Economics ETDs

Publication Date



This dissertation investigates three important issues in the US health care system: the low utilization of family-friendly policies by health care professionals, the sub-optimal quality of medical services, and the high level of emergency department (ED) expenditures. Chapter 2 uses a unique dataset from a choice experiment to address the first issue by exploring the impact of supervision support on the economic value of family-friendly policies. My results suggest that supervisors’ support for the use of family-friendly services significantly increase the economic value of the family-friendly benefits provided. Chapter 3 and 4 investigate the effectiveness of patient-centered care models in improving health outcomes, health care quality and reduce emergency department expenditures. Using six panels of the Medical Expenditure Panel Survey, I construct a multidimensional measure of patient-centered communication that integrates items related to cultural competency, coordinated care, shared decision-making, and patient-centeredness. The results reveal that patient-centered communication significantly increases patients’ likelihood to report a better physical or mental health, as well as health care quality. Furthermore, being foreign born, non-English proficient, with mental, social, or physical disability, all significantly decrease the risk of having enhanced access to care and patient-centered communication with medical provider. Finally, having an enhanced access to primary care and a patient-centered communication with primary care provider significantly reduces both ED use and expenditures. Estimated average reduction in ED expenditures attributed to a better access to primary care and a patient centered-communication varies from $1.180,53 to $1.191,89 per year per individual.

Degree Name


Level of Degree


Department Name

Department of Economics

First Committee Member (Chair)

Jennifer Thacher

Second Committee Member

Alok Bohara

Third Committee Member

Melissa Binder

Fourth Committee Member

Jose Pagan




family-friendly policies, discrete choice experiment, patient-centered communication, patient-centered care, emergency department expenditures, health outcomes, health care quality

Document Type


Included in

Economics Commons