryland Medical Center, we did three projects related to hospital efficiency. We used stochastic modeling and simulation to optimize the throughput of a cardiac surgery post-operative unit. We found that altering the mix of post-operative beds could significant increase the effective capacity. After unsuccessfully attempting to use data mining and survival analysis to predict hospital census, we performed a statistical analysis of patient length of stay patterns and discovered surgeons were improving their chances of having available beds for incoming cases by adjusting their discharge practices by day of week. In the final project, we used integer programming and heuristics to develop schedules that match incoming surgical patients with the discharge of earlier patients. The results indicate that altering the surgical schedule can substantially improve the flow of patients through the hospital.
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    Employee Health: A Value Creating Organizational Resource
    (2009) Kiyatkin, Lori; Baum, J. Robert; Business and Management: Management & Organization; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    U.S. businesses have overwhelmingly approached employee health from a cost management, rather than investment, perspective. This singular focus on costs is likely due to lack of clarity regarding the potential of employee health to be a value creating organizational resource and the underlying mechanisms by which health may be subject to organizational influence. In this dissertation, I outline the `resource potential' of employee health from an organizational perspective. First, I draw upon the resource-based view and past research on health promotion and health care cost management to outline the significant organizational performance implications of employee health as a source of value generation in organizations. In so doing, I propose a model that explains the process by which employees' health risks, health motivations, and healthy behaviors impact organizational outcomes. Next, I develop a model that explains how two distinct categories of healthy behaviors - `healthy consumption' and `physical/mental fitness' uniquely impact medical costs and organizational productivity. To test these models, I employ structural equation modeling to examine a dataset of 152 and 149 organizational level outcomes regarding models 1 and 2, respectively. I find support for my assertions that employee health is a value creating organizational resource and that health motivations are an important means by which this resource may be built. I also find that healthy consumption behaviors have a stronger relative impact on costs whereas physical/mental fitness behaviors strongly promote productivity. Based on these findings, I argue that minimalistic cost management approaches to employee health are unwise from both organizational social and financial performance perspectives. In particular, this research demonstrates the crucial importance, and potential, of employee health and its components as value creating resources from a strategic organizational management perspective. Further, this research suggests that employee healthcare may be `strategic' social performance as organizational health promotion can simultaneously address both financial and social performance interests. Implications and areas for future research are discussed.