An optimization framework for large-scale screening under limited testing capacity with application to COVID-19
AbstractWe consider the problem of targeted mass screening of heterogeneous populations under limited testing capacity. Mass screening is an essential tool that arises in various settings, e.g., ensuring a safe supply of blood, reducing prevalence of sexually transmitted diseases, and mitigating the spread of infectious disease outbreaks. The goal of mass screening is to classify whole population groups as positive or negative for an infectious disease as efficiently and accurately as possible. Under limited testing capacity, it is not possible to screen the entire population and hence administrators must reserve testing a...
Source: Health Care Management Science - April 24, 2024 Category: Health Management Source Type: research
Do adjustment costs constrain public healthcare providers ’ technical efficiency? Evidence from the New Zealand Public Healthcare System
AbstractEfficiency analysis is crucial in healthcare to optimise resource allocation and enhance patient outcomes. However, the prompt adaptation of inputs can be hindered by adjustment costs, which impact Long-Run Technical Efficiency (LRTE). To bridge this gap in healthcare literature, this research employs a Bayesian Dynamic Stochastic Frontier Model to estimate parameters and explore healthcare efficiency dynamics over time. The study reveals the LRTE for New Zealand District Health Boards (DHBs) as 0.76, indicating around 32% more input utilisation due to adjustment costs. Most DHBs exhibit consistent short-run operat...
Source: Health Care Management Science - March 11, 2024 Category: Health Management Source Type: research
Real-time management of intra-hospital patient transport requests
AbstractThis paper addresses the management of patients ’ transportation requests within a hospital, a very challenging problem where requests must be scheduled among the available porters so that patients arrive at their destination timely and the resources invested in patient transport are kept as low as possible. Transportation requests arrive durin g the day in an unpredictable manner, so they need to be scheduled in real-time. To ensure that the requests are scheduled in the best possible manner, one should also reconsider the decisions made on pending requests that have not yet been completed, a process that will b...
Source: Health Care Management Science - March 6, 2024 Category: Health Management Source Type: research
Applications of data envelopment analysis in acute care hospitals: a systematic literature review, 1984 –2022
This study reviews scholarly publications on data envelopment analysis (DEA) studies on acute care hospital (ACH) efficiency published between 1984 and 2022 in scholarly peer-reviewed journals. We employ systematic literature review (SLR) method to identify and analyze pertinent past research using predetermined steps. The SLR offers a comprehensive resource that meticulously analyzes DEA methodology for practitioners and researchers focusing on ACH efficiency measurement. The articles r eviewed in the SLR are analyzed and synthesized based on the nature of the DEA modelling process and the key findings from the DEA mode...
Source: Health Care Management Science - March 4, 2024 Category: Health Management Source Type: research
Editorial – Acknowledgement of reviewers and editorial board members
(Source: Health Care Management Science)
Source: Health Care Management Science - February 19, 2024 Category: Health Management Source Type: research
Optimization of the stroke hospital selection strategy and the distribution of endovascular thrombectomy resources
AbstractNowadays, emergency medical technicians (EMTs) decide to send a suspected stroke patient to a primary stroke center (PSC) or to an endovascular thrombectomy (EVT)-capable hospital, based on the Cincinnati Prehospital Stroke Scale (CPSS) and the number of symptoms a patient presents at the scene. Based on existing studies, the patient is likely to have a better functional outcome after three months if the time between the onset of symptoms and receiving EVT treatment is shorter. However, if an acute ischemic stroke (AIS) patient with large vessel occlusion (LVO) is first sent to a PSC, and then needs to be transferr...
Source: Health Care Management Science - February 12, 2024 Category: Hospital Management Source Type: research
The potential of patient-based nurse staffing – a queuing theory application in the neonatal intensive care setting
AbstractFaced by a severe shortage of nurses and increasing demand for care, hospitals need to optimally determine their staffing levels. Ideally, nurses should be staffed to those shifts where they generate the highest positive value for the quality of healthcare. This paper develops an approach that identifies the incremental benefit of staffing an additional nurse depending on the patient mix. Based on the reasoning that timely fulfillment of care demand is essential for the healthcare process and its quality in the critical care setting, we propose to measure the incremental benefit of staffing an additional nurse thro...
Source: Health Care Management Science - January 30, 2024 Category: Health Management Source Type: research
Integrated procurement and reprocessing planning for reusable medical devices with a limited shelf life
We present a new model formulation for a multiproduct dynamic order quantity problem with product returns and a reprocessing option. The optimization considers the limited shelf life of sterile medical devices as well as the capacity constraints of reprocessing and sterilization resources. The time-varying demand is known in advance and must be satisfied by purchasing new medical devices or by reprocessing used and expired devices. The objective is to determine a feasible procurement and reprocessing plan that minimizes the incurred costs. The problem is solved in a heuristic manner in two steps. First, we use a Dantzig-Wo...
Source: Health Care Management Science - January 25, 2024 Category: Hospital Management Source Type: research
Correction to: Prediction of hospitalization and waiting time within 24 h of emergency department patients with unstructured text data
(Source: Health Care Management Science)
Source: Health Care Management Science - January 10, 2024 Category: Hospital Management Source Type: research
Efficiency effects of public hospital closures in the context of public hospital reform: a multistep efficiency analysis
The objective of this study is to examine the effect of closure on competitive hospital performances. Using administrative data from Turkish Public Hospital Statistical Yearbooks for the years 2005 to 2007 and 2014 to 2017, we conducted a three-step efficiency analysis by incorporating data envelopment analysis (DEA) and propensity score matching techniques, followed by a difference-in-differences (DiD) regression. First, we used bootstrapped DEA to calculate the efficiency scores of hospitals that were located near hospitals that had been closed. Second, we used nearest neighbour propensity score matching to form control ...
Source: Health Care Management Science - December 6, 2023 Category: Hospital Management Source Type: research
Patient-to-nurse ratios: Balancing quality, nurse turnover, and cost
We present results based on data collected from three participating hospitals, the American Hospital Association (AHA), and the California Office of Statewide Health Planning and Development (OSHPD). By incorporating patient and nurse outcomes, we show that lower patient-to-nurse ratios can potentially provide hospitals with financial benefits in addition to improving the quality of care. Furthermore, our results show that higher policy patient-to-nurse ratio upper limits may not be as harmful in smaller hospitals, but lower policy patient-to-nurse ratios may be necessary for larger hospitals. These results suggest that a ...
Source: Health Care Management Science - November 29, 2023 Category: Health Management Source Type: research
Combining machine learning and optimization for the operational patient-bed assignment problem
AbstractAssigning inpatients to hospital beds impacts patient satisfaction and the workload of nurses and doctors. The assignment is subject to unknown inpatient arrivals, in particular for emergency patients. Hospitals, therefore, need to deal with uncertainty on actual bed requirements and potential shortage situations as bed capacities are limited. This paper develops a model and solution approach for solving the patient bed-assignment problem that is based on a machine learning (ML) approach to forecasting emergency patients. First, it contributes by improving the anticipation of emergency patients using ML approaches,...
Source: Health Care Management Science - November 28, 2023 Category: Health Management Source Type: research
Determining optimal COVID-19 testing center locations and capacities
The objective is to minimize the total number of delayed appointments and specimens subject to budget, capacity, and turnaround time constraints, which will in turn improve the accessibility to testing. We apply our model to a case study for locating COVID-19 testing centers in the Region of Waterloo, Canada using data from the Ontario Ministry of Health, public health databases, and medical literature. We also test the performance of the model under uncertain demand and analyze its outputs under various scenarios. Our analyses provide practical insights to the public health decision-makers on the timing of capacity expans...
Source: Health Care Management Science - November 7, 2023 Category: Health Management Source Type: research
Managing a multi-panel clinic with heterogeneous patients
This study quantifies patient overflow and builds a mathematical model to evaluate the effect of two implementable panel assignments. In special ized panel assignment, patients are assigned based on their medical needs or visit frequency. In equal panel assignment, patients are distributed uniformly to maintain a similar composition across panels. We utilize majorization theory and numerical examples to evaluate the performance of the two de signs. The results show that specialized panel assignment outperforms when (1) patient demands and physician capacity are relatively balanced or (2) patients who require frequent visit...
Source: Health Care Management Science - November 6, 2023 Category: Hospital Management Source Type: research
Prediction of hospitalization and waiting time within 24 hours of emergency department patients with unstructured text data
This study aimed to develop a useful and inexpensive tool derived from electronic medical records that supports clinical decision-making and can be easily utilized by emergency department physicians. We presented machine learning models that predicted the likelihood of hospitalizations within 24 hours and estimated waiting times. Moreover, we revealed the enhanced performance of these machine learning models compared to existing models by incorporating unstructured text data. Among several evaluated models, the extreme gradient boosting model that incorporated text data yielded the best performance. This model achieved an ...
Source: Health Care Management Science - November 3, 2023 Category: Health Management Source Type: research
