Yu-Chu Shen, Ph.D.

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September 1, 2009

Yu-Chu Shen, Ph.D., is an associate professor of economics in the Graduate School of Business and Public Policy at the Naval Postgraduate School. Dr. Shen's research focuses on health economics and policy issues including organizational changes and financial incentives in health care markets, the dynamics of the managed care industry, hospital ownership, public health capacity, access to care for vulnerable populations, and disparities in health care and health insurance.

Dr. Shen received a Ph.D. in health policy with a concentration in economics and an A.B. in applied mathematics from Harvard University. In addition to her appointment at the Naval Postgraduate School, she is a faculty research fellow at the National Bureau of Economic Research. Prior to joining the Naval Postgraduate School in 2004, Dr. Shen was a research associate at the Urban Institute's Health Policy Center.

Dr. Shen is currently the principal investigator of the HCFO-sponsored grant, “Effect of Decreased Emergency Department Access on Patient Outcomes." The researchers are examining whether decreased emergency department (ED) access results in adverse patient outcomes or changes in other health indicators. The population of interest is acute myocardial infarction (AMI) patients, a relatively homogenous patient population who would be most likely affected by changes in emergency department availability. Using data from the American Hospital Association annual surveys and hospital cost reports from the Centers for Medicare and Medicaid Services, the researchers are analyzing how permanent and temporary changes in ED access (as measured by ED closures and ambulance diversion times) between 1996 and 2005 affect the mortality rates and other health indicators for AMI patients.

As part of the grant, Dr. Shen and colleagues are examining whether access to ED and trauma centers has deteriorated during the study period and whether deterioration is more likely to happen to some vulnerable populations than others. “Our preliminary findings suggest that low-income communities (both urban and rural) and urban communities with a higher share of African-Americans and Hispanics face worse deterioration in access than other communities, as measured by increased driving time to the closest ED or trauma center,” states Dr. Shen. Dr. Shen presented findings from this grant as a part of a panel titled “Hospital Responses to the Market and Regulatory Environment and Their Impact on the Community,” at the 2009 AcademyHealth Annual Research Meeting. To view the slides, please visit: www.academyhealth.org/files/2009/monday/sheny2.pdf.

Dr. Shen was the co-principal investigator on two other HCFO-sponsored grants. The first, with Glenn Melnick, Ph.D., titled “The Effects of Health Plan Concentration on Hospital Prices, Costs, Capacity, Charity Care, and Outcomes,” examined the effects of HMO market structure on hospital cost and revenue. The researchers completed a retrospective study of all non-federal, short-term, acute care hospitals located in MSAs between 1994 and 2005. Three market aspects were considered in this study: HMO penetration, HMO concentration, and HMO for-profit share. The researchers found that HMO penetration had the strongest effect on hospital revenue, although the historical difference of lower spending in high HMO penetration markets compared to low HMO markets narrowed after 2000. In addition, the relative concentration between HMO and hospital markets can substantially influence hospital spending, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization.  Dr. Shen also presented the findings from this grant at the 2009 AcademyHealth Annual Research Meeting. To view the slides, please visit: www.academyhealth.org/files/2009/monday/shenyuchu.pdf.

Additionally, Dr. Shen was the co-principal investigator on a HCFO study with Karen Eggleston, Ph.D., titled “Hospital Ownership and Performance: An Integrative Research Review.” The researchers conducted a meta-analysis of empirical literature on hospital ownership to examine its effect on health care providers and health plan performance. The researchers found that the impact of hospital ownership varied considerably among these studies, which can be explained by their differences in research focus and methodology. They also found that most studies showed no significant difference between the quality of care in for-profit and nonprofit hospitals. Additional information on the findings of this study can be found in the HCFO Findings Brief  "The Impact of Hospital Ownership: Looking for Consistency Among Conflicting Findings.”

For more information about Dr. Shen and her research, please visit http://research.nps.edu/cgi-bin/vita.cgi?p=display_vita&id=1100543058.