Dissertation/Thesis Abstract

Integrating Health Care Systems to Maintain Quality Care and to Manage Cost
by Noble, Marilynn J., Ph.D., Walden University, 2019, 141; 13880818
Abstract (Summary)

The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the Donabedian quality health care model were used to interpret the study results. A data set of 180 participants was evaluated using a cross-sectional quantitative methodology. Two Spearman correlations were used to examine the relationship between financial burden and satisfaction (r = .41, p < .001) and financial burden and confidence (r = .44, p < .001). Linear and binary regressions assessed the effects of age and gender on satisfaction with health care finder functionality when requesting a waiver (F (2,26) = 1.22, p = .313, R2 = .09). A computation of one-sample t-tests to determine the impact of a closed network, beneficiary out-of-pocket cost, and quality health care in Demonstration areas found the beneficiaries were satisfied with the demonstration. An analysis of the claims data pre and post demonstration showed a difference in the patients' out-of-pocket expenses and the acceptability and preference for a closed network. Social change was demonstrated by a decrease in the cost for TRICARE standard beneficiaries in the Philippines.

Indexing (document details)
Advisor: Green, Eboni
Commitee: Dockins, James, Rohrer, James
School: Walden University
Department: Health Services
School Location: United States -- Minnesota
Source: DAI-B 80/09(E), Dissertation Abstracts International
Subjects: Management, Public policy, Health care management
Keywords: Access to care, Avedis donabedian, Closed network, Out-of-pocket costs, Philippines, Ronald andersen
Publication Number: 13880818
ISBN: 978-1-392-13978-3
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