Date of Award

2017

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Abby Swanson Kazley

Second Advisor

Jillian B. Harvey

Third Advisor

Rachel Hess

Fourth Advisor

James S Zoller

Abstract

Knowing the cost of delivering patient care is a mandatory first step as health care leaders are tasked with reducing the cost of US health care. The Integrated Practice Unit (IPU) model espoused by Michal Porter is a patient centered organizational framework whose tenets support value driven care. University of Utah Health has developed a proprietary costing model that gives them the ability to measure both costs and outcomes at the patient, provider, or in this research case, IPU program level. An interrupted time series (ITS) study design methodology is used to evaluate whether there has been an immediate effect on HF patient costs and related indicators post implementation of the HF IPU. The ITS pre/post analyses show an overall declining trend in total HF costs, total HF technical costs, total HF professional costs, HF costs (total, surgical and non-surgical), admissions, ED visits, and mean LOS. While VAD costs dropped initially, they began to increase in the post intervention period. HF readmissions remained flat across the pre- and post periods. Statistically significant and declining trends were observed in HF surgical, and non-surgical cost trends. While not all trends were statistically significant, they may be deemed financially or clinically significant and worth further study.

Rights

All rights reserved. Copyright is held by the author.

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