1,720,990 research outputs found
A simulation model to evaluate the impact of prioritisation system on surgical waiting list management
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Evaluating the Impact of the Level of Robustness in Operating Room Scheduling Problems
No full textManaging uncertainty in surgery times presents a critical challenge in operating room (OR) scheduling, as it can have a significant impact on patient care and hospital efficiency. Objectives: By incorporating robustness into the decision-making process, we can provide a more reliable and adaptive solution compared to traditional deterministic approaches. Materials and methods: In this paper, we consider a cardinality-constrained robust optimization model for OR scheduling, addressing uncertain surgery durations. By accounting for patient waiting times, urgency levels and delay penalties in the objective function, our model aims to optimise patient-centred outcomes while ensuring operational resilience. However, to achieve an appropriate balance between resilience and robustness cost, the robustness level must be carefully tuned. In this paper, we conduct a comprehensive analysis of the model’s performance, assessing its sensitivity to robustness levels and its ability to handle different uncertainty scenarios. Results: Our results show significant improvements in patient outcomes, including reduced waiting times, fewer missed surgeries and improved prioritisation of urgent cases. Key contributions of this research include an evaluation of the representativeness and performance of the patient-centred objective function, a comprehensive analysis of the impact of robustness parameters on OR scheduling performance, and insights into the impact of different robustness levels. Conclusions: This research offers healthcare providers a pathway to increase operational efficiency, improve patient satisfaction, and mitigate the negative effects of uncertainty in OR scheduling
A discrete event simulation model to assist the management of surgical waiting list: a case study.
No full textIndicatori di appropriatezza temporale (liste di attesa per ircoveri chirurgici di elezione) (isbn-10; 88-901674-2-4;
No full textAn agent-based simulation model to evaluate alternative co-payment scenarios for contributing to health systems financing
No full textAgeing populations, rapid technological progress and recent public budget cuts currently threaten the sustainability of public health systems. To meet growing needs with declining resources, decision-makers must identify new ways to avoid reducing the quality of services offered to citizens. This paper focuses on the so-called "co-payment" tools aimed to obtain additional resources for the public health budget directly from citizens. Whereas certain forms of co-payments have always been introduced within health systems to prevent moral hazard behaviours, other co-payment mechanisms are explicitly intended to help finance public healthcare systems. Literature and empirical findings do not agree about the final impact of such co-payment tools, particularly whether they can attain system sustainability and guarantee equitably delivered services. In this paper, we develop an agent-based simulation model which can be used by decision-makers as a decision support tool to compare different co-payment rules and evaluate their impact on the public budget and the health expense of different groups of citizens
Project management approach to implement clinical pathways: An example for thyroidectomy
No full textClinical pathway is a concept that from a managerial point of view promotes variance reduction in the delivery of health care and, therefore, is able to reduce costs. To achieve this, health care providers must improve efficiency in the use of resources while completing delivery of care in time with expected achievements in quality. Implementation of the clinical pathways for a specific disease requires a clear identification of tasks that compose the care delivery process by a multi-professional team including physicians, nurses, various therapists and/or health technologist and so on. From this perspective, implementing clinical pathways for a disease can be, therefore, conceptualized as an integrated project with many tasks. Hence, the management of the care delivery tasks in time nicely fits into project management, an operations research tool. With this conceptualization, we test the potential use of project management to organize the integrated care delivery tasks of the thyroid disease as a project. Probabilistic and deterministic project management models have been implemented and solved for a real case study to demonstrate the estimated duration for the clinical pathway, where critical activities must be carefully monitored by the caregiving team to reduce or eliminate the variation in care delivery
Assessing migration health care implications: a systematic review of literature - Collana Percorsi di Scienze Economiche e Sociali
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