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Health Care Management Science

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https://www.readbyqxmd.com/read/29330735/acknowledgement-of-referees-services
#1
(no author information available yet)
No abstract text is available yet for this article.
January 12, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29305681/dynamically-accepting-and-scheduling-patients-for-home-healthcare
#2
Mustafa Demirbilek, Juergen Branke, Arne Strauss
The importance of home healthcare is growing rapidly since populations of developed and even developing countries are getting older and the number of hospitals, retirement homes, and medical staff do not increase at the same rate. We consider the Home Healthcare Nurse Scheduling Problem where patients arrive dynamically over time and acceptance and appointment time decisions have to be made as soon as patients arrive. The objective is to maximise the average number of daily visits for a single nurse. For the sake of service continuity, patients have to be visited at the same day and time each week during their episode of care...
January 5, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29204772/a-stochastic-tabu-search-algorithm-to-align-physician-schedule-with-patient-flow
#3
Nazgol Niroumandrad, Nadia Lahrichi
In this study, we consider the pretreatment phase for cancer patients. This is defined as the period between the referral to a cancer center and the confirmation of the treatment plan. Physicians have been identified as bottlenecks in this process, and the goal is to determine a weekly cyclic schedule that improves the patient flow and shortens the pretreatment duration. High uncertainty is associated with the arrival day, profile and type of cancer of each patient. We also include physician satisfaction in the objective function...
December 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29177993/classification-of-hospital-admissions-into-emergency-and-elective-care-a-machine-learning-approach
#4
Jonas Krämer, Jonas Schreyögg, Reinhard Busse
Rising admissions from emergency departments (EDs) to hospitals are a primary concern for many healthcare systems. The issue of how to differentiate urgent admissions from non-urgent or even elective admissions is crucial. We aim to develop a model for classifying inpatient admissions based on a patient's primary diagnosis as either emergency care or elective care and predicting urgency as a numerical value. We use supervised machine learning techniques and train the model with physician-expert judgments. Our model is accurate (96%) and has a high area under the ROC curve (>...
November 25, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29177758/reducing-copd-readmissions-through-predictive-modeling-and-incentive-based-interventions
#5
Xiang Zhong, Sujee Lee, Cong Zhao, Hyo Kyung Lee, Philip A Bain, Tammy Kundinger, Craig Sommers, Christine Baker, Jingshan Li
This paper introduces a case study at a community hospital to develop a predictive model to quantify readmission risks for patients with chronic obstructive pulmonary disease (COPD), and use it to support decision making for appropriate incentive-based interventions. Data collected from the community hospital's database are analyzed to identify risk factors and a logistic regression model is developed to predict the readmission risk within 30 days post-discharge of an individual COPD patient. By targeting on the high-risk patients, we investigate the implementability of the incentive policy which encourages patients to take interventions and helps them to overcome the compliance barrier...
November 25, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29164424/service-quality-benchmarking-via-a-novel-approach-based-on-fuzzy-electre-iii-and-ipa-an-empirical-case-involving-the-italian-public-healthcare-context
#6
Concetta Manuela La Fata, Toni Lupo, Tommaso Piazza
A novel fuzzy-based approach which combines ELECTRE III along with the Importance-Performance Analysis (IPA) is proposed in the present work to comparatively evaluate the service quality in the public healthcare context. Specifically, ELECTRE III is firstly considered to compare the service performance of examined hospitals in a noncompensatory manner. Afterwards, IPA is employed to support the service quality management to point out improvement needs and their priorities. The proposed approach also incorporates features of the Fuzzy Set Theory so as to address the possible uncertainty, subjectivity and vagueness of involved experts in evaluating the service quality...
November 21, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29143942/acknowledgement-of-referees-services
#7
(no author information available yet)
No abstract text is available yet for this article.
November 16, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29124483/stochastic-integer-programming-for-multi-disciplinary-outpatient-clinic-planning
#8
A G Leeftink, I M H Vliegen, E W Hans
Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multi-disciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are jointly optimized. As this currently is an open question in the literature, our research is the first to address this problem. This research is motivated by a Dutch hospital, which uses a multi-disciplinary cancer clinic to communicate the diagnosis and to explain the treatment plan to their patients...
November 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29080053/probabilistic-sensitivity-analysis-on-markov-models-with-uncertain-transition-probabilities-an-application-in-evaluating-treatment-decisions-for-type-2-diabetes
#9
Yuanhui Zhang, Haipeng Wu, Brian T Denton, James R Wilson, Jennifer M Lobo
Markov models are commonly used for decision-making studies in many application domains; however, there are no widely adopted methods for performing sensitivity analysis on such models with uncertain transition probability matrices (TPMs). This article describes two simulation-based approaches for conducting probabilistic sensitivity analysis on a given discrete-time, finite-horizon, finite-state Markov model using TPMs that are sampled over a specified uncertainty set according to a relevant probability distribution...
October 27, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28993965/an-optimization-model-to-determine-appointment-scheduling-window-for-an-outpatient-clinic-with-patient-no-shows
#10
Li Luo, Ying Zhou, Bernard T Han, Jialing Li
This paper investigates appointment scheduling for an outpatient department in West China Hospital (WCH), one of the largest single point of access hospitals in the world. Our pilot data analysis shows that the appointment system at WCH can be improved through leveraging the scheduling window (i.e., the number of days in advance a patient makes an appointment for future services). To gain full insight into this strategy, our study considers two cases, based on if patients are willing to wait for scheduled appointments or not...
October 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28887763/population-level-intervention-and-information-collection-in-dynamic-healthcare-policy
#11
Lauren E Cipriano, Thomas A Weber
We develop a general framework for optimal health policy design in a dynamic setting. We consider a hypothetical medical intervention for a cohort of patients where one parameter varies across cohorts with imperfectly observable linear dynamics. We seek to identify the optimal time to change the current health intervention policy and the optimal time to collect decision-relevant information. We formulate this problem as a discrete-time, infinite-horizon Markov decision process and we establish structural properties in terms of first and second-order monotonicity...
September 8, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28871511/nurses-work-with-interruptions-an-objective-model-for-testing-interventions
#12
Robert A Myers, Pratik J Parikh
Interruptions experienced by nurses may lead to errors as their focus and attention to multiple patient needs are disrupted. As quantitative models to understand the dynamics of interruptions are lacking, the objective of this study is a model of a nurse's work with interruptions, generating insights into the onset of interruptions and evaluating suggested interventions. We observed nurses in a US Level I trauma center for 47.3 h, including 259 interruptions (9.1% of total time) across 580 nursing activities...
September 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28871456/queueing-theoretic-analysis-of-labor-and-delivery-understanding-management-styles-and-c-section-rates
#13
Matthew Gombolay, Toni Golen, Neel Shah, Julie Shah
Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts...
September 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28861650/optimal-timing-of-drug-sensitivity-testing-for-patients-on-first-line-tuberculosis-treatment
#14
Sze-Chuan Suen, Margaret L Brandeau, Jeremy D Goldhaber-Fiebert
Effective treatment for tuberculosis (TB) patients on first-line treatment involves triaging those with drug-resistant (DR) TB to appropriate treatment alternatives. Patients likely to have DR TB are identified using results from repeated inexpensive sputum-smear (SS) tests and expensive but definitive drug sensitivity tests (DST). Early DST may lead to high costs and unnecessary testing; late DST may lead to poor health outcomes and disease transmission. We use a partially observable Markov decision process (POMDP) framework to determine optimal DST timing...
August 31, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28822005/a-supply-model-for-nurse-workforce-projection-in-malaysia
#15
Zuraida Abal Abas, Mohamad Raziff Ramli, Mohamad Ishak Desa, Nordin Saleh, Ainul Nadziha Hanafiah, Nuraini Aziz, Zaheera Zainal Abidin, Abdul Samad Shibghatullah, Ahmad Fadzli Nizam Abdul Rahman, Haslinda Musa
The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model...
August 18, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28795264/decreasing-patient-length-of-stay-via-new-flexible-exam-room-allocation-policies-in-ambulatory-care-clinics
#16
Vahab Vahdat, Jacqueline Griffin, James E Stahl
To address prolonged lengths of stay (LOS) in ambulatory care clinics, we analyze the impact of implementing flexible and dynamic policies for assigning exam rooms to providers. In contrast to the traditional approaches of assigning specific rooms to each provider or pooling rooms among all practitioners, we characterize the impact of alternate compromise policies that have not been explored in previous studies. Since ambulatory care patients may encounter multiple different providers in a single visit, room allocation can be determined separately for each encounter accordingly...
August 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28795254/an-efficient-method-for-kidney-allocation-problem-a-credibility-based-fuzzy-common-weights-data-envelopment-analysis-approach
#17
Sahar Ahmadvand, Mir Saman Pishvaee
Given the perennial imbalance and chronic scarcity between the demand for and supply of available organs, organ allocation is one of the most critical decisions in the management of organ transplantation networks. Organ allocation systems undergo rapid revisions for the sake of improved outcomes in terms of both equity and medical efficiency. This paper presents a Data Envelopment Analysis (DEA)-based model to evaluate the efficiency of possible patient-organ pairs for kidney allocation in order to enhance the fitness of organ allocation under inherent uncertainty in such problem...
August 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28755176/overflow-models-for-the-admission-of-intensive-care-patients
#18
Yin-Chi Chan, Eric W M Wong, Gavin Joynt, Paul Lai, Moshe Zukerman
An earlier article, inspired by overflow models in telecommunication systems with multiple streams of telephone calls, proposed a new analytical model for a network of intensive care units (ICUs), and a new patient referral policy for such networks to reduce the blocking probability of external emergency patients without degrading the quality of service (QoS) of canceled elective operations, due to the more efficient use of ICU capacity overall. In this work, we use additional concepts and insights from traditional teletraffic theory, including resource sharing, trunk reservation, and mutual overflow, to design a new patient referral policy to further improve ICU network efficiency...
July 28, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28755175/regional-variation-in-hospitalisation-and-mortality-in-heart-failure-comparison-of-england-and-lombardy-using-multistate-modelling
#19
Alex Bottle, Chiara Maria Ventura, Kumar Dharmarajan, Paul Aylin, Francesca Ieva, Anna Maria Paganoni
Heart failure (HF) is a common, serious chronic condition with high morbidity, hospitalisation and mortality. The healthcare systems of England and the northern Italian region of Lombardy share important similarities and have comprehensive hospital administrative databases linked to the death register. We used them to compare admission for HF and mortality for patients between 2006 and 2012 (n = 37,185 for Lombardy, 234,719 for England) with multistate models. Despite close similarities in age, sex and common comorbidities of the two sets of patients, in Lombardy, HF admissions were longer and more frequent per patient than in England, but short- and medium-term mortality was much lower...
July 28, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28735459/diabetes-and-the-hospitalized-patient-a-cluster-analytic-framework-for-characterizing-the-role-of-sex-race-and-comorbidity-from-2006-to-2011
#20
Nisha Nataraj, Julie Simmons Ivy, Fay Cobb Payton, Joseph Norman
In the US, one in four adults has two or more chronic conditions; this population accounts for two thirds of healthcare spending. Comorbidity, the presence of multiple simultaneous health conditions in an individual, is increasing in prevalence and has been shown to impact patient outcomes negatively. Comorbidities associated with diabetes are correlated with increased incidence of preventable hospitalizations, longer lengths of stay (LOS), and higher costs. This study focuses on sex and race disparities in outcomes for hospitalized adult patients with and without diabetes...
July 22, 2017: Health Care Management Science
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