Modeling an Integrated Approach to Promote Well-being: Culturally Inclusive Healthcare and Harm Reduction Initiative for Increasing Access to Services
Restricted (Penn State Only)
- Author:
- Abu Aridah, Sara
- Graduate Program:
- Industrial Engineering
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- December 16, 2024
- Committee Members:
- Saurabh Basu, Program Head/Chair
Soundar Kumara, Major Field Member
Paul Griffin, Chair & Dissertation Advisor
Vittaldas Prabhu, Major Field Member
Scarlett Miller, Major Field Member
Jessica Myrick, Outside Unit & Field Member - Keywords:
- Harm Reduction
Opioid Overdose
Health Equity
Health Disparities
Access to Healthcare - Abstract:
- We explore the intersection between health equity, social determinants of health (SDH), and public health strategies to improve health services access and the consequences of opioid use disorders. We first investigate healthcare access for children enrolled in Medicaid-managed care health plans across the United States. We examine the association between eight patients' experience outcome measures and racial/ethnic and geographic groups using The Consumer Assessment of Healthcare Providers and Systems (CAHPS) health plan survey data for 2019 for Medicaid children enrolled in managed care plans. We found differences by group and discussed the implications for equitable health outcomes. Second, we developed an approach to determine the optimal allocation of harm reduction smart vending machines (SVMS) to increase access to naloxone in communities to mitigate the consequences of substance use overdoses. The method considers program budget, an individual’s willingness to travel, health improvement through quality-adjusted life years (QALYs) gained, and equity. Additionally, we perform sensitivity analysis to determine an appropriate budget range for desired health outcomes. Lastly, we evaluate the cost-effectiveness of using uncrewed aerial vehicles (UAVs) together with ambulance dispatches in response to opioid overdoses, comparing accessibility and response times in urban, suburban, and rural areas. We develop a simulation model to evaluate the dispatch process and validate the outcomes with publicly available data. We consider bystanders' availability, weather conditions, and the urban context of the overdose incident location. The overall goal of this dissertation is to promote the well-being of our communities by informing policies and interventions that promote equitable healthcare resource allocation and harm reduction strategies.