医疗运营中的不确定性：医院如何抵御完美风暴

IF 6.5 2区管理学 Q1 MANAGEMENT

Journal of Operations Management Pub Date : 2024-09-02 DOI:10.1002/joom.1327

Sriram Thirumalai, Sarv Devaraj, Tyson R. Browning

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引用次数: 0

摘要

我们重点关注医疗运营中众多不确定性来源中的两个，即混合不确定性--患者组合所需的医疗服务复杂性的变化，以及数量不确定性--患者群体所需的医疗服务数量的变化。我们采用跨学科的视角，研究了混合不确定性和数量不确定性对住院时间和手术次数这两个重要医疗结果的影响，以及相关重点和利用水平等运营概念的缓解影响。基于美国中西部 5 个州 731 家医院 26 个临床科室 830,853 名出院患者的大型数据集，我们的研究结果表明，组合和数量的不确定性对患者护理均有显著影响。我们还发现，相关重点和科室利用水平对医疗环境中的不确定性有缓解作用。最后，我们还发现不确定性对不同类型医院和科室的影响存在很大差异。我们将讨论研究结果的主要研究意义和管理意义。

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Uncertainty in healthcare operations: How hospitals weather the perfect storm

We focus on two of the many sources of uncertainty in healthcare operations, mix uncertainty – the variation in the complexity of care required by the patient mix, and volume uncertainty – the variation in the volume of care demanded by the patient population. Using an interdisciplinary perspective, we study the impact of mix and volume uncertainties on two important healthcare outcomes, length of stay and number of procedures, along with the mitigation impacts of the operational concepts of related focus and utilization levels. Based on large dataset of 830,853 patient discharges in 26 clinical departments across 731 hospitals in five U.S. Midwest states, our results indicate that mix and volume uncertainties each have a significant impact on patient care. We also find that related focus and department utilization levels have a mitigating effect on uncertainty in healthcare settings. Lastly, we find considerable heterogeneity in the effects of uncertainty across hospital types and departments. We discuss key research and managerial implications of our findings.

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来源期刊

Journal of Operations Management 管理科学-运筹学与管理科学

CiteScore

11.00

自引率

15.40%

发文量

审稿时长

24 months

期刊介绍： The Journal of Operations Management (JOM) is a leading academic publication dedicated to advancing the field of operations management (OM) through rigorous and original research. The journal's primary audience is the academic community, although it also values contributions that attract the interest of practitioners. However, it does not publish articles that are primarily aimed at practitioners, as academic relevance is a fundamental requirement. JOM focuses on the management aspects of various types of operations, including manufacturing, service, and supply chain operations. The journal's scope is broad, covering both profit-oriented and non-profit organizations. The core criterion for publication is that the research question must be centered around operations management, rather than merely using operations as a context. For instance, a study on charismatic leadership in a manufacturing setting would only be within JOM's scope if it directly relates to the management of operations; the mere setting of the study is not enough. Published papers in JOM are expected to address real-world operational questions and challenges. While not all research must be driven by practical concerns, there must be a credible link to practice that is considered from the outset of the research, not as an afterthought. Authors are cautioned against assuming that academic knowledge can be easily translated into practical applications without proper justification. JOM's articles are abstracted and indexed by several prestigious databases and services, including Engineering Information, Inc.; Executive Sciences Institute; INSPEC; International Abstracts in Operations Research; Cambridge Scientific Abstracts; SciSearch/Science Citation Index; CompuMath Citation Index; Current Contents/Engineering, Computing & Technology; Information Access Company; and Social Sciences Citation Index. This ensures that the journal's research is widely accessible and recognized within the academic and professional communities.