Hospitals across the country struggled to deliver intensive care services in the context of increasing demand due to pandemic. Over 20% of the hospitals in the country reported over 95% ICU bed utilization and capacities at other hospitals were not very different. Hospital systems and individual hospitals adopted a variety of mechanisms including service innovation, engagement in health information exchange, and management of personal protection equipment (PPE) inventories. After the availability of vaccines, the distribution channel for these vaccines brought up additional challenges with managing the administration and inventories of vaccines. This dissertation is structured into three essays to address these aspects.When the pandemic started, healthcare practitioners struggled with uncertainties regarding the choice of correct treatment procedures and understanding the factors that determine the outcomes of such procedures. In the first essay, we consider the impact of health systems' choice of adopting service innovation in the form of convalescent plasma therapy (CPT), their participation in community-based health information exchanges, and the geographical proximity of affiliated hospitals on their ability to lower ICU bed utilization. A health system level panel dataset is carefully compiled, and a difference-in-difference analysis has been used to inform this research investigation. We found that adoption of service innovation (CPT) may help health systems to marginally decrease bed utilization. However, such benefit strengthens when these systems participate in a community HIE. Interestingly, our study finds that when a health system adopts CPT, proximity of affiliated hospitals increases the health system's intensive care bed utilization. The findings offer important theoretical and managerial implications for managing health care capacities in the context of a pandemic.During a pandemic, availability of vaccines is critical to combat adverse health consequences. Second phase of the pandemic journey began when the vaccine distribution formally started in the country on December 14th, 2020, and, eventually, the policymakers scaled up the last-mile vaccine distribution to increase vaccine access to wider population. Vaccines are administered in facilities that differ in their capacity and the level of access, such as hospitals, local health departments, community clinics, medical practices, and pharmacies. New facilities are introduced over a course of time to provide the requisite capacity for vaccination. The second essay examines how additions of such new facilities in a region impact the number of vaccines administered by existing facilities in that region. The essay also investigates the impact of the proximity of a vaccine provider to a vaccine hub on the number of vaccines administered by the provider. A quasi-experimental difference-in-difference set up involving a unique panel data of 1627 vaccine providers in Texas over a period of 30 days is used to analyze the data. Our results provide guidance to policy makers with the process of scaling the vaccine administration infrastructure during a pandemic. Our results seem to suggest that addition of new vaccine providers contributes to the vaccination rates of existing providers in an area. We find that more accessible providers such as pharmacies tend to distribute more vaccines in the population with the burgeoning vaccine provider ecosystem as compared to their less accessible peers. These findings offer some important theoretical and policy implications regarding how vaccine distribution should be scaled to effectively combat the pandemic.As we moved past the first and second phase of the pandemic, the supply of medical and personal protection equipment (PPE) began to stabilize. However, bigger hospitals in the areas of higher COVID-19 cases started bulking up their PPE inventory in the anticipation of uncertain future demand. The biggest healthcare supply chain concern is that the health systems may need to write off the excess inventory in case the demand never materialized, which entails higher inventory management costs and higher opportunity costs for the hospitals in need for PPE. In the third essay, we look beyond health systems and examine how higher hospital bed occupancy increases PPE inventory levels. Further, based on our interviews with both supply chain and clinical professionals across several health systems, we investigate the effectiveness of the creation of the isolation wards in controlling the demand for PPE while informing on the trade-offs in hospital capacity management and clinical care. We conducted experiments using empirically grounded agent-based model of a typical Midwestern hospital operations during the recent pandemic to propose a framework that will help the hospitals to choose the right configuration of isolation wards to prevent bulking up on PPE inventory while maintaining high quality of clinical service to the community.
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