Healthcare Systems : three studies of patient management and policy change

Abstract

For my PhD thesis, I conducted behavioral science research and wrote three first- author journal format papers, of which one paper has been published and the other two will be submitted to healthcare management journals after completion of my degree. All three papers introduce new information about either the cost or the behaviors of patients in local clinics, filling a gap in the healthcare system's management and policy literature. The first paper studies patients with diabetes who are non-adherent to scheduled appointments with physicians in a specialized diabetes clinic setting in Boston. I developed and introduced new and interesting ''technology comfort" measures and a "Smartphone usage" scale, to evaluate if patients would be able to use smart technologies for their disease self-management. This paper not only suggests that patients with diabetes could potentially benefit from using existing advanced technologies, but that new policies can be introduced to reduce the rate of diabetes patients' appointment-related non-adherence. The second paper examines the system of adherence or self-management in five areas ( diet, exercise, medications, doctor's appointments and regular glucose monitoring), revealing how it is correlated to emergency visits and patient lifestyle satisfaction. I analyze predictors of emergency room visits and propose potential policies to reduce these ER visits through the use of advanced smart technologies. The third paper identifies the incidence and consequences of not practicing non- pharmaceutical interventions, during the time of a pandemic, in a student population at a local university clinic.