设计分层网络以改善患者获得护理的机会:退伍军人眼科护理的案例研究

IF 1 Q3 ENGINEERING, MULTIDISCIPLINARY
Adam VanDeusen, Amy E. M. Cohn, April Y. Maa
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引用次数: 0

摘要

在美国各地,许多患者,包括退伍军人患者,在获得适当、及时和负担得起的医疗保健方面面临障碍。在开发或修改医疗保健系统以改善患者可及性时,我们可以考虑一些策略(例如远程医疗),在这些策略中,使用成本更低、资源更丰富的服务,通常需要更有限和/或更昂贵的专门资源。我们提出了一个框架,在这个框架中,分层护理网络允许患者从成本更低、更容易获得的替代方案中获得一线护理,而专门的资源则保留给更复杂的护理。我们使用运筹学工具,包括混合整数规划和设施位置模型,来设计和分析这些网络。我们提出了一个案例研究,应用这些方法来改善退伍军人获得眼科保健筛查的机会。案例研究结果表明,在整个系统的不同地点使用不同的提供者可以使筛查的患者人数增加近四倍,而预算仅增加2.5%。在设计医疗保健网络以改善可及性时,决策者必须考虑若干权衡,包括如何分配资源。运筹学工具是理解、设计和评估这些权衡的有效方法,以最好地理解资源(再)分配的广泛影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Designing hierarchical networks to improve patient access to care: a case study in veteran eye care
Across the United States, many patients, including veteran patients, face barriers in accessing appropriate, timely, and affordable healthcare. When developing or modifying healthcare systems to improve patient access, we can consider strategies (e.g., telehealth) in which lower-cost, more abundant resources are used for services often performed with more constrained and/or more expensive, specialized resources. We propose a framework in which hierarchical care networks allow patients to receive frontline care from lower cost, more accessible alternatives, while specialized resources are reserved for more complex care. We use operations research tools, including mixed-integer programming and facility location models, to design and analyze these networks. We present a case study applying these methods to improve veterans’ access to eye care screenings. The case study results demonstrate that using different providers in locations throughout the system can increase the number of patients screened by nearly four times the number currently screened while increasing the budget by only 2.5%. When designing healthcare networks to improve access, decision makers must consider several trade-offs, including how resources are distributed. Operations research tools are effective methods for understanding, designing, and evaluating these trade-offs to best understand the wide-ranging impacts of resource (re)distribution.
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来源期刊
CiteScore
2.80
自引率
12.50%
发文量
40
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