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dc.contributor.advisorJohnson, Norman A.
dc.contributor.advisorRobinson, Powell
dc.creatorNwafor, Onyi
dc.date.accessioned2018-12-03T14:44:43Z
dc.date.available2018-12-03T14:44:43Z
dc.date.created2018-05
dc.date.issuedMay 2018
dc.date.submittedMay 2018
dc.identifier.urihttp://hdl.handle.net/10657/3597
dc.description.abstractIn recent years, there has been a dramatic increase in the push for various organizational interventions aimed at improving the coordination of healthcare delivery services. Two examples of such interventions are care coordination teams (CCTs), which are used in hospitals to coordinate patient flow across care units; and Accountable Care Organizations (ACOs), which are used to coordinate care delivery across healthcare organizations. Despite the widespread adoption of, and continued push for these interventions, there is very little systematic and rigorous research investigating their impacts on operational performance, such that to date, how beneficial they are remains an open question. Research findings in this area have been inconclusive, and there is a lack of theory to explain or reconcile these inconclusive results. This dissertation, which consists of two essays, addresses these shortcomings. The first essay focuses on the value of CCTs to hospitals. Using theories of organizational coordination, we develop hypotheses describing the influence of CCT structure on the efficiency and effectiveness of patient flow processes, and how team-patient coordination causally mediates this direct effect. We test this hypothesis in a field study of CCTs using quasi-experimental methods. The second essay focuses on the recent emergence of ACOs as an organizational form that can promote care coordination across healthcare organizations. Drawing on the contingency theory of organization, we propose and test the hypothesis that input uncertainty, knowledge insufficiency, and prevalence influence hospitals’ decision to participate in ACOs, as well as its effect on cost and quality performance. The theoretical contribution of this dissertation focuses on clarifying how these organizational interventions work to affect performance. The practical contribution focuses on identifying specific elements of the intervention that are most beneficial to hospitals, and conditions under which these interventions work best.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.rightsThe author of this work is the copyright owner. UH Libraries and the Texas Digital Library have their permission to store and provide access to this work. Further transmission, reproduction, or presentation of this work is prohibited except with permission of the author(s).
dc.subjectHealth care
dc.subjectHealth care coordination
dc.subjectHealth care policy
dc.titleEssays on Healthcare Coordination
dc.date.updated2018-12-03T14:44:44Z
dc.type.genreThesis
thesis.degree.nameDoctor of Philosophy
thesis.degree.levelDoctoral
thesis.degree.disciplineBusiness Administration
thesis.degree.grantorUniversity of Houston
thesis.degree.departmentDecision and Information Sciences, Department of
dc.contributor.committeeMemberSahin, Funda
dc.contributor.committeeMemberKeller, Robert T.
local.embargo.terms2020-05-01
local.embargo.lift2020-05-01
dcterms.accessRightsThe full text of this item is not available at this time because the student has placed this item under an embargo for a period of time. The Libraries are not authorized to provide a copy of this work during the embargo period.
dc.type.dcmiText
dc.format.digitalOriginborn digital
dc.description.departmentDecision and Information Sciences, Department of
thesis.degree.collegeC. T. Bauer College of Business


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