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While access and quality of healthcare in the U.S. are shaped by several factors—location, work, insurance—a simple change can make a big difference for patients. According to a new study led by the institute-affiliated Center for the Business of Health Faculty Director Brad Staats, delivering mental and physical care at the same location can improve patient experience and care efficiency. This week’s Kenan Insight offers a chance for our experts to explore the findings of this new study.

The choice of location is a key facet of decision-making in operations. One such choice is whether to colocate activities, services, or personnel. Prior research, including in healthcare, has reported that colocation yields benefits. However, these benefits may need to be balanced with higher costs of colocation (e.g., due to operational constraints). Thus, it is critical to understand not only whether colocation makes a difference but also under what circumstances it is most beneficial, and the mechanisms through which those benefits are realized. We consider colocation in the context of healthcare services, and ask: Does colocation of mental and physical health resources improve patient outcomes? This colocation is important, as primary care serves as a gateway to address mental health concerns and referrals to specialists. We next study colocation's relationship with two important operational variables: continuity of care (CoC) with a provider, and patient severity. Finally, we examine the mediating role of patients' no-shows and medication adherence in the colocation-outcomes relationship. As America's largest integrated healthcare system, the Veterans Health Administration offers us an excellent setting to study these questions. We analyze over 300,000 patients – over an eleven-year period – who suffer from diabetes, a chronic condition, and show evidence of mental illness. We use an empirical approach to quantify the relationship between colocation and four key outcomes attributable to mental illness: hospitalizations, length of stay (LOS), 30-day readmissions, and suicidal behavior. We find that colocation is associated with improvement in outcomes. For example, a one standard deviation increase in the mean colocation measure is related to a 2.4% decrease in LOS – equivalent to an annual savings of approximately $1.5 million, on average, just for our cohort. In addition, we find that colocation and CoC are substitutes, in that colocation benefits patients whose care is fragmented. Further, we find that colocation offers greater benefits to patients whose mental health conditions are more severe. Finally, our analysis reveals that colocation improves outcomes (partially) through a reduction in the no-show rate and an increase in medication adherence. Our findings are validated by extensive robustness checks and sensitivity analyses. Our study has implications for both the theory and practice of healthcare operations. Theoretically, we advance the location literature, establish its connection with the continuity literature, and highlight key moderators and mediators in the colocation-outcomes relationship. Practically, our work offers insights into how to design an operationally efficient system and, in settings with limited resources, where to target colocation. Our study is particularly timely as it may help address the growing mental health crisis in America and around the world, further exacerbated during the COVID-19 pandemic.

The nursing profession in the United States was experiencing a labor shortage and facing diversity and inclusion challenges prior to the COVID-19 pandemic. Magnifying these problems was a shift in the nation’s population, both geographically and demographically. The result was changes in both where nurses are needed in the healthcare system and the nursing skill set required to address healthcare needs of a far more diverse clientele of patients—in terms of race, ethnicity, sex, gender identity, age, living arrangements, socioeconomic status and primary language.

Join the Center for the Business of Health virtually as they discuss the complexity of the healthcare ecosystem and how innovation and interconnectivity are necessary to build a more robust and flexible system.

The global COVID-19 pandemic has been a recurring theme throughout the 2020 U.S. elections, and its health and economic consequences will be felt far beyond November 3. In this Kenan Insight, we look at both the challenges and potential opportunities the pandemic has created for accelerating innovations in healthcare delivery and pharmaceutical development.

The global COVID-19 pandemic has been a recurring theme throughout the 2020 U.S. elections, and its health and economic consequences will be felt far beyond November 3. In this Kenan Insight, we look at both the challenges and potential opportunities the pandemic has created for accelerating innovations in healthcare delivery and pharmaceutical development.

The staffing of parallel servers in a queue has interested operations researchers for decades, resulting in countless mathematical models studying queuing behavior. But to achieve tractability, these models typically assume the service rate and productivity of individual servers is independent of other servers and the status of the system. We question this assumption and consider whether inter-server dependence impacts queue performance, specifically through server task selection.

The COVID-19 pandemic has exposed vulnerabilities in many supply chains, none more so than the healthcare supply chain. What factors have contributed to the alarming lack of readily available healthcare resources in the wake of overwhelming need? And what can be done to prevent such a disconnect from happening again? Professor Brad Staats, faculty director of the UNC Center for the Business of Health, and UNC Kenan-Flagler Business School Professor Jay Swaminathan present the findings of their most recent supply chain research in this week’s Kenan Insight.

A panel of experts convened by UNC Kenan-Flagler Business School and its affiliated Kenan Institute of Private Enterprise will be offering a press briefing via webinar on the effects of COVID-19 on the healthcare system, its providers and supply chains. Join tomorrow, Tuesday, April 14, at 11 a.m. EDT.

To help separate fact from fiction and legitimate concern from panic, the Kenan Institute of Private Enterprise and UNC Kenan-Flagler Business School convened six top faculty researchers to discuss the likely effects of the pandemic on business and the economy.

A slate of experts from UNC Kenan-Flagler Business School and its affiliated Kenan Institute of Private Enterprise will be offering a press briefing via teleconference on the tremendous effects of COVID-19 on business, workers and the economy at large. Join tomorrow, Tuesday, March 17, at 11 a.m.

The conference, hosted by the Center for the Business of Health, the Kenan-Flagler Healthcare Club, and the Kenan Institute of Private Enterprise, attracted students, faculty and practitioners from all sectors of the healthcare system.