Dissertation: Productivity information should be applied to reduce unwarranted variation in healthcare
David Derichs’s (MSc of Accounting and Finance) doctoral dissertation in the field of Management Accounting explores ways to mitigate the growing financial pressures on developed countries’ healthcare systems. He takes an interventionist approach to tackle the widely recognized problem of unwarranted variation in patient treatment, resulting in better and more productive care. In doing so, he adds to the current public debate of delivering efficient and sustainable public healthcare at a high level of quality.
Increasing demand for the delivery and maintenance of healthcare due to an aging population and increasing prevalence of chronic conditions fuel growth in costs. Scientific and technological advancements further aggravate the escalation of costs by enhancing supply of treatments and expensive diagnostics – this recipe for unsustainability mandates responsible stewardship of resources across all levels of a given healthcare system.
‘Despite reform, large differences in cost of care continue to persist between and within countries and even institutions. Part of the variation is explained by severity of illness, patient preferences, or available organizational infrastructure. A large part of the variation, however, remains unexplained and is characterized as unwarranted. Physician practice style is the main reason for its existence and persistence,’ David Derichs explains.
To understand how unwarranted variation can be reduced, David Derichs, a member of the Healthcare Productivity Group at Aalto University School of Business, developed physician-focused reporting interventions together with leading healthcare organizations. Specifically, the researchers collaborated with the Helsinki University Hospital’s Psychiatric Ward and MetroHealth’s (Cleveland, Ohio, USA) ward of Internal Medicine to get to the bottom of the problem.
Participants changed their behavior
Through his intervention, Derichs discovered ways to contextualize key performance indicators (KPIs) to be both medically and economically meaningful. The KPIs were developed together with medical staff from both case institutions. Once validated, they were implemented through state-of-the-art reporting systems to participating medical staff. In both institutions, participants changed their behavior as a result of the documented interventions.
Through his dissertation entitled ’Applying Productivity Information to Reduce Unwarranted Variation in Healthcare’, Derichs further shows ways of how the vast amount of ever increasing unstructured data collected at hospitals can be harnessed to medical practitioners’ and ultimately, society’s advantage. These findings are particularly timely as data collection efforts are increasing, while they are often considered a cost by medical staff, rather than the input to better clinical decisions.
This dissertation presents an excellent example of a successful, cross-disciplinary, and international collaboration between Aalto Unversity and external institutions.
Professor Sofia M. Lourenço will act as the opponent during the defense. Professor Lourenço graduated with a Doctor of Business Administration from Harvard Business School in 2010 and has since been researching and teaching at ISEG - Lisbon School of Economics & Management, Universidade de Lisboa. Jaakko Honko Professor of Management Accounting at Aalto University School of Business Teemu Malmi will act as the Custos during the defense.
The dissertation can be accessed under the following link: http://urn.fi/URN:ISBN:978-952-60-8713-9
The doctoral dissertation defense of David Derichs (MSc Accounting and Finance) will take place at Aalto University School of Business (Auditorium U006, Ekonominaukio 1, Espoo) on 11 October 2019 at 12:00.