College of Health Professions
Permanent URI for this collectionhttps://hdl.handle.net/10877/17051
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Browsing College of Health Professions by Author "Beauvais, Bradley"
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Item A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses(Multidisciplinary Digital Publishing Institute, 2020-04) Fulton, Lawrence V.; Beauvais, Bradley; Brooks, Matthew; Kruse, Clemens S.; Lee, KimberlyA major consideration for consumers and the residential construction industry is the cost–benefit and break-even of various sustainable construction options. This research provides a publicly available simulation that allows users to compare baseline construction options versus sustainable options and evaluates both break-even costs as well as environmental effects. This R Shiny Monte Carlo simulation uses common pseudo-random number streams for replicability and includes options for solar, rainwater harvesting, wells, Icynene foam, engineered lumber, Energy Star windows and doors, low flow fixtures, aerobic/non-aerobic/city waste treatment, electric versus gasoline vehicles, and many other options. This is the first simulation to quantify multiple sustainable construction options, associated break-even points, and environmental considerations for public use.Using user default parameters, coupled with a 100% solar solution for a baseline 3000 square foot/279square meter house with 2 occupants results in a break-even of 9 years. Results show that many of the sustainable options are both green for the environment and green for the pocketbook.Item Sustainable Residential Building Considerations for Rural Areas: A Case Study(Multidisciplinary Digital Publishing Institute, 2020-05) Fulton, Lawrence V.; Beauvais, Bradley; Brooks, Matthew; Kruse, Clemens S.; Lee, KimberlyIntelligent use of rural residential land and sustainable construction is inexorably linked to cost; however, options exist that are eco-friendly and have a positive return on investment. In 2011, a research residence was built to evaluate various land-use and sustainable components. This Texas house has subsequently been used for both residential and research purposes. The purpose of this case study was to evaluate break-even construction considerations, to assess environmental impacts, and to evaluate qualitatively efficacy of sustainable options incorporated in the research residence. Some of the specific components discussed are home site placement (directional positioning); materiel acquisition (transportation); wood product minimization; rainwater harvesting; wastewater management; grid-tied solar array power; electric car charging via a solar array; geothermal heating and cooling; insulation selection; windows, fixtures, and appliance selection; and on-demand electric water heaters for guest areas. This study seeks to identify the impact of proper land use and sustainable techniques on the environment and return-on-investment in rural areas. Break-even and 15-year Net Present Value (NPV) analysis at 3% and 5% cost of capital were used to evaluate traditional construction, partially sustainable construction, and fully sustainable construction options for the case study house, which was built sustainably. The additional cost of sustainable construction is estimated at $54,329. At 3%, the analysis suggests a 15-year NPV of $334,355 (traditional) versus $250,339 million (sustainable) for a difference of $84K. At 5% cost of capital, that difference falls to $63K. The total estimated annual difference in carbon emissions is 4.326 million g/CO2e for this research residence. The results indicate that good choices for quick return-on-investment in rural construction would be the use of engineered lumber, Icynene foam, and Energy Star windows and doors. Medium-term options include photovoltaic systems (PVS) capable of powering the home and an electric car. Sustainable construction options should positively affect the environment and the pocketbook. Regulations and code should require adoption of short-range, break-even sustainable solutions in residential construction.Item Testing Kissick’s Iron Triangle—Structural Equation Modeling Analysis of a Practical Theory(Multidisciplinary Digital Publishing Institute, 12/18/2021) Beauvais, Bradley; Kruse, Clemens S.; Fulton, Lawrence V.; Brooks, Matthew; Mileski, Michael; Lee, Kimberly; Ramamonjiarivelo, Zo; Shanmugam, RamalingamBackground/Purpose: The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, while others have questioned the model, given the proliferation of quality-enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves. Methods: Structural equation modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare, a subscription site that contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n = 2766). Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases, costs increase, as access increases, quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.