Health Care Management Science最新文献_第8页

Optimal quality oversight in kidney transplantation and its impact on transplant centers' waitlist management. 肾移植的最佳质量监督及其对移植中心候补名单管理的影响。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-06-06 DOI: 10.1007/s10729-025-09713-x

Zahra Gharibi, Hung T Do, Michael Hahsler, Mehmet U S Ayvaci

{"title":"Optimal quality oversight in kidney transplantation and its impact on transplant centers' waitlist management.","authors":"Zahra Gharibi, Hung T Do, Michael Hahsler, Mehmet U S Ayvaci","doi":"10.1007/s10729-025-09713-x","DOIUrl":"10.1007/s10729-025-09713-x","url":null,"abstract":"This paper studies the effects of quality oversight in the context of assessing kidney transplantation-related outcomes and possible unintended consequences (e.g., cherry-picking of organs and selection of healthier transplant candidates). In this context, we propose a stochastic economic model that identifies socially optimal kidney transplant choices given the inherent trade-off between the expected wait time and the quality of the received donor kidney for a given patient. Socially optimal decisions seek to maximize the utilitarian welfare function defined as the sum of all patients' post-transplant expected utilities. To determine the social loss, we compare the socially optimal decisions to those taken by a transplant program that maximizes its utility. We derive the optimal quality oversight policy that minimizes social loss and examine how decisions are impacted due to the changes introduced by the new Kidney Allocation System. Our empirical analysis using data from the Scientific Registry of Transplant Recipients and United States Renal Data System indicates that current quality oversight imposed through Conditions of Participation results in inefficient transplant decisions for 56% of recipients, and the performance is inconsistent across different regions and parameters. We propose that the risk-adjusted post-transplant performance assessment policy considers the factors impacting demand-supply parameters such as organ availability in the 11 US transplant regions, candidates' blood type, and the newly introduced Kidney Allocation System. Policymakers and providers can utilize insights from our findings to design effective oversight mechanisms and make informed decisions regarding transplant and waitlist management that yield desired outcomes.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"381-410"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233965","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

A decomposition-based approach for multi-level appointment planning and scheduling. 基于分解的多级约会计划和调度方法。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-05-21 DOI: 10.1007/s10729-025-09707-9

Tine Meersman, Broos Maenhout

{"title":"A decomposition-based approach for multi-level appointment planning and scheduling.","authors":"Tine Meersman, Broos Maenhout","doi":"10.1007/s10729-025-09707-9","DOIUrl":"10.1007/s10729-025-09707-9","url":null,"abstract":"We study the scheduling of appointments for population-based breast cancer screening, considering different patient types in view of their stochastic no-show behaviour and service duration. The associated multi-level problem under study comprises both tactical planning decisions, assigning patients in advance to a mammography machine at a dispersed unit and appointment day, and operational scheduling decisions, stipulating the appointment time for patients. To mitigate the impact of operational variability, performance is safeguarded by optimising the minimum performance associated with defined chance constraints relative to the minimum number of performed screenings and the maximum patient wait time, resource idle time and overtime. We develop a decomposition method that iterates between tactical and operational decision levels with feedback loops. The tactical problem is reformulated as a deterministic mixed-integer quadratic-constrained programming problem and solved via a heuristic that defines a promising solution region based on problem-specific estimates. The operational problem is solved via Sample Average Approximation and decomposition of patient sequencing and appointment time assignment decisions. Computational results show that the developed decomposition-based procedure with feedback and the phase-specific methodologies are superior in terms of time and solution quality compared to alternative methods.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"478-504"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110306","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

Looking for the crystal ball in unscheduled care: a systematic literature review of the forecasting process. 在计划外护理中寻找水晶球：预测过程的系统文献综述。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-05-23 DOI: 10.1007/s10729-025-09711-z

Mingzhe Shi, Bahman Rostami-Tabar, Daniel Gartner

{"title":"Looking for the crystal ball in unscheduled care: a systematic literature review of the forecasting process.","authors":"Mingzhe Shi, Bahman Rostami-Tabar, Daniel Gartner","doi":"10.1007/s10729-025-09711-z","DOIUrl":"10.1007/s10729-025-09711-z","url":null,"abstract":"The ability to accurately forecast unscheduled care needs is of paramount importance for decision making in healthcare operations, ensuring a continuous and high-quality level of care. In this work, we provide a literature review of 156 research articles of forecasting applications with special focus on care services that are not scheduled in advance such as emergency departments. Our paper presents two key contributions. Firstly, we propose a novel framework designed to characterize the application of forecasting process across various unplanned healthcare services. Our taxonomy facilitates the detection, decomposition, and categorization of forecasting processes, enhancing the understanding of their deployment in different unscheduled care settings. Secondly, we conduct a comprehensive literature review based on a systematic search, critically analyzing the state of forecasting research in unscheduled care services and identifying key research gaps. We explore forecasting problems in depth, examining their purpose, the various methodologies used, the rigor used in generating and evaluating forecasts, and the reproducibility of results, all within the context of the proposed framework. By consolidating the current state of the art, this paper provides valuable insights to both healthcare professionals and academics regarding the effective application of forecasting in unscheduled care services. Finally, it serves as a roadmap for identifying major research gaps and outlines an agenda for future investigations.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"548-564"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127434","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

The crucial role of explainable artificial intelligence (XAI) in improving health care management. 可解释人工智能（XAI）在改善医疗保健管理中的关键作用。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-09-30 DOI: 10.1007/s10729-025-09720-y

Arne Johannssen, Nataliya Chukhrova

引用次数: 0

Enhancing patient accessibility of primary care: the redesign of Italian territorial medicine. 提高病人获得初级保健的机会：意大利领土医学的重新设计。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-10-04 DOI: 10.1007/s10729-025-09721-x

Antonio Diglio, Chiara Morlotti, Giuseppe Bruno, Mattia Cattaneo, Stefano Paleari, Carmela Piccolo

{"title":"Enhancing patient accessibility of primary care: the redesign of Italian territorial medicine.","authors":"Antonio Diglio, Chiara Morlotti, Giuseppe Bruno, Mattia Cattaneo, Stefano Paleari, Carmela Piccolo","doi":"10.1007/s10729-025-09721-x","DOIUrl":"10.1007/s10729-025-09721-x","url":null,"abstract":"Ensuring widespread accessibility of healthcare services is a crucial policy objective. Accordingly, the Italian National Recovery and Resilience Plan (NRRP) has prioritized territorial medicine, channeling post-pandemic investments toward the restructuring of primary care services. A notable change is the establishment of Community Healthcare Centers (CHCs). This paper investigates how CHCs contribute to the accessibility of healthcare in urban and rural areas. By leveraging a comprehensive dataset of general practitioners' availability and estimating future demand-and-supply scenarios, we examine the impact of CHCs under two different capacity allocation strategies. Strategy 1-Capacity expansion-involves allocating additional service hours of general practitioners to CHCs in order to maximize accessibility. Strategy 2-Capacity redistribution-accounts for the persistent shortage of healthcare professionals faced by Italy in the recent years by reallocating a portion of general practitioners' current services from their existing workplace locations to CHCs. Our results indicate that CHCs have the potential to maintain current accessibility levels and also enhance them in the years to come. Moreover, we demonstrate that simply redistributing the current capacity can improve future accessibility. Finally, we show that a mix of the capacity expansion and redistribution strategies (Strategy 3) can maximize accessibility in the future, limiting the need for new professional staff.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"527-547"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225408","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

Innovations in early detection of chronic non-communicable diseases among adolescents through an easy-to-Use AutoML paradigm. 通过易于使用的AutoML模式在青少年慢性非传染性疾病的早期检测方面进行创新。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.1007/s10729-025-09718-6

Nevena Rankovic, Dragica Rankovic, Igor Lukic

{"title":"Innovations in early detection of chronic non-communicable diseases among adolescents through an easy-to-Use AutoML paradigm.","authors":"Nevena Rankovic, Dragica Rankovic, Igor Lukic","doi":"10.1007/s10729-025-09718-6","DOIUrl":"10.1007/s10729-025-09718-6","url":null,"abstract":"In this research, we present an interpretable AutoML approach for the early diagnosis of hypertension and hyperinsulinemia among adolescents, conditions that are critical to identify during these formative years due to their requirement for lifelong care and monitoring. The dataset, collected from 2019 to 2022 by Serbia's Healthcare Center through an observational cross-sectional study, posed challenges common to medical datasets, including imbalances, data scarcity, and a need for transparent, explainable predictive models. To counter these issues, we utilized three AutoML frameworks - AutoGluon, H2O, and MLJAR - in conjunction with a Tabular Variational Autoencoder (TVAE) to synthetically augment the data points, Prinicipal Component Analysis (PCA) for dimensionality reduction, and SHapley Additive exPlanations (SHAP) and Permutation feature importance analyses to extract insights from the results. AutoGluon outperformed the others on the original dataset, delivering better results with weighted ensemble models for both conditions under a 12-minute budget-time constraint and maintaining all evaluation metrics below a 4% threshold, all without the need for further scaling or calibration in the experimental setup. Our research underscores the broad applicability of the current AutoML paradigm, highlighting its particular benefits for the healthcare domain and diagnostics, where such advanced tools can enhance patient care.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"434-460"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951809","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

A two-phase method for layout optimization: The case of a referral cancer center in Latin America. 布局优化的两阶段方法：以拉丁美洲转诊癌症中心为例。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-05-23 DOI: 10.1007/s10729-025-09710-0

Anderson Coutinho, Rafael Morais, Anand Subramanian, Matheus Silva, Oscar Porto, Luciano Costa

{"title":"A two-phase method for layout optimization: The case of a referral cancer center in Latin America.","authors":"Anderson Coutinho, Rafael Morais, Anand Subramanian, Matheus Silva, Oscar Porto, Luciano Costa","doi":"10.1007/s10729-025-09710-0","DOIUrl":"10.1007/s10729-025-09710-0","url":null,"abstract":"This work proposes a two-phase approach for optimizing the layout of a referral cancer center in Latin America, which results from a collaboration between a university, in Brazil, and a consultancy company. The objective of the problem is to minimize the total transportation cost of patients, medical/non-medical staff, materials, and equipment. In the first phase, an integer programming model is used to assign departments to floors in such a way that the vertical transportation cost between departments is reduced. In the second phase, a heuristic method is employed to determine the layout of the blocks across a given floor, when applicable, while minimizing the transportation cost within the floor. Process mining is employed to gather data associated with the movement flow between rooms and departments within the unit. The developed approach was used by the managers of the cancer center to help design a new hospital building, and the layout produced by the optimization procedure was compared with the initial layout originally built by the architects of the hospital. The results obtained demonstrate that our method was capable of significantly reducing both vertical ( <math><mrow><mo>-</mo> <mn>19.7</mn> <mo>%</mo></mrow> </math> ) and horizontal ( <math><mrow><mo>-</mo> <mn>22.7</mn> <mo>%</mo></mrow> </math> ) transportation costs within the hospital.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"411-433"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127431","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

Measuring the effect of deprivation on primary health care performance using data envelopment analysis and Malmquist Indices. 利用数据包络分析和Malmquist指数测量剥夺对初级卫生保健绩效的影响。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-06-07 DOI: 10.1007/s10729-025-09715-9

Holly Bea Merelie, Carla Alexandra Filipe Amado, Sérgio Pereira Dos Santos

{"title":"Measuring the effect of deprivation on primary health care performance using data envelopment analysis and Malmquist Indices.","authors":"Holly Bea Merelie, Carla Alexandra Filipe Amado, Sérgio Pereira Dos Santos","doi":"10.1007/s10729-025-09715-9","DOIUrl":"10.1007/s10729-025-09715-9","url":null,"abstract":"Life expectancy is typically shorter in areas with higher deprivation, highlighting the need for policymakers and health care managers to focus on reducing health inequalities through efficient and effective care. This study aims to assess the impact of deprivation on primary health care performance using data from the National Health Service (NHS) in England. Two methods are applied: Data Envelopment Analysis (DEA) to evaluate the performance of 188 Clinical Commissioning Groups (CCGs), whose duties were recently taken on by the new Integrated Care Systems (ICSs), and the Malmquist Index (MI) to assess deprivation's effect on performance. The DEA results reveal significant variation among CCGs in equity, efficiency, and effectiveness, indicating substantial room for improvement. The MI results show that while CCGs in more deprived areas had more resources per capita and higher efficiency, they were generally less effective than those in less deprived areas. This emphasizes the need to enhance health and social policies to address persistent health inequalities due to deprivation, a critical challenge for the new ICSs. This study illustrates how DEA and the MI can support policymakers and managers in this effort.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"461-477"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247547","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

Data in ambulatory care logistics: What modelers need and what practice can offer. 门诊护理物流中的数据：建模者需要什么，实践可以提供什么。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1007/s10729-025-09714-w

Anne Zander, Melanie Reuter-Oppermann

引用次数: 0

A change-point method for multi-lead electrocardiogram monitoring using weighted multivariate functional principal component analysis. 基于加权多元功能主成分分析的多导联心电图监测变点方法。

IF 2 3区医学

Health Care Management Science Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1007/s10729-025-09712-y

Hesam Hafezalseheh, Mohammad Fathian, Rassoul Noorossana, Yaser Zerehsaz, Kamran Heidari

{"title":"A change-point method for multi-lead electrocardiogram monitoring using weighted multivariate functional principal component analysis.","authors":"Hesam Hafezalseheh, Mohammad Fathian, Rassoul Noorossana, Yaser Zerehsaz, Kamran Heidari","doi":"10.1007/s10729-025-09712-y","DOIUrl":"10.1007/s10729-025-09712-y","url":null,"abstract":"Cardiovascular diseases (CVDs) are one of the primary reasons for death worldwide. These diseases often occur due to the occlusion of coronary arteries, thereby leading to insufficient blood and oxygen supply that damages cardiac muscle cells. Electrocardiogram (ECG) signals which reflect heart electrical activity are being used for diagnosing various cardiac diseases. Typically, a standard ECG consists of 12 channels referred to as leads which enable practitioners to monitor heartbeats through different channels where each heartbeat lasts approximately 600 ms. The majority of studies focus on the classification and early diagnosis of arrhythmias. Although the current studies on change-point methods have acquired massive accuracy in detecting potential shifts during a multi-channel process, they lack flexibility in manually assigning more weights to the channels, which are of more importance for experts. This could be addressed by implementing the weighted multivariate functional principal component analysis (WMFPCA). The objective of this study is to develop a novel change-point detection method to monitor long-term cardiovascular treatment. A third-order tensor structure was employed to represent the 12-lead ECG data in three dimensions (beats × samples × leads). Exploiting intra-beat, inter-beat, and inter-lead correlations along with channel significance in the third-order tensor, the WMFPCA is incorporated into Hotelling's <math> <msup><mrow><mi>T</mi></mrow> <mn>2</mn></msup> </math> statistic to construct monitoring schemes. Simulation results show that the proposed approach outperforms the existing methods in monitoring multi-channel processes. Finally, applying the suggested model on a real-world dataset containing Myocardial Infarction (MI) subjects verifies the model.","PeriodicalId":12903,"journal":{"name":"Health Care Management Science","volume":" ","pages":"357-380"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215666","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