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Using Systems Dynamics Modeling to D...

Spence, Sean.

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Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being./
Author:	Spence, Sean.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
Description:	97 p.
Notes:	Source: Dissertation Abstracts International, Volume: 78-07(E), Section: B.
Contained By:	Dissertation Abstracts International78-07B(E).
Subject:	Engineering. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10254889
ISBN:	9781369551990

Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being.
Spence, Sean.

Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 97 p.

Source: Dissertation Abstracts International, Volume: 78-07(E), Section: B.

Thesis (D.Engr.)--The George Washington University, 2017.

Complex social systems are governed by policies that are designed and implemented by legislators, boards of directors, executives, and government officials. At policy inception, policy designers predict positive impacts on society and minimize known negative impacts, which are often seen as tradeoffs for the greater good of the overall system (Adams, 1976). However, the unknown negative impacts cause unintended consequences. These unintended consequences create gaps in goal-seeking systems trying to stay balanced. The intent of this paper is to gather data, design a model in a sophisticated software package (iThink) and a common software package (excel) to show impact of gaps in large policies such as national healthcare. In particular, I will investigate and model the impacts of increasing out of pocket healthcare costs on the wellbeing of Medicare recipients. I also intend to demonstrate that policy makers could benefit from the use of systems dynamics even if they don't have access to sophisticated modeling software such as iThink by using simpler, more ubiquitous software packages such as excel to model the impact of policy decisions. Currently, policies are created through debates among legislators wherein "one side" may win the debate with some input from the "other side".

ISBN: 9781369551990Subjects--Topical Terms:

586835
Engineering.

Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being.
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100 1 $a Spence, Sean. $3 3287298
245 1 0 $a Using Systems Dynamics Modeling to Demonstrate the Impact of Medicare Out of Pocket Cost Increases on Medicare Recipient Well-Being.
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300 $a 97 p.
500 $a Source: Dissertation Abstracts International, Volume: 78-07(E), Section: B.
500 $a Advisers: Thomas Mazzuchi; Shahram Sarkani.
502 $a Thesis (D.Engr.)--The George Washington University, 2017.
520 $a Complex social systems are governed by policies that are designed and implemented by legislators, boards of directors, executives, and government officials. At policy inception, policy designers predict positive impacts on society and minimize known negative impacts, which are often seen as tradeoffs for the greater good of the overall system (Adams, 1976). However, the unknown negative impacts cause unintended consequences. These unintended consequences create gaps in goal-seeking systems trying to stay balanced. The intent of this paper is to gather data, design a model in a sophisticated software package (iThink) and a common software package (excel) to show impact of gaps in large policies such as national healthcare. In particular, I will investigate and model the impacts of increasing out of pocket healthcare costs on the wellbeing of Medicare recipients. I also intend to demonstrate that policy makers could benefit from the use of systems dynamics even if they don't have access to sophisticated modeling software such as iThink by using simpler, more ubiquitous software packages such as excel to model the impact of policy decisions. Currently, policies are created through debates among legislators wherein "one side" may win the debate with some input from the "other side".
520 $a Sophisticated modeling software could cost upwards of $2,500 per license have steep learning curve that require mathematical prowess. The combination of these barriers, deter systems dynamics use by policy legislators and analyst who typically are not trained in these areas and find it hard to justify the investment to budget constrained governmental organizations. Many of these software packages came out of the need for more sophistication in modeling when the spreadsheets and personal computers were not powerful enough to support modeling as indicated in the publication "Using system dynamics to help develop and implement policies and programs in health care in England" However, at the writing of this Praxis, one could argue that spreadsheet sophistication and personal computing power have come a long way where systems dynamists can now encourage policy analyst to use spreadsheets to model their policy as oppose to only relying on iThink. In this Praxis, I used two software packages, Stella iThink and Microsoft Excel to model well-being of geriatric patient's overtime based on out of pocket expenses and debt levels show that the: a. Impact of out of pocket expenses on Medicare recipient wellbeing: i. Null hypothesis: Increase in out of pocket healthcare costs do not have an impact of Medicare patient wellbeing. ii. Alternative Hypotheses: Increase in out of pocket healthcare costs do have an impact of Medicare patient wellbeing. b. Impact of Affordable Care Act implantation on Medicare out of pocket expenses: i. Null hypothesis: Affordable Care Act (ACA) implantation do not increase Medicare out of pocket healthcare costs. ii. Alternative Hypotheses: Affordable Care Act (ACA) implantation did increase Medicare out of pocket healthcare costs.
520 $a My models (iThink and Excel) both show that increase in out of pocket expense have a substantial impact on the wellbeing of Medicare patients as demonstrated in Figure 28 (iThink) and Figure 38 (Excel). Using a debt level as a proxy for the extra cost of out of pocket expense because Medicare recipients, on a fixed income, must pick up additional spending using debt. Both models show that as debt increases the wellbeing of the recipient decreases therefore we reject the null hypothesis (ai). This indicates that higher out of pocket costs accelerates the reduction of overall health and increases the cost of "policy fixes" for governments in the long run. We also showed through a simple excel analysis that the cost increases within the Medicare Out of Pocket expenses remained the same the 5 year pre and post the implementation of the ACA as indicated in figure 42 therefore we accept the null hypothesis (bi). (Abstract shortened by ProQuest.).
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