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A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand. 基于遗传算法的战略规划框架，用于优化新西兰Northland的一般做法的可及性和成本
IF 1.8
Health Systems Pub Date : 2023-02-16 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2174454
Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson
{"title":"A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand.","authors":"Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson","doi":"10.1080/20476965.2023.2174454","DOIUrl":"10.1080/20476965.2023.2174454","url":null,"abstract":"<p><p>Shortage of general practitioners (GP) is a challenge worldwide, not only in Europe, but also in countries like New Zealand. Providing primary care in rural areas is especially challenging. In order to support decision makers, it is necessary to first assess the current GP coverage and then to determine different scenarios and plans for the future. In this paper, we first present a thorough overview of related literature on locating GP practices. Second, we propose an approach for assessing the GP coverage and determining future GP locations based on a genetic algorithm framework. As a use case, we have chosen the rural New Zealand region of Northland. We also perform a sensitivity analysis for the main input parameters.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"1 1","pages":"332-356"},"PeriodicalIF":1.8,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41535798","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 stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway 使用随机模拟模型研究挪威分散式免入单元的入住率
IF 1.8
Health Systems Pub Date : 2023-02-15 DOI: 10.1080/20476965.2023.2174453
Meetali Kakad, M. Utley, F. A. Dahl
{"title":"Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway","authors":"Meetali Kakad, M. Utley, F. A. Dahl","doi":"10.1080/20476965.2023.2174453","DOIUrl":"https://doi.org/10.1080/20476965.2023.2174453","url":null,"abstract":"ABSTRACT Identifying alternatives to acute hospital admission is a priority for many countries. Over 200 decentralised municipal acute units (MAUs) were established in Norway to divert low-acuity patients away from hospitals. MAUs have faced criticism for low mean occupancy and not relieving pressures on hospitals. We developed a discrete time simulation model of admissions and discharges to MAUs to test scenarios for increasing absolute mean occupancy. We also used the model to estimate the number of patients turned away as historical data was unavailable. Our experiments suggest that mergers alone are unlikely to substantially increase MAU absolute mean occupancy as unmet demand is generally low. However, merging MAUs offers scope for up to 20% reduction in bed capacity, without affecting service provision. Our work has relevance for other admissions avoidance units and provides a method for estimating unconstrained demand for beds in the absence of historical data.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46265431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the impact of software quality models in healthcare software systems. 评估软件质量模型对医疗保健软件系统的影响。
IF 1.2
Health Systems Pub Date : 2023-01-08 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2022.2162445
Elisabetta Ronchieri, Marco Canaparo
{"title":"Assessing the impact of software quality models in healthcare software systems.","authors":"Elisabetta Ronchieri, Marco Canaparo","doi":"10.1080/20476965.2022.2162445","DOIUrl":"10.1080/20476965.2022.2162445","url":null,"abstract":"<p><p>Health and medical care are safety-critical environments. The development of a safe and reliable healthcare software system is one of the most important processes which may affect the accuracy of clinical decision making and have an impact on determining diagnoses of and treatment for diseases. The aim of this study is to assess if software quality models, such as McCall, can have an impact on healthcare software quality for the purpose of reducing software failures. We have identified the main criticalities of healthcare software systems based on existing literature, software quality models and programming language standards; we have related these criticalities to software characteristics; we have analysed the relationship between the main criticalities of healthcare software systems and their software characteristics. The following criticalities - the risk of changing hard-coded software and the importance of developing maintainable software - must be addressed at the start of the software development process.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"85-97"},"PeriodicalIF":1.2,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131150","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
Strategic planning of operating room session allocation using stability analysis. 基于稳定性分析的手术室会期分配策略规划。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2021.1997651
Shiva Faeghi, Kunibert Lennerts, Stefan Nickel
{"title":"Strategic planning of operating room session allocation using stability analysis.","authors":"Shiva Faeghi,&nbsp;Kunibert Lennerts,&nbsp;Stefan Nickel","doi":"10.1080/20476965.2021.1997651","DOIUrl":"https://doi.org/10.1080/20476965.2021.1997651","url":null,"abstract":"<p><p>Operating room (OR) resources are limited, and for this reason there is usually a competition among surgeons to win them. However, the methods developed for allocating OR sessions are mostly based on optimisation methods which compensate the preferences of surgeons or surgical specialities in favour of the productivity of the entire OR department. This leads to conflict and dissatisfaction among surgeons. To overcome this problem, a methodology based on game theoretic solutions is presented in this paper that formulates the allocation problem as a simple game. The surgeons or specialities as players then jointly pursue the goal of achieving overall stability. Stability is defined and measured using a method called Power Index. The proposed method is then combined with the Monte-Carlo technique to deal with uncertainties. To demonstrate the capability of the suggested procedures, they are applied to a case study from the literature and a set of hypothetical scenarios.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 2","pages":"167-180"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208130/pdf/THSS_12_1997651.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195640","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: 2
Mind the gap: a review of optimisation in mental healthcare service delivery. 注意差距:精神卫生保健服务提供的优化审查。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2022.2035260
Sheema Noorain, Maria Paola Scaparra, Kathy Kotiadis
{"title":"Mind the gap: a review of optimisation in mental healthcare service delivery.","authors":"Sheema Noorain,&nbsp;Maria Paola Scaparra,&nbsp;Kathy Kotiadis","doi":"10.1080/20476965.2022.2035260","DOIUrl":"https://doi.org/10.1080/20476965.2022.2035260","url":null,"abstract":"<p><p>Well-planned care arrangements with effective distribution of available resources have the potential to address inefficiencies in mental health services. We begin by exploring the complexities associated with mental health and describe how these influence service delivery. We then conduct a scoping literature review of studies employing optimisation techniques that address service delivery issues in mental healthcare. Studies are classified based on criteria such as the type of planning decision addressed, the purpose of the study and care setting. We analyse the modelling methodologies used, objectives, constraints and model solutions. We find that the application of optimisation to mental healthcare is in its early stages compared to the rest of healthcare. Commonalities between mental healthcare service provision and other services are discussed, and the future research agenda is outlined. We find that the existing application of optimisation in specific healthcare settings can be transferred to mental healthcare. Also highlighted are opportunities for addressing specific issues faced by mental healthcare services.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 2","pages":"133-166"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/47/THSS_12_2035260.PMC10208133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9523966","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: 6
Multi-criteria decision-making methods applied in health-insurance underwriting. 多准则决策方法在健康保险承保中的应用。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2022.2085190
John Mourmouris, Thomas Poufinas
{"title":"Multi-criteria decision-making methods applied in health-insurance underwriting.","authors":"John Mourmouris,&nbsp;Thomas Poufinas","doi":"10.1080/20476965.2022.2085190","DOIUrl":"https://doi.org/10.1080/20476965.2022.2085190","url":null,"abstract":"ABSTRACT This study attempts to structure methodologically the health insurance underwriting process by applying Multi-criteria Decision-making (MCDM) analysis in health insurance underwriting. This is done by assigning a score to each health insurance applicant which can be used to determine whether he or she is accepted, rejected or accepted with special terms and conditions (such as exclusions, additional waiting periods and/ or surcharge). The introduction of MCDM approaches in health insurance underwriting enables the quantification of the selection criteria, the increased standardization and automation of the process and its alignment through quantitative indicators with the risk tolerance/ risk appetite of the insurer, and there lie the novelties of this research. The proposed methodology can be readily implemented by insurers with added value in the underwriting, risk management and distribution (sales & marketing) functions, as well as in the profitability of the company or the level of premium paid by the insured.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"52-84"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013473/pdf/THSS_12_2085190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660049","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: 2
Trade, intellectual property, and the public health bearing. 贸易、知识产权和公共卫生影响。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2022.2062460
Julie Babyar
{"title":"Trade, intellectual property, and the public health bearing.","authors":"Julie Babyar","doi":"10.1080/20476965.2022.2062460","DOIUrl":"https://doi.org/10.1080/20476965.2022.2062460","url":null,"abstract":"<p><p>The objective of this article is to describe the current fracture between global trade and public health priorities, as well as examine opportunities for harmonisation. A literature review of public health, global trade, and intellectual property articles describes several issues with recommendations. Currently, there is mixed quality of research and a lack of health impact assessments to accompany the global trade agenda. Human rights concepts continue in debate as flexibilities to trade laws remain without organised surveillance or evaluation. There are specific, relevant recommendations to implement a trade agenda inclusive of public health leadership. Recent trade and intellctual property advances in public health collaborations should be supported and continued. Trade groups should produce impact assessments before decisions on policies are made, with quality to the research. Lastly, a global research and development treaty should be an open, accessed path.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"123-132"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013560/pdf/THSS_12_2062460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9643124","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
Wait!What does that mean?: Eliminating ambiguity of delays in healthcare from an OR/MS perspective. 等等!这是什么意思?从OR/MS的角度消除医疗保健延迟的模糊性。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2021.2018362
Maria Van Zyl-Cillié, Derya Demirtas, Erwin Hans
{"title":"Wait!What does that mean?: Eliminating ambiguity of delays in healthcare from an OR/MS perspective.","authors":"Maria Van Zyl-Cillié,&nbsp;Derya Demirtas,&nbsp;Erwin Hans","doi":"10.1080/20476965.2021.2018362","DOIUrl":"https://doi.org/10.1080/20476965.2021.2018362","url":null,"abstract":"<p><p>Waiting time in healthcare is a significant problem that occurs across the world and often has catastrophic effects. There are various terms used for waiting time (\"sojourn\", \"throughput\" etc.) and there is no consensus on how these terms are defined. Ambiguous definitions of waiting time make it difficult to compare and measure the problems related to waiting times and delays in healthcare. We present a systematic search and review of the Operations Research and Management Science (ORMS) literature on delays in healthcare services. We search for articles from 2004 to 2019 and base our search strategy on a well-known healthcare planning and control decision taxonomy. An important step towards reducing the ambiguity in the definitions is to distinguish between <i>access time</i> and <i>waiting time</i>. We provide clear definitions and examples of access time and waiting time, and we classify our search results according to three categories: article type, healthcare service investigated and ORMS technique used to solve the delay problem. We find that half of the ORMS research on the waiting and access time problem is done on Ambulatory Care services. We provide tables for each healthcare service that highlight key definitions, the techniques that are used most often and the healthcare environment where the research is done. This research highlights the significant ORMS research that is done on access and waiting time in healthcare as well as the remaining research opportunities. Moreover, it provides a common language for the ORMS community to solve critical waiting time issues in healthcare.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"3-21"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/a5/THSS_12_2018362.PMC10013540.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500501","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: 1
Embedding OR modelling as decision support in health capacity planning: insights from an evaluation. 在卫生能力规划中嵌入OR建模作为决策支持:来自评估的见解。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2021.1983476
Sally Brailsford, Steffen Bayer, Con Connell, Abraham George, Jonathan Klein, Peter Lacey
{"title":"Embedding OR modelling as decision support in health capacity planning: insights from an evaluation.","authors":"Sally Brailsford,&nbsp;Steffen Bayer,&nbsp;Con Connell,&nbsp;Abraham George,&nbsp;Jonathan Klein,&nbsp;Peter Lacey","doi":"10.1080/20476965.2021.1983476","DOIUrl":"https://doi.org/10.1080/20476965.2021.1983476","url":null,"abstract":"<p><p>Literature reviews over five decades have reported the paucity of examples of OR methods being routinely used to support decision-making in health and social care. This paper presents insights from an independent evaluation of a project intended to overcome some of the barriers to implementation by establishing a \"community of practice\" in Kent (England). The project itself was undertaken by practitioners, and had two main aims: providing training in system dynamics modelling to analysts, and making senior managers aware of the benefits of modelling. The findings largely confirmed previous studies, but also raised issues about style of training delivery and selection of problems to be modelled. Project leaders fully understood the barriers to embedding OR modelling skills, and made considerable efforts to avoid them, but nevertheless the main barrier, pressures on people's time, remained an obstacle. The paper concludes with general reflections and advice.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"22-35"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/7f/THSS_12_1983476.PMC10013439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131148","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: 3
Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation. 了解在CPOE实施过程中，医生对工作需求和流程利益的看法是如何演变的。
IF 1.8
Health Systems Pub Date : 2023-01-01 DOI: 10.1080/20476965.2022.2113343
Arun Rai, Mark Keil, Hyoungyong Choi, Vitali Mindel
{"title":"Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation.","authors":"Arun Rai,&nbsp;Mark Keil,&nbsp;Hyoungyong Choi,&nbsp;Vitali Mindel","doi":"10.1080/20476965.2022.2113343","DOIUrl":"https://doi.org/10.1080/20476965.2022.2113343","url":null,"abstract":"<p><p>We examine how physicians' perceptions of two computerized provider order entry (CPOE) capabilities, standardisation of care protocols and documentation quality, are associated with their perceptions of turnaround time, medical error, and job demand at three phases of CPOE implementation: pre-go-live, initial use, and continued use. Through a longitudinal study at a large urban hospital, we find standardisation of care protocols is positively associated with turnaround time reduction in all phases but positively associated with job demand increase only in the initial use phase. Standardisation also has a positive association with medical error reduction in the initial use phase, but later this effect becomes fully mediated through turnaround time reduction in the continued use phase. Documentation quality has a positive association with medical error reduction in the initial use phase and this association strengthens in the continued use phase. Our findings provide insights to effectively manage physicians' response to CPOE implementation.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"98-122"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013386/pdf/THSS_12_2113343.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10471915","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
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