Essays on healthcare operations in india

Abstract

Healthcare systems are confronted with many goals of which proper utilization of existing resources and reduction of wastage in terms of time and resource are essential for managing inefficiencies in the system Both researchers and practitioners in medicine and operations management OM concur on the need to improve efficiency at different levels of the healthcare ecosystem Green 2012 Healthcare in India 20171 This work seeks to address some of the operational challenges related to service delivery efficiency and resource utilization in the context of Indian healthcare The three studies included in this dissertation examine the current approach and provide decision making support to stakeholders in two different healthcare settings In the first study we adopt a macro level healthcare perspective to address the shortage of cadaveric organs for transplant The low organ donation rate coupled with the high demand for transplantable organs has resulted in long organ waitlists in India Nagral and Amalorpavanathan 2014 Srivastava and Mani 2018 This research identifies the incentives and coordination mechanisms to improve the supply of cadaveric organs in the system We develop an analytical model to study the interaction between the supply side entities a coordinating organization and a hospital that performs the organ retrieval under a planner s supervision in a cadaveric organ supply chain The study examines the hospital s channel decision between an uncertain unauthorized channel and an administratively more demanding authorized channel We derive the conditions and the coordinating organization s optimal reimbursement fee to incentivize the hospital to participate in the authorized channel Further we contrast the decisions and payoffs under cooperative and decentralized setups to understand if any benefits from cooperation are forthcoming at the individual and system levels Our results show that the choice of decentralized or cooperative supply chain is not entirely straightforward newline newline