Investigating Strategies To Improve Health Care Labor Market, Health Outcomes, Health Care Quality, And To Reduce Emergency Department Utilization And Costs: A Study Of The Effectiveness Of Family Friendly Policies, Patient-Centered Communication, And Enh

This dissertation investigates three important issues in the US health care system: the low utilization of family-friendly policies by health care professionals, the sub-optimal quality of medical services, and the high level of emergency department (ED) expenditures. Chapter 2 uses a unique dataset from a choice experiment to address the first issue by exploring the impact of supervision support on the economic value of family-friendly policies. My results suggest that supervisors' support for the use of family-friendly services significantly increase the economic value of the family-friendly benefits provided. Chapter 3 and 4 investigate the effectiveness of patient-centered care models in improving health outcomes, health care quality and reduce emergency department expenditures. Using six panels of the Medical Expenditure Panel Survey, I construct a multidimensional measure of patient-centered communication that integrates items related to cultural competency, coordinated care, shared decision-making, and patient-centeredness. The results reveal that patient-centered communication significantly increases patients' likelihood to report a better physical or mental health, as well as health care quality. Furthermore, being foreign born, non-English proficient, with mental, social, or physical disability, all significantly decrease the risk of having enhanced access to care and patient-centered communication with medical provider. Finally, having an enhanced access to primary care and a patient-centered communication with primary care provider significantly reduces both ED use and expenditures. Estimated average reduction in ED expenditures attributed to a better access to primary care and a patient centered-communication varies from $1.180,53 to $1.191,89 per year per individual.