A Simulation Optimization Approach to Long-Term Care Capacity Planning

• 成果类型: Article
• 署名作者: Zhang, Yue; Puterman, Martin L.; Nelson, Matthew; Atkins, Derek
• 署名单位: University System of Ohio; University of Toledo; University of British Columbia; University of Toronto
• 刊物名称: OPERATIONS RESEARCH
• ISSN/ISSBN: 0030-364X
• DOI: 10.1287/opre.1110.1026
• 发表日期: 2012
• 页码: 249-261
• 关键词: pointwise stationary approximation; time-varying demand; queuing-systems; bed allocation; queues; units; MODEL

摘要

This paper describes a methodology for setting long-term care capacity levels over a multiyear planning horizon to achieve target wait time service levels. Our approach integrates demographic and survival analysis, discrete event simulation, and optimization. Based on this methodology, we developed a decision support system for use in practice. We illustrate this approach through two case studies; one for a regional health authority in British Columbia, Canada, and the other for a long-term care facility. We also compare our approach to the fixed ratio approach used in practice and the SIPP (stationary, independent, period by period) and MOL (modified offered load) approaches developed in the call center literature. Our results suggest that our approach is preferable. The fixed ratio approach lacks a rigorous foundation, and the SIPP and MOL approaches do not perform reliably mainly because of long service times. We conclude the paper with policy recommendations.