Mitigating the curse of complexity: The role of focus and the implications for costs of care

Abstract

There has been a resurgence of interest in the role of operational focus in the healthcare operations literature in the backdrop of increasing demand for efficient and effective care. However, the evidence on the benefits of focus in healthcare is mixed. Our study proposes that a key piece of this puzzle that is been largely missing is an explicit consideration of the complexity of patient care needs. Specifically, our study serves to answer the questions: How does the complexity of care requirements affect care delivery operations? How does focus across the hierarchical levels of care affect care delivery outcomes across complexity regimes? The empirical analysis in the study is based on a large generalizable dataset of 246,663 patient discharges across 26 categories at 154 hospitals. We develop a multi-factor measure of complexity of care requirements. The study results point to the deleterious impact of complexity on the costs of care. Next, our findings highlight the differential impact of focus across hierarchical levels (task-level focus, category-level focus, and selective focus in related areas) on the costs of care. Third, our study findings highlight the role of focus in mitigating the effects of complexity on costs in a healthcare setting. We discuss the implications of the study findings for theory and practice, and the directions for future research.