Multi-resource allocation and care sequence assignment in patient management: a stochastic programming approach.
IF 2.3
3区 医学
Q2 HEALTH POLICY & SERVICES
Health Care Management Science
Pub Date : 2024-09-01
Epub Date: 2024-05-30
DOI:10.1007/s10729-024-09675-6
引用次数: 0
Abstract
To mitigate outpatient care delivery inefficiencies induced by resource shortages and demand heterogeneity, this paper focuses on the problem of allocating and sequencing multiple medical resources so that patients scheduled for clinical care can experience efficient and coordinated care with minimum total waiting time. We leverage highly granular location data on people and medical resources collected via Real-Time Location System technologies to identify dominant patient care pathways. A novel two-stage Stochastic Mixed Integer Linear Programming model is proposed to determine the optimal patient sequence based on the available resources according to the care pathways that minimize patients' expected total waiting time. The model incorporates the uncertainty in care activity duration via sample average approximation.We employ a Monte Carlo Optimization procedure to determine the appropriate sample size to obtain solutions that provide a good trade-off between approximation accuracy and computational time. Compared to the conventional deterministic model, our proposed model would significantly reduce waiting time for patients in the clinic by 60%, on average, with acceptable computational resource requirements and time complexity. In summary, this paper proposes a computationally efficient formulation for the multi-resource allocation and care sequence assignment optimization problem under uncertainty. It uses continuous assignment decision variables without timestamp and position indices, enabling the data-driven solution of problems with real-time allocation adjustment in a dynamic outpatient environment with complex clinical coordination constraints.
病人管理中的多资源分配和护理顺序分配：一种随机编程方法。
为了缓解因资源短缺和需求异质性而导致的门诊病人护理服务效率低下问题，本文重点探讨了如何分配和排序多种医疗资源的问题，从而使预约接受临床护理的病人能够在总等待时间最短的情况下获得高效、协调的护理服务。我们利用通过实时定位系统技术收集到的人员和医疗资源的高粒度位置数据来确定主要的患者护理路径。我们提出了一个新颖的两阶段随机混合整数线性规划模型，以根据护理路径确定基于可用资源的最佳患者序列，从而最大限度地减少患者的预期总等待时间。该模型通过样本平均近似法将护理活动持续时间的不确定性纳入其中。我们采用蒙特卡罗优化程序来确定适当的样本大小，以获得在近似精度和计算时间之间取得良好平衡的解决方案。与传统的确定性模型相比，我们提出的模型可以在可接受的计算资源要求和时间复杂度条件下，将患者在诊所的等待时间平均大幅缩短 60%。总之，本文针对不确定条件下的多资源分配和护理序列分配优化问题提出了一种计算效率高的方案。它使用不带时间戳和位置索引的连续分配决策变量，能够在具有复杂临床协调约束的动态门诊环境中以数据为驱动解决实时分配调整问题。
本文章由计算机程序翻译，如有差异，请以英文原文为准。
求助全文
约1分钟内获得全文
求助全文
来源期刊
Health Care Management Science
HEALTH POLICY & SERVICES-
CiteScore
7.20
自引率
5.60%
发文量
40
期刊介绍：
Health Care Management Science publishes papers dealing with health care delivery, health care management, and health care policy. Papers should have a decision focus and make use of quantitative methods including management science, operations research, analytics, machine learning, and other emerging areas. Articles must clearly articulate the relevance and the realized or potential impact of the work. Applied research will be considered and is of particular interest if there is evidence that it was implemented or informed a decision-making process. Papers describing routine applications of known methods are discouraged.
Authors are encouraged to disclose all data and analyses thereof, and to provide computational code when appropriate.
Editorial statements for the individual departments are provided below.
Health Care Analytics
Departmental Editors:
Margrét Bjarnadóttir, University of Maryland
Nan Kong, Purdue University
With the explosion in computing power and available data, we have seen fast changes in the analytics applied in the healthcare space. The Health Care Analytics department welcomes papers applying a broad range of analytical approaches, including those rooted in machine learning, survival analysis, and complex event analysis, that allow healthcare professionals to find opportunities for improvement in health system management, patient engagement, spending, and diagnosis. We especially encourage papers that combine predictive and prescriptive analytics to improve decision making and health care outcomes.
The contribution of papers can be across multiple dimensions including new methodology, novel modeling techniques and health care through real-world cohort studies. Papers that are methodologically focused need in addition to show practical relevance. Similarly papers that are application focused should clearly demonstrate improvements over the status quo and available approaches by applying rigorous analytics.
Health Care Operations Management
Departmental Editors:
Nilay Tanik Argon, University of North Carolina at Chapel Hill
Bob Batt, University of Wisconsin
The department invites high-quality papers on the design, control, and analysis of operations at healthcare systems. We seek papers on classical operations management issues (such as scheduling, routing, queuing, transportation, patient flow, and quality) as well as non-traditional problems driven by everchanging healthcare practice. Empirical, experimental, and analytical (model based) methodologies are all welcome. Papers may draw theory from across disciplines, and should provide insight into improving operations from the perspective of patients, service providers, organizations (municipal/government/industry), and/or society.
Health Care Management Science Practice
Departmental Editor:
Vikram Tiwari, Vanderbilt University Medical Center
The department seeks research from academicians and practitioners that highlights Management Science based solutions directly relevant to the practice of healthcare. Relevance is judged by the impact on practice, as well as the degree to which researchers engaged with practitioners in understanding the problem context and in developing the solution. Validity, that is, the extent to which the results presented do or would apply in practice is a key evaluation criterion. In addition to meeting the journal’s standards of originality and substantial contribution to knowledge creation, research that can be replicated in other organizations is encouraged. Papers describing unsuccessful applied research projects may be considered if there are generalizable learning points addressing why the project was unsuccessful.
Health Care Productivity Analysis
Departmental Editor:
Jonas Schreyögg, University of Hamburg
The department invites papers with rigorous methods and significant impact for policy and practice. Papers typically apply theory and techniques to measuring productivity in health care organizations and systems. The journal welcomes state-of-the-art parametric as well as non-parametric techniques such as data envelopment analysis, stochastic frontier analysis or partial frontier analysis. The contribution of papers can be manifold including new methodology, novel combination of existing methods or application of existing methods to new contexts. Empirical papers should produce results generalizable beyond a selected set of health care organizations. All papers should include a section on implications for management or policy to enhance productivity.
Public Health Policy and Medical Decision Making
Departmental Editors:
Ebru Bish, University of Alabama
Julie L. Higle, University of Southern California
The department invites high quality papers that use data-driven methods to address important problems that arise in public health policy and medical decision-making domains. We welcome submissions that develop and apply mathematical and computational models in support of data-driven and model-based analyses for these problems.
The Public Health Policy and Medical Decision-Making Department is particularly interested in papers that:
Study high-impact problems involving health policy, treatment planning and design, and clinical applications;
Develop original data-driven models, including those that integrate disease modeling with screening and/or treatment guidelines;
Use model-based analyses as decision making-tools to identify optimal solutions, insights, recommendations.
Articles must clearly articulate the relevance of the work to decision and/or policy makers and the potential impact on patients and/or society. Papers will include articulated contributions within the methodological domain, which may include modeling, analytical, or computational methodologies.
Emerging Topics
Departmental Editor:
Alec Morton, University of Strathclyde
Emerging Topics will handle papers which use innovative quantitative methods to shed light on frontier issues in healthcare management and policy. Such papers may deal with analytic challenges arising from novel health technologies or new organizational forms. Papers falling under this department may also deal with the analysis of new forms of data which are increasingly captured as health systems become more and more digitized.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
