Multi-resource allocation and care sequence assignment in patient management: a stochastic programming approach.

Autor: Yao X; Carnegie Mellon University, Pittsburgh, PA, USA., Shehadeh KS; Lehigh University, Bethlehem, PA, USA., Padman R; Carnegie Mellon University, Pittsburgh, PA, USA. rpadman@cmu.edu.
Jazyk: angličtina
Zdroj: Health care management science [Health Care Manag Sci] 2024 Sep; Vol. 27 (3), pp. 352-369. Date of Electronic Publication: 2024 May 30.
DOI: 10.1007/s10729-024-09675-6
Abstrakt: To mitigate outpatient care delivery inefficiencies induced by resource shortages and demand heterogeneity, this paper focuses on the problem of allocating and sequencing multiple medical resources so that patients scheduled for clinical care can experience efficient and coordinated care with minimum total waiting time. We leverage highly granular location data on people and medical resources collected via Real-Time Location System technologies to identify dominant patient care pathways. A novel two-stage Stochastic Mixed Integer Linear Programming model is proposed to determine the optimal patient sequence based on the available resources according to the care pathways that minimize patients' expected total waiting time. The model incorporates the uncertainty in care activity duration via sample average approximation.We employ a Monte Carlo Optimization procedure to determine the appropriate sample size to obtain solutions that provide a good trade-off between approximation accuracy and computational time. Compared to the conventional deterministic model, our proposed model would significantly reduce waiting time for patients in the clinic by 60%, on average, with acceptable computational resource requirements and time complexity. In summary, this paper proposes a computationally efficient formulation for the multi-resource allocation and care sequence assignment optimization problem under uncertainty. It uses continuous assignment decision variables without timestamp and position indices, enabling the data-driven solution of problems with real-time allocation adjustment in a dynamic outpatient environment with complex clinical coordination constraints.
(© 2024. The Author(s).)
Databáze: MEDLINE
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