Integration of decision levels in operating room scheduling problems: Systematic review and proposition of a decision support framework

Abstract

Resource allocation problems are a significant subset of optimization problems widely present in the healthcare industry. Notably, the Operating Room Scheduling Problem (ORSP) is prominent in literature due to its substantial cost and revenue implications. ORSP is structured into three hierarchical decision levels: strategic, tactical and operational, with higher-level decisions influencing subsequent ones. While most studies focus on single decision levels, there has been a growing interest in integrated models, as these offer a more holistic view and often result in better outcomes, despite their complexity of resolution. Although various literature reviews have explored different aspects of ORSP, few have focused on models integrating multiple decision levels. This study addresses that gap by systematically reviewing the literature focusing on contributions presenting mathematical programming models and optimization algorithms that simultaneously address multiple decision levels of the ORSP. Following the PRISMA 2020 protocol, the review spans works published until October 2024, totaling 46 articles. It outlines objectives, characteristics, solution approaches, and identifies gaps in literature. Additionally, a decision framework summarizing the identified integration levels is proposed.