医疗管理HealthcareManagementSci期刊摘要.docx

医疗管理HealthcareManagementSci期刊摘要.docx

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医疗管理HealthcareManagementSci期刊摘要

1.Thu-Ba,T,Nguyen,Appa,Iyer,Sivakumar,Stephen,C,Graves.Schedulingrulesto

achievelead-timetargetsinoutpatientappointmentsystems[J].HealthCareManagementScience,2017,20（4）:

578-599

Thispaperconsidershowtoscheduleappointmentsforoutpatients,foraclinicthatissubjecttoappointmentlead-timetargetsforbothnewandreturningpatients.Wedevelopheuristicrules,whicharetheexactandrelaxedappointmentschedulingrules,toscheduleeachnewpatientappointment（only）inlightofuncertaintyaboutfuturearrivals.Theschedulingrulesentailtwodecisions.First,therulesneedtodeterminewhetherornotapatient'srequestcanbeaccepted;then,iftherequestisnotrejected,therulesprescribehowtoassignthepatienttoanavailableslot.Theintentoftheschedulingrulesistomaximizetheutilizationoftheplannedresource（i.e.,thephysicianstaff）,orequivalentlytomaximizethenumberofpatientsthatareadmitted,whilemaintainingtheservicetargetsonthemedian,the95thpercentile,andthemaximumappointmentlead-times.WetesttheproposedschedulingruleswithnumericalexperimentsusingrealdatafromthechosenclinicofTanTockSenghospitalinSingapore.Theresultsshowtheefficiencyandtheefficacyoftheschedulingrules,intermsoftheservice-targetsatisfactionandtheresourceutilization.Fromthesensitivityanalysis,wefindthattheperformanceoftheproposedschedulingrulesisfairlyrobusttothespecificationoftheestablishedlead-timetargets.

1.Michael,Samudra,Erik,Demeulemeester,Brecht,Cardoen.Duetimedrivensurgery

scheduling[J].HealthCareManagementScience,2017,20（3）:

326-352

Inmanyhospitalstherearepatientswhoreceivesurgerylaterthanwhatismedicallyindicated.InoneofEurope?

slargesthospitals,theUniversityHospitalLeuven,thisisthecaseforapproximatelyeverythirdpatient.ServingpatientslatecannotalwaysbeavoidedasahighlyutilizedORdepartmentwillsometimessuffercapacityshortage,occasionallyleadingtounavoidabledelaysinpatientcare.Nevertheless,servingpatientslateisaproblemasitexposesthemtoanincreasedhealthriskandhenceshouldbeavoidedwheneverpossible.Inordertoimprovethecurrentsituation,thedelayinpatientschedulinghadtobequantifiedandtheresponsiblemechanism,theschedulingprocess,hadtobebetterunderstood.Drawingfromthisunderstanding,weimplementedandtestedrealisticpatientschedulingmethodsinadiscreteeventsimulationmodel.Wefoundthatitisimportanttomodelnon-electivearrivalsandtoincludeelectivereschedulingdecisionsmadeonsurgerydayitself.ReschedulingensuresthatORrelatedperformancemeasures,suchasovertime,willonlylooselydependonthechosenpatientschedulingmethod.Wealsofoundthatcapacityconsiderationsshouldguideactionsperformedbeforethesurgery

daysuchaspatientschedulingandpatientreplanning.ThisisthecaseasthoseschedulingstrategiesthatensurethatORcapacityisefficientlyusedwillalsoresultinahighnumberofpatientsservedwithintheirmedicallyindicatedtimelimit.AnefficientuseofORcapacitycanbeachieved,forinstance,byservingpatientsfirstcome,firstserved.Asapplyingfirstcome,firstservedmightnotalwaysbepossibleinarealsetting,wefounditisimportanttoallowforpatientreplanning.

2.Chih-Ching,Yang.Measuringhealthindicatorsandallocatinghealthresources:

a

DEA-basedapproach[J].HealthCareManagementScience,2017,20（3）:

365-378

ThispapersuggestsnewempiricalDEAmodelsforthemeasurementofhealthindicatorsandtheallocationofhealthresources.Theproposedmodelsweredevelopedbyfirstsuggestingapopulation-basedhealthindicator.ByintroducingthesuggestedindicatorintoDEAmodels,anewapproachthatsolvestheproblemofhealthresourceallocationhasbeendeveloped.TheproposedmodelsareappliedtoanempiricalstudyofTaiwan?

shealthsystem.Empiricalfindingsshowthatthesuggestedindicatorcansuccessfullyaccommodatethedifferencesinhealthresourcedemandsbetweenpopulations,providingmorereliableperformanceinformationthantraditionalindicatorssuchasphysiciandensity.Usingourmodelsandacommonlyusedallocationmechanism,capitation,toallocatemedicalexpenditures,itisfoundthattheproposedmodelalwaysobtainshigherperformancethanthosederivedfromcapitation,andthesuperiorityincreasesasallocatedexpendituresrise.

3.Lara,Wiesche,Matthias,Schacht,Brigitte,Werners.Strategiesforinterday

appointmentschedulinginprimarycare[J].HealthCareManagementScience,2017,20（3）:

403-418

Whenfacedwithamedicalproblem,patientscontacttheirprimarycarephysician（PCP）first.Heremainlytwotypesofpatientrequestsoccur:

non-scheduledpatientswhoarewalk-inswithoutanappointmentandscheduledpatientswithanappointment.Numberandpositionofthescheduledappointmentsinfluencewaitingtimesforpatients,capacityfortreatmentandtheutilizationofPCPs.Asthenumberofpatientrequestsdifferssignificantlybetweenweekdays,thechallengeistomatchcapacitywithpatientrequestsandprovideasfewappointmentslotsasnecessary.Inthisway,capacityforwalk-insismaximizedwhileoverallcapacityrestrictionsaremet.Decisionsastotheoptimalappointmentcapacityperdayonatacticaldecisionlevelhasgainedlittleattentionintheliterature.Amixedintegerlinearmodelisdeveloped,wheretheminimumnumberofappointments

scheduledforaweeklyprofileisdetermined.WearethusabletogivetheanswerastohowmanyappointmentstoofferoneachdayinaweekinordertocreateaschedulethattakespatientpreferencesaswellasPCPpreferencesintoaccount.Appointmentschedulesareofteninfluencedbyuncertaindemandsduetothenumberofurgentpatients,interarrivalsandservicetimes.Basedonanexemplarycasestudy,theadvantagesoftheoptimalappointmentscheduleondifferentperformancecriteriaareshownbydetailedstochasticsimulations.

1.Muge,Capan,Julie,S,Ivy,James,R,Wilson.Astochasticmodelofacute-care

decisionsbasedonpatientandproviderheterogeneity[J].HealthCareManagementScience,2017,20

（2）:

187-206

Theprimarycauseofpreventabledeathinmanyhospitalsisthefailuretorecognizeand/orrescuepatientsfromacutephysiologicdeterioration（APD）.APDaffectsallhospitalizedpatients,potentiallycausingcardiacarrestanddeath.IdentifyingAPDisdifficult,andresponsetimingiscritical-delaysinresponserepresentasignificantandmodifiablepatientsafetyissue.Hospitalshaveinstitutedrapidresponsesystemsorteams（RRT）toprovidetimelycriticalcareforAPD,withthresholdsthattriggertheinvolvementofcriticalcareexpertise.TheNationalEarlyWarningScore（NEWS）wasdevelopedtodefinethesethresholds.However,currenttriggersareinconsistentandignorepatient-specificfactors.Further,acutecareisdeliveredbyproviderswithdifferentclinicalexperience,resultinginquality-of-carevariation.Thisarticledocumentsasemi-MarkovdecisionprocessmodelofAPDthatincorporatespatientandproviderheterogeneity.Themodelallowsforstochasticallychanginghealthstates,whiledeterminingpatientsubpopulation-specificRRT-activationthresholds.Theobjectivefunctionminimizesthetotaltimeassociatedwithpatientdeteriorationandstabilization;andtherelativevaluesofnursingandRRTtimescanbemodified.AcasestudyfromJanuary2011toDecember2012identifiedsixsubpopulations.RRTactivationwasoptimalforpatientsin“slightlyconcerning”healthstates（NEWS?

>?

0）forallsubpopulations,exceptsurgicalpatientswithlowriskofdeteriorationforwhomRRTwasactivatedin“concerning”states（NEWS?

>?

4）.ClusteringmethodsidentifiedproviderclustersconsideringRRT-activationpreferencesandestimationofstabilization-relatedresourceneeds.ProviderswithconservativeresourceestimatespreferredwaitingoveractivatingRRT.Thisstudyprovidessimplepracticalrulesforpersonalizedacutecaredelivery.

2.Sebastian,Hof,Andreas,Fügener,Jan,Schoenfelder.Casemixplanninginhospitals:

areviewandfutureagenda[J].HealthCareManagementScience,2017,20

（2）:

207-220

Thecasemixplanningproblemdealswithchoosingtheidealcompositionandvolumeofpatientsinahospital.Withmanycountrieshavingrecentlychangedtosystemswherehospitalsarereimbursedforpatientsaccordingtotheirdiagnosis,casemixplanninghasbecomeanimportanttoolinstrategicandtacticalhospitalplanning.Selectingpatientsinsuchapaymentsystemcanhaveasignificantimpactonahospital?

srevenue.Thecontributionofthisarticleistoprovidethefirstliteraturereviewfocusingonthecasemixplanningproblem.Wedescribetheproblem,distinguishitfromsimilarplanningproblems,andevaluatetheexistingliteraturewithregardtoproblemstructureandmanagerialimpact.Further,weidentifygapsintheliterature.Wehopetofosterresearchinthefieldofcasemixplanning,whichonlylatelyhasreceivedgrowingattentiondespiteitsfundamentaleconomicimpactonhospitals.

3.Jeong,Hoon,Choi,Imsu,Park,Ilyoung,Jung,Asoke,Dey.Complementaryeffectof

patientvolumeandqualityofcareonhospitalcostefficiency[J].HealthCareManagementScience,2017,20

（2）:

221-231

ThisstudyexploresthedirecteffectofanincreaseinpatientvolumeinahospitalandthecomplementaryeffectofqualityofcareonthecostefficiencyofU.S.hospitalsintermsofpatientvolume.Thesimultaneousequationmodelwiththree-stageleastsquaresisusedtomeasurethedirecteffectofpatientvolumeandthecomplementaryeffectofqualityofcareandv