Behavioural incentivization in healthcare operations

• Main Author: YEO, Nicholas Teck Boon
• Format: text
• Language: English
• Published: Institutional Knowledge at Singapore Management University 2021
• Subjects: Behavioural Incentivization; Healthcare Operations; Screening Adherence; Pipeline Queue; Blood Donation; Donor Management; Health and Medical Administration; Operations and Supply Chain Management
• Online Access: https://ink.library.smu.edu.sg/etd_coll/356; https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1355&context=etd_coll
• Institution: Singapore Management University

Common across current research in healthcare operations is the conclusion that there exist many inefficiencies in today’s healthcare systems. Governments and healthcare organisations have sought to address these inefficiencies through the introduction of new policies and operational procedures or by relying on incentives to encourage specific behaviour. However, despite these attempts to reduce inefficiencies in the healthcare systems, the problem persists and is further exacerbated by growing medical complexities coupled with a rapidly ageing population. Against this backdrop, this dissertation investigates two issues within healthcare operations: (i) colorectal cancer (CRC) screening adherence, and (ii) blood donor management. A distinguishing feature of this dissertation looks at the incentivization of participants’ behaviours within the two main operations in healthcare operations management. The first chapter of the dissertation empirically examines the determinants and barriers of CRC screening adherence. Using responses drawn from a nationwide survey, the data highlights that CRC screening adherence levels continue to remain low despite the government’s implementation of nationwide screening programs. To study the reasons behind the low adherence rate, I conduct a stepwise logistic regression model and identify several key predictors of the screening adherence. I found that age and individual perceived risk of developing CRC have significant quadratic trends towards screening participation. The results further show that participant's proficiency in probability literacy has an impact on perceiving an individual's risk of developing CRC towards screening adherence. Linear predictors consisting of CRC knowledge and factor of trust in government are also significant predictors towards screening participation. Motivated by the significant quadratic trend of age, I further investigate the nonmonotonic relationship between age and the adherence rate and provide policymakers with insights on possible interventions to CRC screening policies via a mediation model. I found that policy mediation factors in the form of financial means - CPF account balance and ownership of private insurance were statistically significant mediators that drives the nonmonotonic relationship. The second chapter studies the strategic management of blood inventory through donor incentivization policies where under-incentivization may lead to shortage of critical blood supply while over-incentivization potentially causes excessive wastage. Incorporating key features of the blood donation such as perishable inventory, observation queue and stochastic demand and supply, I propose an optimization model to solve the donor incentivization decisions in the blood donor management problem by modelling both the blood inventory and donor flow process. Building on the techniques of the Pipeline Queues framework, the optimization model can be reformulated into a convex problem and be efficiently solved. Numerical experiments were further conducted to study how the structure of the optimal policies can change with respect to donors’ responsiveness, inventory levels, changes in demand for blood, new donor recruitment rate and distribution of donors in the observation window. Based on the results, the study also puts forward important practical implications relevant in supply chains with social impact.