Optimization-driven framework to understand health care network costs and resource allocation
AbstractIn the last several decades, the U.S. Health care industry has undergone a massive consolidation process that has resulted in the formation of large delivery networks. However, the integration of these networks into a unified operational system faces several challenges. Strategic problems, such as ensuring access, allocating resources and capacity efficiently, and defining case-mix in a multi-site network, require the correct modeling of network costs, network trade-offs, and operational constraints. Unfortunately, traditional practices related to cost accounting, specifically the allocation of overhead and labor c...
Source: Health Care Management Science - May 3, 2021 Category: Health Management Source Type: research
Prediction of personal protective equipment use in hospitals during COVID-19
AbstractDemand for Personal Protective Equipment (PPE) such as surgical masks, gloves, and gowns has increased significantly since the onset of the COVID-19 pandemic. In hospital settings, both medical staff and patients are required to wear PPE. As these facilities resume regular operations, staff will be required to wear PPE at all times while additional PPE will be mandated during medical procedures. This will put increased pressure on hospitals which have had problems predicting PPE usage and sourcing its supply. To meet this challenge, we propose an approach to predict demand for PPE. Specifically, we model the admiss...
Source: Health Care Management Science - April 12, 2021 Category: Health Management Source Type: research
An integer programming model to assign patients based on mental health impact for tele-psychotherapy intervention during the Covid –19 emergency
AbstractThe Covid –19 pandemic challenges healthcare systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and preven ts mental health disorders. Many countries are offering diverse and accessible services of tele-psychological intervention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis inte...
Source: Health Care Management Science - April 11, 2021 Category: Health Management Source Type: research
Balancing scarce hospital resources during the COVID-19 pandemic using discrete-event simulation
AbstractCOVID-19 has disrupted healthcare operations and resulted in large-scale cancellations of elective surgery. Hospitals throughout the world made life-altering resource allocation decisions and prioritised the care of COVID-19 patients. Without effective models to evaluate resource allocation strategies encompassing COVID-19 and non-COVID-19 care, hospitals face the risk of making sub-optimal local resource allocation decisions. A discrete-event-simulation model is proposed in this paper to describe COVID-19, elective surgery, and emergency surgery patient flows. COVID-19-specific patient flows and a surgical patient...
Source: Health Care Management Science - April 9, 2021 Category: Hospital Management Source Type: research
An integrated quality and resilience engineering framework in healthcare with Z-number data envelopment analysis
This study presents an integrated quality and resilience engineering (QRE) framework for evaluating medical equipment suppliers ’ performance using structural equation modeling andZ-number data envelopment analysis (Z-DEA). Noise analysis is used to select the bestα-cut for the Z-DEA model, and fuzzy data are used to handle uncertainties. We show that flexibility, conformance to standards, redundancy, cost, quality certifications, and delivery time significantly affect the medical equipment suppliers ’ performance. In addition, we demonstrate that the proposed integrated QRE framework is more efficient and informative...
Source: Health Care Management Science - April 9, 2021 Category: Health Management Source Type: research
Real-time forecasting of COVID-19 bed occupancy in wards and Intensive Care Units
AbstractThis paper presents a mathematical model that provides a real-time forecast of the number of COVID-19 patients admitted to the ward and the Intensive Care Unit (ICU) of a hospital based on the predicted inflow of patients, their Length of Stay (LoS) in both the ward and the ICU as well as transfer of patients between the ward and the ICU. The data required for this forecast is obtained directly from the hospital ’s data warehouse. The resulting algorithm is tested on data from the first COVID-19 peak in the Netherlands, showing that the forecast is very accurate. The forecast may be visualised in real-time in the...
Source: Health Care Management Science - March 25, 2021 Category: Health Management Source Type: research
Managing capacity for virtual and office appointments in chronic care
In this study, we build a capacity allocation model to study the use of virtual appointments in a chronic care setting. We consider a cohort of patients receiving chronic care and model the flow of the patients between office and virtual appointments using an open migration network. We formulate the planning of capacity needed for office and virtual appointments with a newsvendor model to maximize long-run average earnings. We consider differences in treatment and diagnosis effectiveness for office and virtual appointments. We derive optimal capacity allocation policies and implement numerical experiments. With the model d...
Source: Health Care Management Science - March 24, 2021 Category: Health Management Source Type: research
The development and deployment of a model for hospital-level COVID-19 associated patient demand intervals from consistent estimators (DICE)
We describe its development and deployment at an academic medical center in California during the ‘second wave’ of COVID-19 in the Unite States. We show that DICE is consistent under mild assumptions and suitable for use with perfect, biased and unbiased regional forecasts. We evaluate its performance on empirical data from a large academic medical center as well as on synthetic data. (Source: Health Care Management Science)
Source: Health Care Management Science - March 22, 2021 Category: Hospital Management Source Type: research
Using data envelopment analysis and the bootstrap method to evaluate organ transplantation efficiency in Brazil
This study aims to evaluate the efficiency of the Brazilian states and the Federal District in transforming potential organ donors into actual donations. We applied data envelopment analysis (DEA) in conjunction with the bootstrap technique, using organ transplantation data from 2018. The bootstrap methods applied (bootstrap technique, the bootstrap-biased scores of efficiency, and the bootstrap bias –corrected scores of efficiency) allow to obtain a confidence interval for DEA scores and provide greater robustness to studies based on DEA methodology. The bootstrap bias–corrected model indicates that there is significa...
Source: Health Care Management Science - March 17, 2021 Category: Health Management Source Type: research
Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
AbstractThe COVID-19 pandemic has prompted an international effort to develop and repurpose medications and procedures to effectively combat the disease. Several groups have focused on the potential treatment utility of angiotensin-converting –enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for hypertensive COVID-19 patients, with inconclusive evidence thus far. We couple electronic medical record (EMR) and registry data of 3,643 patients from Spain, Italy, Germany, Ecuador, and the US with a machine learning framewo rk to personalize the prescription of ACEIs and ARBs to hypertensive COVID-19 patients...
Source: Health Care Management Science - March 15, 2021 Category: Health Management Source Type: research
Optimal portfolios of blood safety interventions: test, defer or modify?
We present structural properties that reduce the state space and required computation time in certain cases, and we develop a linear approximation of the model. We apply the model to retrospectively evaluate U.S. blood safety policies for Zika and West Nile virus for the years 2017, 2018, and 2019, defining donor groups based on season and geography. We leverage structural properties to efficiently find an optimal solution. We find that the optimal portfolio varies geographically, seasonally, and over time. Additionally, we show that for this problem the approximated model yields the same optimal solution as the exact mode...
Source: Health Care Management Science - March 5, 2021 Category: Health Management Source Type: research
Assessing the efficiency of Malaysia health system in COVID-19 prevention and treatment response
The objective of this study was to investigate the relative efficiency level of managing COVID-19 in Malaysia using network data envelopment analysis. Malaysia state-level data were extracted from secondary data sources which include variables such as total number of confirmed cases, death cases and recovered cases. These variables were used as inputs and outputs in a network process that consists of 3 sub processes i) community surveillance, ii) medical care I and iii) medical care II. A state-level analysis was performed according to low, medium and high population density categories. The efficiency level of community su...
Source: Health Care Management Science - March 2, 2021 Category: Hospital Management Source Type: research
A predictive and prescriptive analytical framework for scheduling language medical interpreters
AbstractAlthough most hospitals in the United States provide medical services in English, a significant percentage of the U.S. population uses languages other than English. Mostly, the interpreting department in a hospital finds interpreters for limited English proficiency (LEP) patients, including inpatients, outpatients, and emergency patients. The department employs full-time and part-time interpreters to cover the demand of LEP patients. Two main challenges are facing an interpreting department: 1) there are many interpreting agencies in the market in which part-time interpreters can be chosen from. Selecting a part-ti...
Source: Health Care Management Science - February 24, 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 - February 23, 2021 Category: Health Management Source Type: research
From predictions to prescriptions: A data-driven response to COVID-19
AbstractThe COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at a steep economic price. We design analytical tools to support these decisions and combat the pandemic. Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. By leveraging cohort-level clinical data, patie...
Source: Health Care Management Science - February 15, 2021 Category: Health Management Source Type: research
