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
Enhanced coverage by integrating site interdependencies in capacitated EMS location models
AbstractIn order to allocate limited resources in emergency medical services (EMS) networks, mathematical models are used to select sites and their capacities. Many existing standard models are based on simplifying assumptions, including site independency and a similar system-wide busyness of ambulances. In practice, when a site is busy, a call is forwarded to another site. Thus, the busyness of each site depends not only on the rate of calls in the surrounding area, but also on interactions with other facilities. If the demand varies across the urban area, assuming an average system-wide server busy fraction may lead to a...
Source: Health Care Management Science - July 13, 2021 Category: Health Management Source Type: research
Beyond COVID-19 deaths during the COVID-19 pandemic in the United States
This study considers both COVID-19 deaths and non-COVID-19 deaths during a 39 weeks period beginning 1 March in both 2020 and averaged over the five years from 2015 to 2019. Across 22 age and gender cohorts, death risks are compared using odds ra tios. The results indicate that younger people (those under 15 years old) have experienced the same or a reduction in death risk between 2020 and the average from 2015 to 2019, suggesting that societal changes were protective for some of them. With all COVID-19 deaths removed from the 2020 death co unts, 15–64 year olds experienced increased death risk between 2020 and the 20...
Source: Health Care Management Science - June 30, 2021 Category: Hospital Management Source Type: research
Transforming COVID-19 vaccines into vaccination
AbstractAmid the prolonged COVID-19 pandemic, the miraculous breakthroughs of multiple effective and safe COVID-19 vaccines offer hopeful prospects. Yet, the endgame of the pandemic is not vaccines; it is vaccination. The daunting challenge of vaccinating the world offers ample investigative opportunities for management scientists who are interested in improving the efficiency and equity of vaccine supply chains. In this article, we provide a brief overview of these opportunities through three constituent parts: (1) supply, (2) demand, and (3) matching supply with demand. (Source: Health Care Management Science)
Source: Health Care Management Science - June 16, 2021 Category: Health Management Source Type: research
A case for location based contact tracing
We present an evaluation of the effectiveness of manual contact tracing compared to bulletin board contact tracing. Classical contact tracing relies on reaching individuals who have been in proximity to an infectious person. A bulletin board approach focuses on identifying locations visited by an infectious person, and then contacting those who were at those locations. We present results comparing their effects on the overall reproductive number as well as the incidence and prevalence of disease. We evaluate them by building a new agent based simulation (ABS) model using the Susceptible Exposed Infectious and Recovered (SE...
Source: Health Care Management Science - June 16, 2021 Category: Health Management Source Type: research
Introduction to the special issue: Management Science in the Fight Against Covid-19
(Source: Health Care Management Science)
Source: Health Care Management Science - June 15, 2021 Category: Health Management Source Type: research
Managing admission and discharge processes in intensive care units
AbstractThe intensive care unit (ICU) is one of the most crucial and expensive resources in a health care system. While high fixed costs usually lead to tight capacities, shortages have severe consequences. Thus, various challenging issues exist: When should an ICU admit or reject arriving patients in general? Should ICUs always be able to admit critical patients or rather focus on high utilization? On an operational level, both admission control of arriving patients and demand-driven early discharge of currently residing patients are decision variables and should be considered simultaneously. This paper discusses the trad...
Source: Health Care Management Science - June 10, 2021 Category: Hospital Management Source Type: research
Patients, primary care, and policy: Agent-based simulation modeling for health care decision support
AbstractPrimary care systems are a cornerstone of universally accessible health care. The planning, analysis, and adaptation of primary care systems is a highly non-trivial problem due to the systems ’ inherent complexity, unforeseen future events, and scarcity of data. To support the search for solutions, this paper introduces the hybrid agent-based simulation model SiM-Care. SiM-Care models and tracks the micro-interactions of patients and primary care physicians on an individual level. At t he same time, it models the progression of time via the discrete-event paradigm. Thereby, it enables modelers to analyze multiple...
Source: Health Care Management Science - May 25, 2021 Category: Hospital Management Source Type: research
Correction to: Repeat SARS-CoV-2 testing models for residential college populations
A Correction to this paper has been published:https://doi.org/10.1007/s10729-021-09568-y (Source: Health Care Management Science)
Source: Health Care Management Science - May 25, 2021 Category: Health Management Source Type: research
Leveraging electronic health record data to inform hospital resource management
AbstractEarly identification of resource needs is instrumental in promoting efficient hospital resource management. Hospital information systems, and electronic health records (EHR) in particular, collect valuable demographic and clinical patient data from the moment patients are admitted, which can help predict expected resource needs in early stages of patient episodes. To this end, this article proposes a data mining methodology to systematically obtain predictions for relevant managerial variables by leveraging structured EHR data. Specifically, these managerial variables are: i) Diagnosis categories, ii) procedure cod...
Source: Health Care Management Science - May 24, 2021 Category: Health Management Source Type: research
Acknowledgement to Reviewers and Editors (2020)
(Source: Health Care Management Science)
Source: Health Care Management Science - May 15, 2021 Category: Health Management Source Type: research
How hospitals can improve their public quality metrics: a decision-theoretic model
AbstractThe public reporting of hospitals ’ quality of care is providing additional motivation for hospitals to deliver high-quality patient care. Hospital Compare, a consumer-oriented website by the Centers for Medicare and Medicaid Services (CMS), provides patients with detailed quality of care data on most US hospitals. Given that many quality metrics are the aggregate result of physicians’ individual clinical decisions, the question arises if and how hospitals could influence their physicians so that their decisions positively contribute to hospitals’ quality goals. In this paper, we develop a decision-theoretic ...
Source: Health Care Management Science - May 15, 2021 Category: Health Management Source Type: research
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 - May 15, 2021 Category: Health Management Source Type: research
Predicting rapid progression phases in glaucoma using a soft voting ensemble classifier exploiting Kalman filtering
AbstractIn managing patients with chronic diseases, such as open angle glaucoma (OAG), the case treated in this paper, medical tests capture the disease phase (e.g. regression, stability, progression, etc.) the patient is currently in. When medical tests have low residual variability (e.g. empirical difference between the patient ’s true and recorded value is small) they can effectively, without the use of sophisticated methods, identify the patient’s current disease phase; however, when medical tests have moderate to high residual variability this may not be the case. This paper presents a framework for handling the l...
Source: Health Care Management Science - May 13, 2021 Category: Hospital Management Source Type: research
A multi-stage stochastic programming approach to epidemic resource allocation with equity considerations
In this study, we address this core limitation by presenting a multi-stage stochastic programming compartmental model, which integrates the uncertain disease progression and resource allocation to control an infectious disease outbreak. The proposed multi-stage stochastic program involves various disease growth scenarios and optimizes the distribution of treatment centers and resources while minimizing the total expected number of new infections and funerals. We define two new equity metrics, namely infection and capacity equity, and explicitly consider equity for allocating treatment funds and facilities over multiple tim...
Source: Health Care Management Science - May 10, 2021 Category: Hospital Management Source Type: research
