Health Care Management Science最新文献_第4页

Efficiency effects of public hospital closures in the context of public hospital reform: a multistep efficiency analysis. 公立医院改革背景下关闭公立医院的效率效应：多步骤效率分析。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-03-01 Epub Date: 2023-12-06 DOI: 10.1007/s10729-023-09661-4

Songul Cinaroglu

{"title":"Efficiency effects of public hospital closures in the context of public hospital reform: a multistep efficiency analysis.","authors":"Songul Cinaroglu","doi":"10.1007/s10729-023-09661-4","DOIUrl":"10.1007/s10729-023-09661-4","url":null,"abstract":"In the wake of hospital reforms introduced in 2011 in Turkey, public hospitals were grouped into associations with joint management and some shared operational and administrative functions, similar in some ways to hospital trusts in the English National Health Service. Reorganization of public hospitals effect hospital and market area characteristics and existence of hospitals. The objective of this study is to examine the effect of closure on competitive hospital performances. Using administrative data from Turkish Public Hospital Statistical Yearbooks for the years 2005 to 2007 and 2014 to 2017, we conducted a three-step efficiency analysis by incorporating data envelopment analysis (DEA) and propensity score matching techniques, followed by a difference-in-differences (DiD) regression. First, we used bootstrapped DEA to calculate the efficiency scores of hospitals that were located near hospitals that had been closed. Second, we used nearest neighbour propensity score matching to form control groups and ensure that any differences between these and the intervention groups could be attributed to being near a hospital that had closed rather than differences in hospital and market area characteristics. Lastly, we employed DiD regression analysis to explore whether being near a closed hospital had an impact on the efficiency of the surviving hospitals while considering the effect of the 2011 hospital reform policies. To shed light on a potential time lag between hospital closure and changes in efficiency, we used various periods for comparison. Our results suggest that the efficiency of public hospitals in Turkey increased in hospitals that were located near hospitals that closed in Turkey from 2011. Hospital closure improves the efficiency of competitive hospitals under hospital market reforms. Future studies may wish to examine the efficiency effects of government and private sector collaboration on competition in the hospital market.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"88-113"},"PeriodicalIF":3.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The policy case for designating EMS teams for vulnerable patient populations: Evidence from an intervention in Boston. 为弱势病人群体指定急救队的政策依据：波士顿干预措施的证据。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-03-01 Epub Date: 2023-04-12 DOI: 10.1007/s10729-023-09635-6

Mark Brennan, Sophia Dyer, Jonas Jonasson, James Salvia, Laura Segal, Erin Serino, Justin Steil

{"title":"The policy case for designating EMS teams for vulnerable patient populations: Evidence from an intervention in Boston.","authors":"Mark Brennan, Sophia Dyer, Jonas Jonasson, James Salvia, Laura Segal, Erin Serino, Justin Steil","doi":"10.1007/s10729-023-09635-6","DOIUrl":"10.1007/s10729-023-09635-6","url":null,"abstract":"This study documents more than five years of analysis that drove the policy case, deployment, and retrospective evaluation for an innovative service model that enables Boston Emergency Medical Services (EMS) to respond quickly and effectively to investigation incidents in an area of heavy need in Boston. These investigation incidents are typically calls for service from passers-by or other third-party callers requesting that Boston EMS check in on individuals, often those who may appear to have an altered mental status or to be unhoused. First, this study reports the pre-intervention analytics in 2017 that built the policy case for service segmentation, a new Community Assistance Team designated \"Squad 80\" that primarily responds to investigation incidents in one broad area of the city with high rates of substance abuse and homelessness, helping patients who often refuse ambulance transport connect to social services. Second, this study reports a post-intervention, observational evaluation of its operational advantages and trade-offs. We observe that incidents involving the Community Assistance Team have significantly shorter response times and result in fewer transports to emergency departments than investigation incidents not involving the unit, leading to fewer ambulance unit-hours utilized across the system. This study documents the descriptive analytics that built the successful policy case for a substantive change in the healthcare-delivery supply chain in Boston and how this change offers operational advantages. It is written to be an accessible guide to the analysts and policy makers considering emergency services segmentation, an important frontier in equitable public-service delivery.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"72-87"},"PeriodicalIF":3.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9299816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Heterogeneous donor circles for fair liver transplant allocation. 异质捐献者圈，实现公平的肝移植分配。

IF 2.3 3区医学

Health Care Management Science Pub Date : 2024-03-01 Epub Date: 2022-07-20 DOI: 10.1007/s10729-022-09602-7

Shubham Akshat, Sommer E Gentry, S Raghavan

{"title":"Heterogeneous donor circles for fair liver transplant allocation.","authors":"Shubham Akshat, Sommer E Gentry, S Raghavan","doi":"10.1007/s10729-022-09602-7","DOIUrl":"10.1007/s10729-022-09602-7","url":null,"abstract":"The United States (U.S.) Department of Health and Human Services is interested in increasing geographical equity in access to liver transplant. The geographical disparity in the U.S. is fundamentally an outcome of variation in the organ supply to patient demand (s/d) ratios across the country (which cannot be treated as a single unit due to its size). To design a fairer system, we develop a nonlinear integer programming model that allocates the organ supply in order to maximize the minimum s/d ratios across all transplant centers. We design circular donation regions that are able to address the issues raised in legal challenges to earlier organ distribution frameworks. This allows us to reformulate our model as a set-partitioning problem. Our policy can be viewed as a heterogeneous donor circle policy, where the integer program optimizes the radius of the circle around each donation location. Compared to the current policy, which has fixed radius circles around donation locations, the heterogeneous donor circle policy greatly improves both the worst s/d ratio and the range between the maximum and minimum s/d ratios. We found that with the fixed radius policy of 500 nautical miles (NM), the s/d ratio ranges from 0.37 to 0.84 at transplant centers, while with the heterogeneous circle policy capped at a maximum radius of 500 NM, the s/d ratio ranges from 0.55 to 0.60, closely matching the national s/d ratio average of 0.5983. Our model matches the supply and demand in a more equitable fashion than existing policies and has a significant potential to improve the liver transplantation landscape.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"20-45"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40520364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accessible location of mobile labs for COVID-19 testing. COVID-19 检测流动实验室的便利位置。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-03-01 Epub Date: 2022-10-03 DOI: 10.1007/s10729-022-09614-3

Dianne Villicaña-Cervantes, Omar J Ibarra-Rojas

{"title":"Accessible location of mobile labs for COVID-19 testing.","authors":"Dianne Villicaña-Cervantes, Omar J Ibarra-Rojas","doi":"10.1007/s10729-022-09614-3","DOIUrl":"10.1007/s10729-022-09614-3","url":null,"abstract":"In this study, we address the problem of finding the best locations for mobile labs offering COVID-19 testing. We assume that people within known demand centroids have a degree of mobility, i.e., they can travel a reasonable distance, and mobile labs have a limited-and-variable service area. Thus, we define a location problem concerned with optimizing a measure representing the accessibility of service to its potential clients. In particular, we use the concepts of classical, gradual, and cooperative coverage to define a weighted sum of multiple accessibility indicators. We formulate our optimization problem via a mixed-integer linear program which is intractable by commercial solvers for large instances. In response, we designed a Biased Random-Key Genetic Algorithm to solve the defined problem; this is capable of obtaining high-quality feasible solutions over large numbers of instances in seconds. Moreover, we present insights derived from a case study into the locations of COVID-19 testing mobile laboratories in Nuevo Leon, Mexico. Our experimental results show that our optimization approach can be used as a diagnostic tool to determine the number of mobile labs needed to satisfy a set of demand centroids, assuming that users have reduced mobility due to the restrictions because of the pandemic.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"1-19"},"PeriodicalIF":3.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prediction of hospitalization and waiting time within 24 hours of emergency department patients with unstructured text data. 利用非结构化文本数据预测急诊科患者24小时内的住院和等待时间。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-03-01 Epub Date: 2023-11-03 DOI: 10.1007/s10729-023-09660-5

Hyeram Seo, Imjin Ahn, Hansle Gwon, Hee Jun Kang, Yunha Kim, Ha Na Cho, Heejung Choi, Minkyoung Kim, Jiye Han, Gaeun Kee, Seohyun Park, Dong-Woo Seo, Tae Joon Jun, Young-Hak Kim

{"title":"Prediction of hospitalization and waiting time within 24 hours of emergency department patients with unstructured text data.","authors":"Hyeram Seo, Imjin Ahn, Hansle Gwon, Hee Jun Kang, Yunha Kim, Ha Na Cho, Heejung Choi, Minkyoung Kim, Jiye Han, Gaeun Kee, Seohyun Park, Dong-Woo Seo, Tae Joon Jun, Young-Hak Kim","doi":"10.1007/s10729-023-09660-5","DOIUrl":"10.1007/s10729-023-09660-5","url":null,"abstract":"Overcrowding of emergency departments is a global concern, leading to numerous negative consequences. This study aimed to develop a useful and inexpensive tool derived from electronic medical records that supports clinical decision-making and can be easily utilized by emergency department physicians. We presented machine learning models that predicted the likelihood of hospitalizations within 24 hours and estimated waiting times. Moreover, we revealed the enhanced performance of these machine learning models compared to existing models by incorporating unstructured text data. Among several evaluated models, the extreme gradient boosting model that incorporated text data yielded the best performance. This model achieved an area under the receiver operating characteristic curve score of 0.922 and an area under the precision-recall curve score of 0.687. The mean absolute error revealed a difference of approximately 3 hours. Using this model, we classified the probability of patients not being admitted within 24 hours as Low, Medium, or High and identified important variables influencing this classification through explainable artificial intelligence. The model results are readily displayed on an electronic dashboard to support the decision-making of emergency department physicians and alleviate overcrowding, thereby resulting in socioeconomic benefits for medical facilities.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"114-129"},"PeriodicalIF":3.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71434220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction to: Prediction of hospitalization and waiting time within 24 h of emergency department patients with unstructured text data. 更正：利用非结构化文本数据预测急诊科患者的住院时间和 24 小时内的等待时间。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-03-01 DOI: 10.1007/s10729-023-09662-3

Hyeram Seo, Imjin Ahn, Hansle Gwon, Hee Jun Kang, Yunha Kim, Ha Na Cho, Heejung Choi, Minkyoung Kim, Jiye Han, Gaeun Kee, Seohyun Park, Dong-Woo Seo, Tae Joon Jun, Young-Hak Kim

引用次数: 0

Editorial - Acknowledgement of reviewers and editorial board members. 编辑 - 感谢审稿人和编辑委员会成员。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2024-02-19 DOI: 10.1007/s10729-024-09666-7

引用次数: 0

Select, route and schedule: optimizing community paramedicine service delivery with mandatory visits and patient prioritization. 选择、路线和时间表：通过强制就诊和患者优先顺序优化社区护理服务提供。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2023-12-01 Epub Date: 2023-07-18 DOI: 10.1007/s10729-023-09646-3

Shima Azizi, Özge Aygül, Brenton Faber, Sharon Johnson, Renata Konrad, Andrew C Trapp

{"title":"Select, route and schedule: optimizing community paramedicine service delivery with mandatory visits and patient prioritization.","authors":"Shima Azizi, Özge Aygül, Brenton Faber, Sharon Johnson, Renata Konrad, Andrew C Trapp","doi":"10.1007/s10729-023-09646-3","DOIUrl":"10.1007/s10729-023-09646-3","url":null,"abstract":"Healthcare delivery in the United States has been characterized as overly reactive and dependent on emergency department care for safety net coverage, with opportunity for improvement around discharge planning and high readmissions and emergency department bounce-back rates. Community paramedicine is a recent healthcare innovation that enables proactive visitation of patients at home, often shortly after emergency department and hospital discharge. We establish the first optimization-based framework to study efficiencies in the management and operation of a community paramedicine program. The collective innovations of our modeling include i) a novel hierarchical objective function with the goals of fairly increasing patient welfare, lowering hospital costs, and reducing readmissions and emergency department visits, ii) a new constraint set that ensures priority same-day visits for emergent patients, and iii) a further extension of our model to determine the minimum supplemental resources necessary to ensure feasibility in a single optimization formulation. Our medical-need based objective function prioritizes patients based on their clinical features and seeks to select and schedule patient visits and route healthcare providers to maximize overall patient welfare while favoring shorter tours. We use our methods to develop managerial insights via computational experiments on a variety of test instances based on real data from a hospital system in Upstate New York. We are able to identify optimal and nearly optimal tours that efficiently select, route, and schedule patients in reasonable timeframes. Our results lead to insights that can support managerial decisions about establishing (and improving existing) community paramedicine programs.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"719-746"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10157611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging the E-commerce footprint for the surveillance of healthcare utilization. 利用电子商务足迹监控医疗保健使用情况。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2023-12-01 Epub Date: 2023-08-29 DOI: 10.1007/s10729-023-09645-4

Manuel Hermosilla, Jian Ni, Haizhong Wang, Jin Zhang

{"title":"Leveraging the E-commerce footprint for the surveillance of healthcare utilization.","authors":"Manuel Hermosilla, Jian Ni, Haizhong Wang, Jin Zhang","doi":"10.1007/s10729-023-09645-4","DOIUrl":"10.1007/s10729-023-09645-4","url":null,"abstract":"The utilization of healthcare services serves as a barometer for current and future health outcomes. Even in countries with modern healthcare IT infrastructure, however, fragmentation and interoperability issues hinder the (short-term) monitoring of utilization, forcing policymakers to rely on secondary data sources, such as surveys. This deficiency may be particularly problematic during public health crises, when ensuring proper and timely access to healthcare acquires special importance. We show that, in specific contexts, online pharmacies' digital footprint data may contain a strong signal of healthcare utilization. As such, online pharmacy data may enable utilization surveillance, i.e., the monitoring of short-term changes in utilization levels in the population. Our analysis takes advantage of the scenario created by the first wave of the Covid-19 pandemic in Mainland China, where the virus' spread lead to pervasive and deep reductions of healthcare service utilization. Relying on a large sample of online pharmacy transactions with full national coverage, we first detect variation that is strongly consistent with utilization reductions across geographies and over time. We then validate our claims by contrasting online pharmacy variation against credit-card transactions for medical services. Using machine learning methods, we show that incorporating online pharmacy data into the models significantly improves the accuracy of utilization surveillance estimates.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"604-625"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10167152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The assignment-dial-a-ride-problem. 分配问题。

IF 3.6 3区医学

Health Care Management Science Pub Date : 2023-12-01 Epub Date: 2023-10-21 DOI: 10.1007/s10729-023-09655-2

Chane-Haï Timothée, Vercraene Samuel, Monteiro Thibaud

{"title":"The assignment-dial-a-ride-problem.","authors":"Chane-Haï Timothée, Vercraene Samuel, Monteiro Thibaud","doi":"10.1007/s10729-023-09655-2","DOIUrl":"10.1007/s10729-023-09655-2","url":null,"abstract":"In this paper, we present the first Assignment-Dial-A-Ride problem motivated by a real-life problem faced by medico-social institutions in France. Every day, disabled people use ride-sharing services to go to an appropriate institution where they receive personal care. These institutions have to manage their staff to meet the demands of the people they receive. They have to solve three interconnected problems: the routing for the ride-sharing services; the assignment of disabled people to institutions; and the staff size in the institutions. We formulate a general Assignment-Dial-A-Ride problem to solve all three at the same time. We first present a matheuristic that iteratively generates routes using a large neighborhood search in which these routes are selected with a mixed integer linear program. After being validated on two special cases in the literature, the matheuristic is applied to real instances in three different areas in France. Several managerial results are derived. In particular, it is found that the amount of cost reduction induced by the people assignment is equivalent to the amount of cost reduction induced by the sharing of vehicles between institutions.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"770-784"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0