New developments for the journal in 2020
(Source: Health Care Management Science)
Source: Health Care Management Science - November 4, 2020 Category: Health Management Source Type: research
Aligning SARS-CoV-2 indicators via an epidemic model: application to hospital admissions and RNA detection in sewage sludge
AbstractAscertaining the state of coronavirus outbreaks is crucial for public health decision-making. Absent repeated representative viral test samples in the population, public health officials and researchers alike have relied on lagging indicators of infection to make inferences about the direction of the outbreak and attendant policy decisions. Recently researchers have shown that SARS-CoV-2 RNA can be detected in municipal sewage sludge with measured RNA concentrations rising and falling suggestively in the shape of an epidemic curve while providing an earlier signal of infection than hospital admissions data. The pre...
Source: Health Care Management Science - October 28, 2020 Category: Health Management Source Type: research
Scheduling patient appointment in an infusion center: a mixed integer robust optimization approach
AbstractInfusion centers are experiencing greater demand, resulting in long patient wait times. The duration of chemotherapy treatment sessions often varies, and this uncertainty also contributes to longer patient wait times and to staff overtime, if not managed properly. The impact of such long wait times can be significant for cancer patients due to their physical and emotional vulnerability. In this paper, a mixed integer programming infusion appointment scheduling (IAS) mathematical model is developed based on patient appointment data, obtained from a cancer center of an academic hospital in Central Virginia. This mode...
Source: Health Care Management Science - October 12, 2020 Category: Health Management Source Type: research
Personalized treatment for coronary artery disease patients: a machine learning approach
AbstractCurrent clinical practice guidelines for managing Coronary Artery Disease (CAD) account for general cardiovascular risk factors. However, they do not present a framework that considers personalized patient-specific characteristics. Using the electronic health records of 21,460 patients, we created data-driven models for personalized CAD management that significantly improve health outcomes relative to the standard of care. We develop binary classifiers to detect whether a patient will experience an adverse event due to CAD within a 10-year time frame. Combining the patients ’ medical history and clinical examinat...
Source: Health Care Management Science - October 10, 2020 Category: Hospital Management Source Type: research
Predicting and improving patient-level antibiotic adherence
AbstractLow adherence to prescribed medications causes substantial health and economic burden. We analyzed primary data from electronic medical records of 250,000 random patients from Israel ’s Maccabi Healthcare services from 2007 to 2017 to predict whether a patient will purchase a prescribed antibiotic. We developed a decision model to evaluate whether an intervention to improve purchasing adherence is warranted for the patient, considering the cost of the intervention and the cost of non-adherence. The best performing prediction model achieved an average area under the receiver operating characteristic curve (AUC) of...
Source: Health Care Management Science - October 4, 2020 Category: Health Management Source Type: research
Markov chain analysis for the neonatal inpatient flow in a hospital
AbstractDiscrete-time Markov chain and queueing-theoretic models are used to quantitatively formulate the flow of neonatal inpatients over several wards in a hospital. Parameters of the models are determined from the operational analysis of the record of the numbers of admission/departure for each ward every day and the order log of patient movement from ward to ward for two years provided by the Medical Information Department of the University of Tsukuba Hospital in Japan. Our formulation is based on the analysis of the precise routes (the route of an inpatient is defined as a sequence of the wards in which he/she stays f...
Source: Health Care Management Science - September 29, 2020 Category: Health Management Source Type: research
A Markov chain model for analysis of physician workflow in primary care clinics
AbstractThis paper studies physician workflow management in primary care clinics using terminating Markov chain models. The physician workload is characterized by face-to-face encounters with patients and documentation of electronic health record (EHR) data. Three workflow management policies are considered: preemptive priority (stop ongoing documentation tasks if a new patient arrives); non-preemptive priority (finish ongoing documentation even if a new patient arrives); and batch documentation (start and finish documentation when the desired number of tasks is reached). Analytical formulas are derived to quantify the per...
Source: Health Care Management Science - September 21, 2020 Category: Hospital Management Source Type: research
Monitoring of high-yield and periodical processes in health care
AbstractStatistical control charts have found valuable applications in health care, having been largely adopted from operations research in manufacturing. However, the most common types are not best-suited to monitor high-yield processes (outcomes comprising true/false fractions, ‘near-zero’) and periodical processes (characterized by sequences of single populations of finite sizes), but rather to monitor variable vital signs levels and, to a lesser degree, service performance indicators. We discuss control charts that are most suitable for fraction non-conforming measur ements. We focus particularly on high-yield and ...
Source: Health Care Management Science - September 17, 2020 Category: Health Management Source Type: research
Modeling patients as decision making units: evaluating the efficiency of kidney transplantation through data envelopment analysis
AbstractThe main applications of Data Envelopment Analysis (DEA) to medicine focus on evaluating the efficiency of different health structures, hospitals and departments within them. The evolution of patients after undergoing a medical procedure or their response to a given treatment are not generally studied through this programming technique. In addition to the difficulty inherent to the collection of this type of data, the use of a technique that is mainly applied to evaluate the efficiency of decision making units representing industrial and production structures to analyze the evolution of human patients may seem inap...
Source: Health Care Management Science - September 17, 2020 Category: Health Management Source Type: research
Association between leniency of anesthesiologists when evaluating certified registered nurse anesthetists and when evaluating didactic lectures
AbstractDaily evaluations of certified registered nurse anesthetists ’ (CRNAs’) work habits by anesthesiologists should be adjusted for rater leniency. The current study tested the hypothesis that there is a pairwise association by rater between leniencies of evaluations of CRNAs’ daily work habits and of didactic lectures. The historical cohorts were anesthesi ologists’ evaluations over 53 months of CRNAs’ daily work habits and 65 months of didactic lectures by visiting professors and faculty. The binary endpoints were the Likert scale scores for all 6 and 10 items, respectively, equaling the maximums of 5 for...
Source: Health Care Management Science - September 17, 2020 Category: Health Management Source Type: research
Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market
This study therefore aims to investigate the relationship between hospitals’ urgency characteristics and their efficiency. Our analyses are based on 4094 observations from 1428 hospitals throughout Germany for the years 2015, 2 016, and 2017. We calculate an average urgency score for each hospital based on all cases treated in that hospital per year and also investigate the within-hospital dispersion of medical urgency. To analyze the association of these urgency measures with hospitals’ efficiency we use a two-stage dou ble bootstrap data envelopment analysis approach with truncated regression. We find a negative rela...
Source: Health Care Management Science - September 15, 2020 Category: Health Management Source Type: research
Are patients more adherent to newer drugs?
In this study, we perform cross-sectional retrospective analyses to study whether patients who use newer drugs are more adherent to pharmacotherapy than patients using older drugs within the same therapeutic class, accounting for unobserved heterogeneity at the individual level (e.g. healthy adherer bias). We use US Marketscan commercial claims and encounters data for 2008 –2013 on patients initiating therapy for five chronic conditions. Productivity is captured by a drug’s earliest Food and Drug Administration (FDA) approval year (“drug vintage”) and by FDA” therapeutic potential” designation. We control for s...
Source: Health Care Management Science - August 7, 2020 Category: Health Management Source Type: research
Optimal cost adjustment for a selfish routing healthcare network
This study p roposes methods that can help direct patient flows in a desirable direction and suggests ways to effectively manage the cost of healthcare. The study also discusses how selfish patients act in ways that maximize their benefits by choosing a specific hospital and in turn forcing the hospital and the healthcare network to bear more costs than is necessary. The study proposes a model describing the need for intervention from the government to control the cost escalation resulting from selfish routing. The study proposes two heuristic algorithms to solve the suggested model. The flow-based algorit hm addresses the...
Source: Health Care Management Science - August 7, 2020 Category: Health Management Source Type: research
Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case
AbstractEnsuring regular and timely access to efficient and quality health services reduces the risk of maternal mortality. Specifically, improving technical efficiency (TE) can result in improved health outcomes. To date, no studies in Mexico have explored the connection of TE with either the production of maternal health services at the primary-care level or the maternal-mortality ratio (MMR) in populations without social security coverage. The present study combined data envelopment analysis (DEA), longitudinal data and selection bias correction methods with the purpose of obtaining original evidence on the impact of TE...
Source: Health Care Management Science - July 26, 2020 Category: Hospital Management Source Type: research
A heuristic approach to the task planning problem in a home care business
AbstractIn this paper, we study a task scheduling problem in a home care business. The company has a set of supervisors in charge of scheduling the caregivers ’ weekly plans. This can be a time-consuming task due to the large number of services they work with, as well as the need to consider user preferences, services required time windows and travel times between users’ homes. Apart from that, it is also important to have a continuity of care, i.e., that users generally prefer not to have their caregiver changed. This problem involves both route planning and employee task planning, which are usually very challenging. ...
Source: Health Care Management Science - July 24, 2020 Category: Hospital Management Source Type: research
