家庭护理和中心护理:从替代到协同。支持灵活提供护理服务的优化模式

IF 6.7 2区 管理学 Q1 MANAGEMENT
{"title":"家庭护理和中心护理:从替代到协同。支持灵活提供护理服务的优化模式","authors":"","doi":"10.1016/j.omega.2024.103184","DOIUrl":null,"url":null,"abstract":"<div><div>The delivery of health care services, especially for patients with chronic conditions and/or requiring cyclical treatment, can be accomplished by resorting to two organizational models: center-based care and home-based care. In developed countries, government pressure to reduce healthcare spending and the COVID-19 pandemic have led to the spread of home-based care. This type of care is proven to outperform the center-based one in terms of cost-effectiveness, patient satisfaction, and adherence to treatment guidelines. However, even for treatments usually suitable to be delivered at home, the patient's health status or other constraints may make it inappropriate to deliver service at the patient's home. This calls for a new organizational model, referred to as flexible care, where home-based and center-based care are not seen as mutually exclusive models but as options that can be activated according to the patient's and provider's needs. This paper presents a novel network-based deterministic optimization model and two matheuristics to address a scheduling problem typically faced by providers adopting a flexible care model. The model considers a provider relying on a treatment room with a fixed number of medical chairs, a fleet of vehicles, and a team of operators. It allows for determining on which days of the planning horizon, in which setting (home or center), and by which operator each patient will be treated. The model takes into account patients’ preferences and considers two objective functions: minimizing provider costs and patients’ travel time. In addition, we propose a two-stage mixed-integer stochastic programming model with recourse actions. This model allows incorporating the uncertainty due to the occurrence of adverse events. Adverse events are sudden changes in the patient's condition randomly happening at a specific point in the planning horizon. These events render the patient unsuitable for home care and require them to be visited at the center from that moment onward. The models have been inspired by a real case and tested on multiple random instances.</div></div>","PeriodicalId":19529,"journal":{"name":"Omega-international Journal of Management Science","volume":null,"pages":null},"PeriodicalIF":6.7000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Home-based care and center-based care: From being alternatives to being synergistic. Optimization models to support flexible care delivery\",\"authors\":\"\",\"doi\":\"10.1016/j.omega.2024.103184\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>The delivery of health care services, especially for patients with chronic conditions and/or requiring cyclical treatment, can be accomplished by resorting to two organizational models: center-based care and home-based care. In developed countries, government pressure to reduce healthcare spending and the COVID-19 pandemic have led to the spread of home-based care. This type of care is proven to outperform the center-based one in terms of cost-effectiveness, patient satisfaction, and adherence to treatment guidelines. However, even for treatments usually suitable to be delivered at home, the patient's health status or other constraints may make it inappropriate to deliver service at the patient's home. This calls for a new organizational model, referred to as flexible care, where home-based and center-based care are not seen as mutually exclusive models but as options that can be activated according to the patient's and provider's needs. This paper presents a novel network-based deterministic optimization model and two matheuristics to address a scheduling problem typically faced by providers adopting a flexible care model. The model considers a provider relying on a treatment room with a fixed number of medical chairs, a fleet of vehicles, and a team of operators. It allows for determining on which days of the planning horizon, in which setting (home or center), and by which operator each patient will be treated. The model takes into account patients’ preferences and considers two objective functions: minimizing provider costs and patients’ travel time. In addition, we propose a two-stage mixed-integer stochastic programming model with recourse actions. This model allows incorporating the uncertainty due to the occurrence of adverse events. Adverse events are sudden changes in the patient's condition randomly happening at a specific point in the planning horizon. These events render the patient unsuitable for home care and require them to be visited at the center from that moment onward. The models have been inspired by a real case and tested on multiple random instances.</div></div>\",\"PeriodicalId\":19529,\"journal\":{\"name\":\"Omega-international Journal of Management Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Omega-international Journal of Management Science\",\"FirstCategoryId\":\"91\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S030504832400149X\",\"RegionNum\":2,\"RegionCategory\":\"管理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MANAGEMENT\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Omega-international Journal of Management Science","FirstCategoryId":"91","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S030504832400149X","RegionNum":2,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MANAGEMENT","Score":null,"Total":0}
引用次数: 0

摘要

提供医疗服务,尤其是为慢性病患者和/或需要周期性治疗的患者提供医疗服务,可以采用两种组织模式:中心护理和家庭护理。在发达国家,政府削减医疗开支的压力和 COVID-19 的流行导致了家庭护理的普及。事实证明,这种护理方式在成本效益、患者满意度和遵守治疗指南方面优于中心护理方式。然而,即使是通常适合在家中提供的治疗,由于患者的健康状况或其他限制因素,也可能不适合在患者家中提供服务。这就需要一种新的组织模式,即 "灵活护理",在这种模式下,居家护理和中心护理并不被视为相互排斥的模式,而是可以根据患者和医疗服务提供者的需求进行选择。本文提出了一种新颖的基于网络的确定性优化模型和两种数学启发式方法,以解决采用灵活护理模式的医疗服务提供者通常面临的调度问题。该模型考虑了医疗服务提供者依赖一个拥有固定数量医疗椅的治疗室、一个车队和一个操作员团队的情况。通过该模型,可以确定每位患者在计划期内的哪一天、在哪种环境(家庭或中心)以及由哪位操作员进行治疗。该模型考虑了患者的偏好,并考虑了两个目标函数:最大限度地降低医疗服务提供者的成本和患者的旅行时间。此外,我们还提出了一个带有追索行动的两阶段混合整数随机编程模型。该模型考虑到了不良事件发生所带来的不确定性。不良事件是指在计划范围内的某个特定时间点随机发生的患者病情突变。这些事件会导致病人不适合接受家庭护理,并要求他们从那时起到中心就诊。这些模型受到真实案例的启发,并在多个随机实例上进行了测试。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Home-based care and center-based care: From being alternatives to being synergistic. Optimization models to support flexible care delivery
The delivery of health care services, especially for patients with chronic conditions and/or requiring cyclical treatment, can be accomplished by resorting to two organizational models: center-based care and home-based care. In developed countries, government pressure to reduce healthcare spending and the COVID-19 pandemic have led to the spread of home-based care. This type of care is proven to outperform the center-based one in terms of cost-effectiveness, patient satisfaction, and adherence to treatment guidelines. However, even for treatments usually suitable to be delivered at home, the patient's health status or other constraints may make it inappropriate to deliver service at the patient's home. This calls for a new organizational model, referred to as flexible care, where home-based and center-based care are not seen as mutually exclusive models but as options that can be activated according to the patient's and provider's needs. This paper presents a novel network-based deterministic optimization model and two matheuristics to address a scheduling problem typically faced by providers adopting a flexible care model. The model considers a provider relying on a treatment room with a fixed number of medical chairs, a fleet of vehicles, and a team of operators. It allows for determining on which days of the planning horizon, in which setting (home or center), and by which operator each patient will be treated. The model takes into account patients’ preferences and considers two objective functions: minimizing provider costs and patients’ travel time. In addition, we propose a two-stage mixed-integer stochastic programming model with recourse actions. This model allows incorporating the uncertainty due to the occurrence of adverse events. Adverse events are sudden changes in the patient's condition randomly happening at a specific point in the planning horizon. These events render the patient unsuitable for home care and require them to be visited at the center from that moment onward. The models have been inspired by a real case and tested on multiple random instances.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Omega-international Journal of Management Science
Omega-international Journal of Management Science 管理科学-运筹学与管理科学
CiteScore
13.80
自引率
11.60%
发文量
130
审稿时长
56 days
期刊介绍: Omega reports on developments in management, including the latest research results and applications. Original contributions and review articles describe the state of the art in specific fields or functions of management, while there are shorter critical assessments of particular management techniques. Other features of the journal are the "Memoranda" section for short communications and "Feedback", a correspondence column. Omega is both stimulating reading and an important source for practising managers, specialists in management services, operational research workers and management scientists, management consultants, academics, students and research personnel throughout the world. The material published is of high quality and relevance, written in a manner which makes it accessible to all of this wide-ranging readership. Preference will be given to papers with implications to the practice of management. Submissions of purely theoretical papers are discouraged. The review of material for publication in the journal reflects this aim.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信