Agent-based evolving network modeling: a new simulation method for modeling low prevalence infectious diseases
We present a new simulation technique, agent-basedevolving network modeling (ABENM), which includes a new network generation algorithm, Evolving Contact Network Algorithm (ECNA), for generating scale-free networks. ABENM simulates only infected persons and their immediate contacts at the individual-level as agents of the simulation, and uses the ECNA for generating the contact structures between these individuals. All other susceptible persons are modeled using a compartmental modeling structure. Thus, ABENM has a hybrid agent-based and compartmental modeling structure. The ECNA uses concepts from graph theory for generati...
Source: Health Care Management Science - September 1, 2021 Category: Hospital Management Source Type: research
Optimal patient protocols in regional acute stroke care
We describe acute stroke care as a multi-flow two-level hierarchical facility location problem and the model is formulated as a mixed integer linear program. The objective of the model is the minimization of the total time until treatment in a region and it incorporates volume-dependent in-hospital delays. The resulting model is used to gain insight in the performance of practically oriented patient allocation protocols, used by EMS. We observe that the protocol of directly driving to the nearest stroke centre with s pecial facilities (i.e., the mothership protocol) performs closest to optimal, with an average total time d...
Source: Health Care Management Science - September 1, 2021 Category: Hospital Management Source Type: research
The effect of correlation and false negatives in pool testing strategies for COVID-19
AbstractDuring the current COVID-19 pandemic, active testing has risen as a key component of many response strategies around the globe. Such strategies have a common denominator: the limited availability of diagnostic tests. In this context, pool testing strategies have emerged as a means to increase testing capacity. The efficiency gains obtained by using pool testing, derived from testing combined samples simultaneously, vary according to the spread of the SARS-CoV-2 virus in the population being tested. Motivated by the need for testing closed populations, such as long-term care facilities (LTCFs), where significant cor...
Source: Health Care Management Science - August 28, 2021 Category: Hospital Management Source Type: research
A two-stage robust optimization approach for the master surgical schedule problem under uncertainty considering downstream resources
AbstractThis paper addresses a planning decision for operating rooms (ORs) that aim at supporting hospital management. Focusing on elective patients, we determined the master surgical schedule (MSS) on a one-week time horizon. We assigned the specialties to available sessions and allocated surgeries to them while taking into consideration the priorities of the outpatients in the ambulatory surgical discipline. Surgeries were selected from the waiting lists according to their priorities. The proposed approach considered operating theater (OT) restrictions, patients ’ priorities and accounted for the availability of both i...
Source: Health Care Management Science - August 21, 2021 Category: Hospital Management Source Type: research
The Waiting Game – How Cooperation Between Public and Private Hospitals Can Help Reduce Waiting Lists
AbstractProlonged waiting to access health care is a primary concern for nations aiming for comprehensive effective care, due to its adverse effects on mortality, quality of life, and government approval. Here, we propose two novel bargaining frameworks to reduce waiting lists in two-tier health care systems with local and regional actors. In particular, we assess the impact of 1) trading patients on waiting lists among hospitals, the 2) introduction of the role of private hospitals in capturing unfulfilled demand, and the 3) hospitals ’ willingness to share capacity on the system performance. We calibrated our models wi...
Source: Health Care Management Science - August 17, 2021 Category: Hospital Management Source Type: research
Identification of predictors and model for predicting prolonged length of stay in dengue patients
Conclusion: Our findings demonstrated that the logistic regression with elastic-net was the best fit with an AUC of 0.75 and there is a significant association betwee n LOS greater than five days and identified patient-specific variables. This method can identify the patients at highest risks and help focus time and resources. (Source: Health Care Management Science)
Source: Health Care Management Science - August 14, 2021 Category: Hospital Management Source Type: research
Dynamic multistage scheduling for patient-centered care plans
AbstractWe investigate the scheduling practices of multistage outpatient health programs that offer care plans customized to the needs of their patients. We formulate the scheduling problem as a Markov decision process (MDP) where patients can reschedule their appointment, may fail to show up, and may become ineligible. The MDP has an exponentially large state space and thus, we introduce a linear approximation to the value function. We then formulate an approximate dynamic program (ADP) and implement a dual variable aggregation procedure. This reduces the size of the ADP while still producing dual cost estimates that can ...
Source: Health Care Management Science - August 10, 2021 Category: Hospital Management Source Type: research
Point-of-use hospital inventory management with inaccurate usage capture
AbstractMany hospital supply chains in the US follow a “stockless” structure, often implemented with the acquisition of new systems promising improved efficiencies and responsiveness. Despite vendor promises, supply chain gains from new technology are often unfulfilled or result in a reduction of performance. A critical component of achieving promis ed gains is the hospital’s ability to accurately and consistently capture hospital inventory use. In practice, recording demand with perfect, 100% accuracy is infeasible, so our models condition on the level of accuracy in a particular hospital department, or point-of-use...
Source: Health Care Management Science - August 6, 2021 Category: Hospital Management Source Type: research
Optimizing diabetes screening frequencies for at-risk groups
AbstractThere is strong evidence that diabetes is underdiagnosed in the US: the Centers for Disease Control and Prevention (CDC) estimates that approximately 25% of diabetic patients are unaware of their condition. To encourage timely diagnosis of at-risk patients, we develop screening guidelines stratified by body mass index (BMI), age, and prior test history by using a Partially Observed Markov Decision Process (POMDP) framework to provide more personalized screening frequency recommendations. We identify structural results that prove the existence of threshold solutions in our problem and allow us to determine the relat...
Source: Health Care Management Science - August 6, 2021 Category: Hospital Management Source Type: research
Point-of-use hospital inventory management with inaccurate usage capture
AbstractMany hospital supply chains in the US follow a “stockless” structure, often implemented with the acquisition of new systems promising improved efficiencies and responsiveness. Despite vendor promises, supply chain gains from new technology are often unfulfilled or result in a reduction of performance. A critical component of achieving promis ed gains is the hospital’s ability to accurately and consistently capture hospital inventory use. In practice, recording demand with perfect, 100% accuracy is infeasible, so our models condition on the level of accuracy in a particular hospital department, or point-of-use...
Source: Health Care Management Science - August 6, 2021 Category: Hospital Management Source Type: research
