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dc.contributor.advisorNelson Repenning and John Sterman.en_US
dc.contributor.authorLyan, Dmitriy Eduarden_US
dc.contributor.otherSystem Design and Management Program.en_US
dc.date.accessioned2014-10-08T15:22:59Z
dc.date.available2014-10-08T15:22:59Z
dc.date.copyright2012en_US
dc.date.issued2013en_US
dc.identifier.urihttp://hdl.handle.net/1721.1/90690
dc.descriptionThesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, June 2013.en_US
dc.descriptionCataloged from PDF version of thesis. "June 2012."en_US
dc.descriptionIncludes bibliographical references (pages 113-116).en_US
dc.description.abstractThe prevalence of Post Traumatic Stress Disorder (PTSD) and other related behavioral health conditions among active duty service members and their families has grown over 100% in the past six years and are now estimated to afflict 18% of the total military force. A 2007 DoD task force on mental health concluded that the current military psychological health care system is insufficient to meet the needs of the served population. In spite of billions of dollars committed to hundreds of programs and improvement initiatives since then, the system continues to experience provider shortages, surging costs, poor access to and quality of care as well as persistently high service-related suicide rates. We developed a model to study how the resourcing policies and incentive structures interact with the operations of military behavioral health clinics and contribute to their ability to provide effective care. We show that policies and incentives skewed towards increased patient loads and improvement in access to initial care result in a number of vicious cycles that reinforce provider shortages, increase costs and decrease access to care. Additionally we argue that insufficient informational feedback contributes to incorrect attributions and the persistence of ineffective policies. Finally we propose a set of policies and enabling performance metrics that can contribute to sustained improvement in system performance by turning death spirals into virtuous cycles leading to higher provider and patient satisfaction, better quality of care and more efficient resource utilization contributing to better healthcare outcomes and increased levels of medical readiness.en_US
dc.description.statementofresponsibilityby Dmitriy Eduard Lyan.en_US
dc.format.extent116 pagesen_US
dc.language.isoengen_US
dc.publisherMassachusetts Institute of Technologyen_US
dc.rightsM.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission.en_US
dc.rights.urihttp://dspace.mit.edu/handle/1721.1/7582en_US
dc.subjectEngineering Systems Division.en_US
dc.subjectSystem Design and Management Program.en_US
dc.titlePerformance dynamics in military behavioral health clinicsen_US
dc.typeThesisen_US
dc.description.degreeS.M. in Engineering and Managementen_US
dc.contributor.departmentMassachusetts Institute of Technology. Engineering Systems Division.en_US
dc.contributor.departmentSystem Design and Management Program.en_US
dc.identifier.oclc890939780en_US


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