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Health Care Management Science

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https://www.readbyqxmd.com/read/28032261/identifying-congestion-levels-sources-and-determinants-on-intensive-care-units-the-portuguese-case
#1
Diogo Ferreira, Rui Cunha Marques
Healthcare systems are facing a resources scarcity so they must be efficiently managed. On the other hand, it is commonly accepted that the higher the consumed resources, the higher the hospital production, although this is not true in practice. Congestion on inputs is an economic concept dealing with such situation and it is defined as the decreasing of outputs due to some resources overuse. This scenario gets worse when inpatients' high severity requires a strict and effective resources management, as happens in Intensive Care Units (ICU)...
December 28, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27817060/two-milp-models-for-scheduling-elective-surgeries-within-a-private-healthcare-facility
#2
Hejer Khlif Hachicha, Farah Zeghal Mansour
This paper deals with an Integrated Elective Surgery-Scheduling Problem (IESSP) that arises in a privately operated healthcare facility. It aims to optimize the resource utilization of the entire surgery process including pre-operative, per-operative and post-operative activities. Moreover, it addresses a specific feature of private facilities where surgeons are independent service providers and may conduct their surgeries in different private healthcare facilities. Thus, the problem requires the assignment of surgery patients to hospital beds, operating rooms and recovery beds as well as their sequencing over a 1-day period while taking into account surgeons' availability constraints...
November 5, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27787751/technical-and-scale-efficiency-in-public-and-private-irish-nursing-homes-a-bootstrap-dea-approach
#3
Shiovan Ni Luasa, Declan Dineen, Marta Zieba
This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores...
October 27, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27645496/acknowledgement-of-referees-services
#4
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26370396/the-operating-room-case-mix-problem-under-uncertainty-and-nurses-capacity-constraints
#5
Zakaria Yahia, Amr B Eltawil, Nermine A Harraz
Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26163809/determinants-of-received-long-term-care-individual-responses-to-regional-nursing-home-provisions
#6
Adam Pilny, Magdalena A Stroka
Existing literature analyzing the choice of received long-term care by frail elderly (65+ years) predominantly focuses on physical and psychological conditions of elderly people as factors that influence the decision for a particular type of care. Until now, however, the regional in-patient long-term care supply has been neglected as influential factor in this decision-making process. In this study, we analyze the determinants of received long-term care in Germany by explicitly taking the regional supply of nursing homes into account...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26156688/capacity-planning-and-appointment-scheduling-for-new-patient-oncology-consults
#7
Xiang Ma, Antoine Sauré, Martin L Puterman, Marianne Taylor, Scott Tyldesley
To ensure that patients receive timely access to care, it has become increasingly important to use existing care provider capacity as efficiently as possible and to make informed capacity planning decisions. To support this decision-making process at a regional cancer center in British Columbia (Canada), we undertook a simulation and optimization based study that investigated the simultaneous impact of the available number of new patient consultation slots, appointment scheduling policies and oncologist specialization configurations on the timeliness of patient access to care and physician workload...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26143594/iterative-optimization-algorithm-with-parameter-estimation-for-the-ambulance-location-problem
#8
Sun Hoon Kim, Young Hoon Lee
The emergency vehicle location problem to determine the number of ambulance vehicles and their locations satisfying a required reliability level is investigated in this study. This is a complex nonlinear issue involving critical decision making that has inherent stochastic characteristics. This paper studies an iterative optimization algorithm with parameter estimation to solve the emergency vehicle location problem. In the suggested algorithm, a linear model determines the locations of ambulances, while a hypercube simulation is used to estimate and provide parameters regarding ambulance locations...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26018176/the-effect-of-information-technology-on-hospital-performance
#9
Cynthia Williams, Yara Asi, Amanda Raffenaud, Matt Bagwell, Ibrahim Zeini
While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/26003321/creating-impact-with-operations-research-in-health-making-room-for-practice-in-academia
#10
Margaret L Brandeau
Operations research (OR)-based analyses have the potential to improve decision making for many important, real-world health care problems. However, junior scholars often avoid working on practical applications in health because promotion and tenure processes tend to value theoretical studies more highly than applied studies. This paper discusses the author's experiences in using OR to inform and influence decisions in health and provides a blueprint for junior researchers who wish to find success by taking a similar path...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/25913830/measuring-the-efficiency-of-the-greek-rural-primary-health-care-using-a-restricted-dea-model-the-case-of-southern-and-western-greece
#11
Nikolaos Oikonomou, Yannis Tountas, Argiris Mariolis, Kyriakos Souliotis, Kostas Athanasakis, John Kyriopoulos
This is a study to measure the efficiency of the rural Health Centres (HCs) and their Regional Surgeries (RSs) of the 6th Health Prefecture (HP) of Greece, which covers Southern and Western Greece. Data Envelopment Analysis (DEA) was applied under Constant and Variable Returns to Scale, using a weight-restricted, output-oriented model, to calculate pure technical efficiency (PΤΕ), scale efficiency (SE) and total technical efficiency (TE). The selection of inputs, outputs and their relative weights in the model was based on two consecutive consensus panels of experts on Primary Health Care (PHC)...
December 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27766509/simulation-based-approximate-policy-iteration-for-dynamic-patient-scheduling-for-radiation-therapy
#12
Yasin Gocgun
We study radiation therapy scheduling problem where dynamically and stochastically arriving patients of different types are scheduled to future days. Unlike similar models in the literature, we consider cancellation of treatments. We formulate this dynamic multi-appointment patient scheduling problem as a Markov Decision Process (MDP). Since the MDP is intractable due to large state and action spaces, we employ a simulation-based approximate dynamic programming (ADP) approach to approximately solve our model...
October 20, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27734237/rfid-based-information-visibility-for-hospital-operations-exploring-its-positive-effects-using-discrete-event-simulation
#13
Daniel A Asamoah, Ramesh Sharda, Howard N Rude, Derek Doran
Long queues and wait times often occur at hospitals and affect smooth delivery of health services. To improve hospital operations, prior studies have developed scheduling techniques to minimize patient wait times. However, these studies lack in demonstrating how such techniques respond to real-time information needs of hospitals and efficiently manage wait times. This article presents a multi-method study on the positive impact of providing real-time scheduling information to patients using the RFID technology...
October 12, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27704323/comparison-of-emergency-department-crowding-scores-a-discrete-event-simulation-approach
#14
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...
October 4, 2016: 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
#15
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...
October 4, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27639567/optimal-healthcare-decision-making-under-multiple-mathematical-models-application-in-prostate-cancer-screening
#16
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...
September 17, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27637491/chemotherapy-appointment-scheduling-under-uncertainty-using-mean-risk-stochastic-integer-programming
#17
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...
September 16, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27600378/a-strategic-gaming-model-for-health-information-exchange-markets
#18
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...
September 6, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27592211/forecasting-the-medical-workforce-a-stochastic-agent-based-simulation-approach
#19
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...
September 3, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27586403/modeling-and-designing-health-care-payment-innovations-for-medical-imaging
#20
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...
September 1, 2016: Health Care Management Science
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