Health Systems最新文献_第2页

Hospital productivity and value in pay-for-performance healthcare programs. 医院生产力和按绩效付费医疗保健计划的价值。

IF 1.2

Health Systems Pub Date : 2024-10-25 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2024.2421533

Chenzhang Bao, Indranil R Bardhan

{"title":"Hospital productivity and value in pay-for-performance healthcare programs.","authors":"Chenzhang Bao, Indranil R Bardhan","doi":"10.1080/20476965.2024.2421533","DOIUrl":"10.1080/20476965.2024.2421533","url":null,"abstract":"Pay-for-performance (P4P) reimbursement models were launched in 2013 to incentivise the value of healthcare delivered by including quality outcomes, such as mortality, readmission, and patient satisfaction, in hospital reimbursement in the U.S. Although a decade has passed, the efficacy of these P4P programs remains unclear. This research intends to evaluate their long-term performance implications along two critical dimensions - productivity and healthcare value. Drawing on a nationwide sample of U.S. hospitals collected from 2008 to 2019, we utilise data envelopment analysis to measure hospital performance and the Malmquist index to evaluate their longitudinal trends. Although average hospital productivity and value improved since the rollout of the P4P programs, we observe that a large proportion of laggard hospitals were unable to catch up with improvements to the performance frontier, raising concerns about disparities in the impact of future value-based programs. Our analyses also indicate that horizontal integration across hospitals is associated with greater productivity and value. While greater physician-hospital (vertical) integration is associated with higher hospital productivity, it does not have a positive impact on value. Our study provides new insights into the antecedents and performance consequences of implementing value-based healthcare initiatives and their implications for hospital managers and policymakers.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"14 2","pages":"131-144"},"PeriodicalIF":1.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reallocation of chemotherapy appointments in a large health system using a mixed integer linear programming approach. 使用混合整数线性规划方法在大型卫生系统中重新分配化疗预约。

IF 1.2

Health Systems Pub Date : 2024-10-23 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2024.2415653

Lauren Moore, Yu-Li Huang

{"title":"Reallocation of chemotherapy appointments in a large health system using a mixed integer linear programming approach.","authors":"Lauren Moore, Yu-Li Huang","doi":"10.1080/20476965.2024.2415653","DOIUrl":"10.1080/20476965.2024.2415653","url":null,"abstract":"Outpatient chemotherapy scheduling has significant implications for both patients and health systems. Consideration of treatment location preference is important for patient satisfaction and outcomes, and it is a complex decision impacted by travel distance. In health systems with one treatment site that stands out from the rest as a destination medical center (the primary site), there are financial and resource utilization incentives to free up as much space as possible for appointments at that site. In this study, we demonstrate that leveraging the underutilized health system sites allows decompression of appointment volume at the primary site, and it takes full advantage of valuable resources such as oncology nurses and chair availability. A Mixed Integer Linear Programming approach was used to develop a model under four scenarios which reallocates appointments from the primary site to other health system sites based on patient travel distance to the sites. This approach was applied to data from the Mayo Clinic Health System Minnesota region, which demonstrated that the health system has the potential to move approximately 50% of eligible appointments out of the primary site, resulting in an overall volume change of approximately 30%. Implications for scheduling policies and infrastructure are discussed.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"14 2","pages":"119-130"},"PeriodicalIF":1.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Balanced patient assignment to healthcare centres through dispatching rules. 通过调度规则平衡患者到医疗中心的分配。

IF 1.2

Health Systems Pub Date : 2024-09-30 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2024.2408543

Aydin Teymourifar, Maria A M Trindade

{"title":"Balanced patient assignment to healthcare centres through dispatching rules.","authors":"Aydin Teymourifar, Maria A M Trindade","doi":"10.1080/20476965.2024.2408543","DOIUrl":"10.1080/20476965.2024.2408543","url":null,"abstract":"In the realm of public health management, ensuring a balanced assignment of patients to healthcare centres is a critical concern. This study introduces a novel approach for this purpose, utilizing dispatching rules. Highlighting the need for an easily applicable approach to regulating patient flow efficiently, the study shows the benefit of utilizing dispatching rules in healthcare management. Innovatively, this research departs from traditional approaches by introducing a multi-objective model grounded in the concept of sectorization. This model, unique in the public health literature, leverages dispatching rules to simplify complex, dynamic patient assignment scenarios. Incorporating various factors, the model is simulated, and the optimization of the dispatching rules is carried out. The study's findings demonstrate that the optimized dispatching rule significantly enhances the model's efficacy in balancing patient assignments across healthcare centres. This improvement is pivotal in addressing the uneven distribution of healthcare resources. This research makes a substantial contribution to the public health literature by offering a novel and practical solution for balancing patient load among healthcare centres. Its successful application in simulated environments suggests a promising pathway for real-world implementations, potentially leading to more efficient healthcare systems and improved patient care outcomes.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"14 2","pages":"104-118"},"PeriodicalIF":1.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 simulation-based approach to analysing delays in the transport of critically ill neonates. 一种基于模拟的方法来分析危重新生儿的运输延迟。

IF 1.2

Health Systems Pub Date : 2024-08-22 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2024.2391740

Lun Li, Viveka Saraiya, Rachel A Umoren, Matthew W Cook, Taylor L Sawyer, Prashanth Rajivan

{"title":"A simulation-based approach to analysing delays in the transport of critically ill neonates.","authors":"Lun Li, Viveka Saraiya, Rachel A Umoren, Matthew W Cook, Taylor L Sawyer, Prashanth Rajivan","doi":"10.1080/20476965.2024.2391740","DOIUrl":"10.1080/20476965.2024.2391740","url":null,"abstract":"Neonatal interfacility transport ensures that critically ill neonatal patients can receive higher levels of care when needed. Delays in the transport process impact the quality of care and increase the risk of medical complications. The objective of this study is to investigate the operations-related factors that contribute to transport delays and explore the role of discrete-event simulation in improving the transport process. Semi-structured interviews were conducted with stakeholders to understand the neonatal interfacility transport process. Analysis of historical call logs and transport data was performed to identify inputs to the discrete-event simulation model. Statistical tests were used to identify the effect of various factors on wait time and transport time in the simulation model. High patient volume and limited bed capacity at the receiving hospitals are identified as bottlenecks that lead to extended wait time and transportation time. Additionally, having more geographically distributed ambulance resources does not significantly help with the time delays when the receiving hospital capacity stays unchanged. Discrete-event simulation models can be used to investigate the effects of operations-related factors in the interfacility transport of critically ill neonates to support future process improvement.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"14 1","pages":"69-84"},"PeriodicalIF":1.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resilience of hospitals in an age of disruptions: a systematic literature review on resources and capabilities. 医院在混乱时代的应变能力：关于资源和能力的系统文献综述。

IF 1.2

Health Systems Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2024.2365144

Nunzia Carbonara, Roberta Pellegrino, Cristina De Luca

{"title":"Resilience of hospitals in an age of disruptions: a systematic literature review on resources and capabilities.","authors":"Nunzia Carbonara, Roberta Pellegrino, Cristina De Luca","doi":"10.1080/20476965.2024.2365144","DOIUrl":"10.1080/20476965.2024.2365144","url":null,"abstract":"Hospitals play a critical role in ensuring continuous and effective healthcare delivery, especially during crises. However, the COVID-19 pandemic exposed vulnerabilities in hospital systems, prompting a need to enhance resilience-the ability to withstand, absorb, respond to, recover from, and learn from disasters. A systematic literature review, grounded in the resource-based view, identified organizational characteristics, in terms of resources and capabilities, and their synergistic effects that bolster hospital resilience. The results demonstrate that digital technologies impact on anticipation and adaptation abilities, organizational capabilities to reorganize roles, tasks, and spaces enhance adaptability, and Inter-organizational collaborations increase the responsiveness of the hospitals. The study provides substantial theoretical and practical contributions. It expands knowledge of hospital resilience in light of recent disruptive events and promotes integration capabilities as determinants for the majority of resilience dimensions. All organisational and inter-organisational collaboration, cooperation, and coordination are deemed crucial for hospital resilience.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"13 3","pages":"192-228"},"PeriodicalIF":1.2,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving COVID-19 vaccination centre operation through computer modelling and simulation. 通过计算机建模和模拟改善COVID-19疫苗接种中心的运作。

IF 1.2

Health Systems Pub Date : 2024-04-09 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2024.2339817

Richard M Wood, Simon J Moss, Ben J Murch, Chris Davies, Christos Vasilakis

{"title":"Improving COVID-19 vaccination centre operation through computer modelling and simulation.","authors":"Richard M Wood, Simon J Moss, Ben J Murch, Chris Davies, Christos Vasilakis","doi":"10.1080/20476965.2024.2339817","DOIUrl":"10.1080/20476965.2024.2339817","url":null,"abstract":"Mass vaccination has provided a route out of the COVID-19 pandemic in a way that social restrictions can be safely eased. For many countries, dedicated vaccination centres have been key to that effort. However, with no directly comparable historical experience there has been little information to guide the operational management and initial configuration of these sites. This paper provides an account of how, early in the mass vaccination effort, Operational Research has been a valuable asset in supporting management decisions at two major vaccination centres in the UK. We first describe a conceptual pathway model representing the key stages of the vaccination process, from registration to clinical assessment, vaccination, and observation. An approximation using discrete event simulation is then presented. On application, we report on its use in influencing the initial setup of one site, with model outputs directly setting the daily number of patient bookings. For the same site, we reveal how analysis has informed a significant operational shift in combining two key activities on the vaccination pathway (clinical assessment and vaccination). Finally, we describe how, at a second site, modelling has examined pathway stability, in terms of resilience to unforeseen \"shocks\" such as delayed arrivals and staff unavailability.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"14 1","pages":"43-57"},"PeriodicalIF":1.2,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using participatory systems approaches to improve healthcare delivery. 利用参与式系统方法改善医疗保健服务。

IF 1.2

Health Systems Pub Date : 2024-01-13 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2285555

Guillaume Lamé, Antuela Tako, Maaike Kleinsmann

引用次数: 0

From digital health to learning health systems: four approaches to using data for digital health design. 从数字健康到学习型健康系统：利用数据进行数字健康设计的四种方法。

IF 1.2

Health Systems Pub Date : 2024-01-13 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2284712

Valeria Pannunzio, Maaike Kleinsmann, Dirk Snelders, Jeroen Raijmakers

引用次数: 0

Application of a composite, multi-scale COVID-19 mitigation framework: US border use-case 多尺度 COVID-19 综合缓解框架的应用：美国边境案例