Abstract
The costs associated with the healthcare system have risen dramatically in recent years. Healthcare decision-makers, especially in areas of hospital management, are rarely fortunate enough to have all necessary information made available to them at once. In this work we propose a stochastic model for the dynamics of the number of patients in a hospital department with the objective to improve the allocation of resources. The solution is based on a stochastic dynamic programming approach where the control variable is the number of admissions in the department. We use the dataset provided by one of the biggest Italian Intensive Care Units to test the application of our model. We propose also a comparison between the optimal policy of admissions and an empirical policy which describes the effective medical practice in the department. The method allows also to reduce the variability of the length of stay.
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Notes
- 1.
The ratio of actual number of hospitalized patients and the capacity of the hospital department.
- 2.
For a collection of data \(\{y_i\}_{i=1,\ldots , m}\) and their estimated values \(\{\widehat{y}_i\}_{i=1,\ldots ,m}\), it is \(AAE=\sum _{i=1}^m \frac{|y_i-\widehat{y}_i|}{m}\).
References
Hans, E.W., Van Houndenhoven, M., Hulshof, P.J.: A framework for healthcare planning and control. In: Handbook of Healthcare System Scheduling, vol. 168, pp. 303–320 (2012)
Harper, P., Shahani, A.: Modelling for the planning and management of bed capacities in hospital. J. Oper. Res. Soc. 53, 11–18 (2002)
Herring, W.L.: Prioritizing patients: stochastic dynamic programming for surgery scheduling and mass casualty incident triage. Doctoral Dissertations (2011)
Castaing, J., Cohn, A., Denton, B., Weizer, A.: A stochastic programming approach to reduce patient wait times and overtime in an outpatient infusion center. IIE Trans. Healthc. Syst. Eng. 6(3), 111–125 (2015)
Erdelyi, A., Topaloglu, H.: Approximate dynamic programming for dynamic capacity allocation with multiple priority levels. IIE Trans. 43(2), 129–142 (2010)
Ozen, A.: Stochastic models for capacity planning in healthcare delivery: case studies in an outpatient, inpatient and surgical setting. Doctoral Dissertations 2014-current. Paper 125 (2014)
Punnakitikashem, P., Rosenberger, J.M., Behan, D.B.: Stochastic programming for nurse assignment. Comput. Optim. Appl. 40(3), 321–349 (2008)
Dong, M., Li, J., Zhao, W.: Admissions optimization and premature discharge decisions in intensive care units. Int. J. Prod. Res. 53, 7329–7342 (2015)
Gilleskie, D.B.: A dynamic stochastic model of medical care use and work absence. Econometrica 66, 1–45 (1998)
Xiao, G., van Jaarsveld, W., Dong, M., van de Klundertc, J.: Stochastic programming analysis and solutions to schedule overcrowded operating rooms in China. Comput. Oper. Res. 74, 78–91 (2016)
Gorunescu, F., McClean, S.I., Millard, P.H.: A queueing model for bed-occupancy management and planning of hospital. J. Oper. Res. Soc. 53, 19–24 (2002)
Green, L.V.: Capacity planning and management in hospital. Oper. Res. Health Care 70, 15–44 (2004)
Kurki, T.S., Hakkinen, U., Lauharanta, J., Ramo, J., Leijala, M.: Euroscore predicts health-related quality of life after coronary artery bypass grafting. Interact. Cardiovasc. Thorac. Surg. 7, 564–568 (2008)
Bertsekas, D.: Dynamic Programming and Optimal Control, vol. 2, 4th edn. Athena Scientific (2011)
Acknowledgements
This research is supported in part by San Camillo-Forlanini Hospital in Rome.
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Papi, M., Pontecorvi, L., Setola, R., Clemente, F. (2017). Stochastic Dynamic Programming in Hospital Resource Optimization. In: Sforza, A., Sterle, C. (eds) Optimization and Decision Science: Methodologies and Applications. ODS 2017. Springer Proceedings in Mathematics & Statistics, vol 217. Springer, Cham. https://doi.org/10.1007/978-3-319-67308-0_15
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