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Health Care Management Science

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https://www.readbyqxmd.com/read/29736901/bayesian-logistic-regression-approaches-to-predict-incorrect-drg-assignment
#1
Mani Suleiman, Haydar Demirhan, Leanne Boyd, Federico Girosi, Vural Aksakalli
Episodes of care involving similar diagnoses and treatments and requiring similar levels of resource utilisation are grouped to the same Diagnosis-Related Group (DRG). In jurisdictions which implement DRG based payment systems, DRGs are a major determinant of funding for inpatient care. Hence, service providers often dedicate auditing staff to the task of checking that episodes have been coded to the correct DRG. The use of statistical models to estimate an episode's probability of DRG error can significantly improve the efficiency of clinical coding audits...
May 7, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29725895/the-self-regulating-nature-of-occupancy-in-icus-stochastic-homoeostasis
#2
Josephine Varney, Nigel Bean, Mark Mackay
As pressure on the health system grows, intensive care units (ICUs) are increasingly operating close to their capacity. This has led a number of authors to describe a link between admission and discharge behaviours, labelled variously as: 'bumping', 'demand-driven discharge', 'premature discharge' etc. These labels all describe the situation that arises when a patient is discharged to make room for the more acute arriving patient. This link between the admission and discharge behaviours, and other potential occupancy-management behaviours, can create a correlation between the arrival process and LOS distribution...
May 3, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29725894/a-study-on-the-impact-of-prioritising-emergency-department-arrivals-on-the-patient-waiting-time
#3
Ellen Van Bockstal, Broos Maenhout
In the past decade, the crowding of the emergency department has gained considerable attention of researchers as the number of medical service providers is typically insufficient to fulfil the demand for emergency care. In this paper, we solve the stochastic emergency department workforce planning problem and consider the planning of nurses and physicians simultaneously for a real-life case study in Belgium. We study the patient arrival pattern of the emergency department in depth and consider different patient acuity classes by disaggregating the arrival pattern...
May 3, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29717401/modelling-mortality-and-discharge-of-hospitalized-stroke-patients-using-a-phase-type-recovery-model
#4
Bruce Jones, Sally McClean, David Stanford
We model the length of in-patient hospital stays due to stroke and the mode of discharge using a phase-type stroke recovery model. The model allows for three different types of stroke: haemorrhagic (the most severe, caused by ruptured blood vessels that cause brain bleeding), cerebral infarction (less severe, caused by blood clots) and transient ischemic attack or TIA (the least severe, a mini-stroke caused by a temporary blood clot). A four-phase recovery process is used, where the initial phase depends on the type of stroke, and transition from one phase to the next depends on the age of the patient...
May 1, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29600469/correction-to-the-use-of-data-envelopment-analysis-dea-in-healthcare-with-a-focus-on-hospitals
#5
Sebastian Kohl, Jan Schoenfelder, Andreas Fügener, Jens O Brunner
The original version of this article unfortunately contained errors. The first column of Tables 5 and 6 in the Appendix section should contain the year of publication instead of the reference number in brackets. The reference citations were then placed in the second column.
March 29, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29536293/data-driven-optimization-methodology-for-admission-control-in-critical-care-units
#6
Amirhossein Meisami, Jivan Deglise-Hawkinson, Mark E Cowen, Mark P Van Oyen
The decision of whether to admit a patient to a critical care unit is a crucial operational problem that has significant influence on both hospital performance and patient outcomes. Hospitals currently lack a methodology to selectively admit patients to these units in a way that patient health risk metrics can be incorporated while considering the congestion that will occur. The hospital is modeled as a complex loss queueing network with a stochastic model of how long risk-stratified patients spend time in particular units and how they transition between units...
March 13, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29532197/keeping-pace-with-the-ebbs-and-flows-in-daily-nursing-home-operations
#7
René Bekker, Dennis Moeke, Bas Schmidt
Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent nursing home departments of a single Dutch nursing home. This demand data is used as input for an optimization model that provides optimal staffing patterns across the day. For the optimization we use a Lindley-type equation and techniques from stochastic optimization to formulate a Mixed-Integer Linear Programming (MILP) model...
March 12, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29511976/mining-the-preferences-of-patients-for-ubiquitous-clinic-recommendation
#8
Tin-Chih Toly Chen, Min-Chi Chiu
A challenge facing all ubiquitous clinic recommendation systems is that patients often have difficulty articulating their requirements. To overcome this problem, a ubiquitous clinic recommendation mechanism was designed in this study by mining the clinic preferences of patients. Their preferences were defined using the weights in the ubiquitous clinic recommendation mechanism. An integer nonlinear programming problem was solved to tune the values of the weights on a rolling basis. In addition, since it may take a long time to adjust the values of weights to their asymptotic values, the back propagation network (BPN)-response surface method (RSM) method is applied to estimate the asymptotic values of weights...
March 6, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29508164/dependence-and-power-in-healthcare-equipment-supply-chains
#9
Jurriaan L de Jong, W C Benton
Most healthcare organizations (HCOs) engage Group Purchasing Organizations (GPOs) as an outsourcing strategy to secure their supplies and materials. When an HCO outsources the procurement function to a GPO, this GPO will directly interact with the HCO's supplier on the HCO's behalf. This study investigates how an HCO's dependence on a GPO affects supply chain relationships and power in the healthcare medical equipment supply chain. Hypotheses are tested through factor analysis and structural equation modeling, using primary survey data from HCO procurement managers...
March 5, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29497913/design-of-shared-unit-dose-drug-distribution-network-using-multi-level-particle-swarm-optimization
#10
Linjie Chen, Thibaud Monteiro, Tao Wang, Eric Marcon
Unit-dose drug distribution systems provide optimal choices in terms of medication security and efficiency for organizing the drug-use process in large hospitals. As small hospitals have to share such automatic systems for economic reasons, the structure of their logistic organization becomes a very sensitive issue. In the research reported here, we develop a generalized multi-level optimization method - multi-level particle swarm optimization (MLPSO) - to design a shared unit-dose drug distribution network...
March 1, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29478088/the-use-of-data-envelopment-analysis-dea-in-healthcare-with-a-focus-on-hospitals
#11
Sebastian Kohl, Jan Schoenfelder, Andreas Fügener, Jens O Brunner
The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications. These research goals can be grouped into four distinct clusters according to our proposed framework...
February 24, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27704323/comparison-of-emergency-department-crowding-scores-a-discrete-event-simulation-approach
#12
Virginia Ahalt, Nilay Tanık Argon, Serhan Ziya, Jeff Strickler, Abhi Mehrotra
According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27704322/an-agent-based-simulation-model-of-patient-choice-of-health-care-providers-in-accountable-care-organizations
#13
Abdullah Alibrahim, Shinyi Wu
Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27639567/optimal-healthcare-decision-making-under-multiple-mathematical-models-application-in-prostate-cancer-screening
#14
Dimitris Bertsimas, John Silberholz, Thomas Trikalinos
Important decisions related to human health, such as screening strategies for cancer, need to be made without a satisfactory understanding of the underlying biological and other processes. Rather, they are often informed by mathematical models that approximate reality. Often multiple models have been made to study the same phenomenon, which may lead to conflicting decisions. It is natural to seek a decision making process that identifies decisions that all models find to be effective, and we propose such a framework in this work...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27637491/chemotherapy-appointment-scheduling-under-uncertainty-using-mean-risk-stochastic-integer-programming
#15
Michelle Alvarado, Lewis Ntaimo
Oncology clinics are often burdened with scheduling large volumes of cancer patients for chemotherapy treatments under limited resources such as the number of nurses and chairs. These cancer patients require a series of appointments over several weeks or months and the timing of these appointments is critical to the treatment's effectiveness. Additionally, the appointment duration, the acuity levels of each appointment, and the availability of clinic nurses are uncertain. The timing constraints, stochastic parameters, rising treatment costs, and increased demand of outpatient oncology clinic services motivate the need for efficient appointment schedules and clinic operations...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27600378/a-strategic-gaming-model-for-health-information-exchange-markets
#16
Diego A Martinez, Felipe Feijoo, Jose L Zayas-Castro, Scott Levin, Tapas K Das
Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27592211/forecasting-the-medical-workforce-a-stochastic-agent-based-simulation-approach
#17
Mário Amorim Lopes, Álvaro Santos Almeida, Bernardo Almada-Lobo
Starting in the 50s, healthcare workforce planning became a major concern for researchers and policy makers, since an imbalance of health professionals may create a serious insufficiency in the health system, and eventually lead to avoidable patient deaths. As such, methodologies and techniques have evolved significantly throughout the years, and simulation, in particular system dynamics, has been used broadly. However, tools such as stochastic agent-based simulation offer additional advantages for conducting forecasts, making it straightforward to incorporate microeconomic foundations and behavior rules into the agents...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27586403/modeling-and-designing-health-care-payment-innovations-for-medical-imaging
#18
Hui Zhang, Christian Wernz, Danny R Hughes
Payment innovations that better align incentives in health care are a promising approach to reduce health care costs and improve quality of care. Designing effective payment systems, however, is challenging due to the complexity of the health care system with its many stakeholders and their often conflicting objectives. There is a lack of mathematical models that can comprehensively capture and efficiently analyze the complex, multi-level interactions and thereby predict the effect of new payment systems on stakeholder decisions and system-wide outcomes...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27577185/profit-efficiency-of-physician-practices-a-stochastic-frontier-approach-using-panel-data
#19
Lukas Kwietniewski, Jonas Schreyögg
While determinants of efficiency have been the subject of a large number of studies in the inpatient sector, relatively little is known about factors influencing efficiency of physician practices in the outpatient sector. With our study, we provide the first paper to estimate physician practice profit efficiency and its' determinants. We base our analysis on a unique panel data set of 4964 physician practices for the years 2008 to 2010. The data contains information on practice costs and revenues, services provided, as well as physician and practice characteristics...
March 2018: Health Care Management Science
https://www.readbyqxmd.com/read/27526192/a-widening-gap-static-and-dynamic-performance-differences-between-specialist-and-general-hospitals
#20
Antonio Vera, Pythagoras Petratos, Torsten Oliver Salge
This paper develops and tests a dynamic model of hospital focus. It does so by tracing the performance trajectories of specialist and general hospitals to identify whether a performance gap exists and whether it widens or shrinks over time. Our longitudinal analyses of all hospital organizations within the English National Health Service (NHS) reveal not only a notable performance gap between specialist and general hospitals in particular with regards to patient satisfaction that widens over time, but also the emergence of a gap especially with regards to hospital staff job satisfaction...
March 2018: Health Care Management Science
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