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Analytics and Healthcare Costs (A Three Essay Dissertation)Bouayad, Lina 01 January 2015 (has links)
Both literature and practice have looked at different strategies to diminish healthcare associated costs. As an extension to this stream of research, the present three paper dissertation addresses the issue of reducing elevated healthcare costs using analytics. The first paper looks at extending the benefits of auditing algorithms from mere detection of fraudulent providers to maximizing the deterrence from inappropriate behavior. Using the structure of the physicians' network, a new auditing algorithm is developed. Evaluation of the algorithm is performed using an agent-based simulation and an analytical model. A case study is also included to illustrate the application of the algorithm in the warranty domain. The second paper relies on experimental data to build a personalized medical recommender system geared towards re-enforcing price-sensitive prescription behavior. The study analyzes the impact of time pressure, and procedure cost and prescription prevalence/popularity on the physicians' use of the system's recommendations. The third paper investigates the relationship between patients' compliance and healthcare costs. The study includes a survey of the literature along with a longitudinal analysis of patients' data to determine factors leading to patients' non-compliance, and ways to alleviate it.
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