Carson, AnitaShirahatti, Ankita2025-05-232025-05-232025https://hdl.handle.net/2144/504852025This dissertation investigates two primary factors contributing to the underperformance of Equity Quality (EQ) among safety-net hospitals. In the initial section of this research, I conduct an analysis of EQ scores for hospitals in Massachusetts between 2013 and 2020 to formally examine whether safety-net institutions are affected by a halo/horn effect, wherein survey respondents disproportionately assign lower ratings to hospitals solely due to their safety-net status. By utilizing a public-payer mix threshold that determines hospital eligibility for uncompensated care subsidies and employing a regression discontinuity methodology, I discover evidence of a horn effect impacting safety-net institutions. In the subsequent section, I leverage a novel dataset of patient experience – specifically, online hospital text reviews – to develop seven innovative EQ metrics that are not formally measured by the Centers for Medicare & Medicaid Services but hold significant relevance to the service experiences of safety-net patients. I then investigate the influence of these metrics on hospital ratings and demand, demonstrating that by harnessing textual information, healthcare providers and policymakers can derive valuable operational metrics to enhance their understanding of patient experiences in safety-net environments. In the final section, I address the trade-offs between quality and speed in drug development within the United States. Employing an organizational learning framework, I examine how partnerships with a focus on disease conditions that disproportionately affect minority populations can assist trial sponsors in navigating this substantial trade-off.en-USOperations researchManagementHealth care managementThesis/Dissertation2025-05-21