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作者：Zhang, Jingyu; Denton, Brian T.; Balasubramanian, Hari; Shah, Nilay D.; Inman, Brant A.
作者单位：Philips; Philips Research; North Carolina State University; University of Massachusetts System; University of Massachusetts Amherst; Mayo Clinic; Duke University
摘要：prostate cancer is the most common solid tumor in American men and is screened for using prostate-specific antigen (PSA) tests. We report on a nonstationary partially observable Markov decision process (POMDP) for prostate biopsy referral decisions. The core states are the patients' prostate cancer related health states, and PSA test results are the observations. Transition probabilities and rewards are inferred from the Mayo Clinic Radical Prostatectomy Registry and the medical literature. Th...
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作者：Day, Robert; Garfinkel, Robert; Thompson, Steven
作者单位：University of Connecticut; University of Richmond
摘要：We consider the problem of balancing two competing objectives in the pursuit of efficient management of operating rooms in a hospital: providing surgeons with predictable, reliable access to the operating room and maintaining high utilization of capacity. The common solution to the first problem (in practice) is to grant exclusive block time, in which a portion of the week in an operating room is designated to a particular surgeon, barring other surgeons from using this room/time. As a major i...
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作者：Dobson, Gregory; Lee, Hsiao-Hui; Sainathan, Arvind; Tilson, Vera
作者单位：University of Rochester; Nanyang Technological University; University of Hong Kong
摘要：We consider the work flow in a medical teaching facility, examining the process that involves an initial patient exam by a resident physician, a subsequent conference between the resident and the attending physician, and the attending physician's visit with the patient. We create an analytical model of a tandem queue with finite buffer space to analyze the impact of different work prioritization policies on the throughput and the flow time of patients in the facility-measures that influence bo...
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作者：Ayvaci, Mehmet U. S.; Alagoz, Oguzhan; Burnside, Elizabeth S.
作者单位：University of Wisconsin System; University of Wisconsin Madison; University of Wisconsin System; University of Wisconsin Madison
摘要：We develop a finite-horizon discrete-time constrained Markov decision process (MDP) to model diagnostic decisions after mammography where we maximize the total expected quality-adjusted life years (QALYs) of a patient under resource constraints. We use clinical data to estimate the parameters of the MDP model and solve it as a mixed-integer program. By repeating optimization for a sequence of budget levels, we calculate incremental cost-effectiveness ratios attributable to consecutive levels o...
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作者：Zhao, Hui; Xiong, Chuanhui; Gavirneni, Srinagesh; Fein, Adam
作者单位：Pennsylvania Commonwealth System of Higher Education (PCSHE); Pennsylvania State University; Pennsylvania State University - University Park; University of North Carolina; Nanyang Technological University
摘要：Free-for-service (FFS) contracts, first introduced in 2004, dramatically changed the way the pharmaceutical distribution supply chains are designed, managed, and operated. Investment buying (IB), forward buying in anticipation of drug price increases, used to be the way the distributors made most of their profits. FFS contracts limit the amount of inventory distributors can carry at any time (by imposing an inventory cap) and require inventory information sharing from the distributors to the m...
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作者：Green, Linda V.
作者单位：Columbia University
摘要：There is now a broad consensus among healthcare professionals that the U.S. healthcare delivery system is woefully inefficient and needs to be radically redesigned. Healthcare costs have always been a driving force in policy and management, but quality has become equally important in driving decisions, particularly since emerging payment systems include metrics on clinical and operational performance. With the increasing use of information technology to capture financial, operational, and clin...
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作者：Froehle, Craig M.; Magazine, Michael J.
作者单位：University System of Ohio; University of Cincinnati; Cincinnati Children's Hospital Medical Center
摘要：This series of discussions presents commentaries on where the field of healthcare operations management is now and possible future research directions, expanding upon the key points raised by Green [Green LV (2012) The vital role of operations analysis in improving healthcare delivery. Manufacturing Service Oper. Management 14(4):488-494].
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作者：Levi, Retsef; Prestipino, Ann L.
作者单位：Massachusetts Institute of Technology (MIT); Adventist Health Services; AdventHealth; Mass General Brigham; Harvard University; Harvard University Medical Affiliates; Massachusetts General Hospital
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作者：Vanberkel, Peter T.; Zonderland, Maartje E.; Boucherie, Richard J.; Hans, Erwin W.
作者单位：Dalhousie University; University of Twente
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作者：Powell, Adam; Savin, Sergei; Savva, Nicos
作者单位：University of Pennsylvania; University of London; London Business School
摘要：We study the impact of physician workload on hospital reimbursement utilizing a detailed data set from the trauma department of a major urban hospital. We find that the proportion of patients assigned a high-severity status for reimbursement purposes, which maps, on average, to a 47.8% higher payment for the hospital, is substantially reduced as the workload of the discharging physician increases. This effect persists after we control for a number of systematic differences in patient character...
