Patrick Jonathan, Puterman Martin L
Assistant Professor, Telfer School of Management, University of Ottawa, Ottawa, ON.
Healthc Policy. 2008 Feb;3(3):75-88.
Widespread public demand for improved access, political pressure for shorter wait times, a stretched workforce, an aging population and overutilized equipment and facilities challenge healthcare leaders to adopt new management approaches. This paper highlights the significant benefits that can be achieved by applying operations research (OR) methods to healthcare management. It shows how queuing theory provides managers with insights into the causes for excessive wait times and the relationship between wait times and capacity. It provides a case study of the use of several OR methods, including Markov decision processes, linear programming and simulation, to optimize the scheduling of patients with multiple priorities. The study shows that by applying this approach, wait time targets can be attained with the judicious use of surge capacity in the form of overtime. It concludes with some policy insights.
公众对改善医疗服务可及性的广泛需求、缩短等待时间的政治压力、人员紧张的劳动力、老龄化人口以及过度使用的设备和设施,都对医疗保健领导者提出了挑战,促使他们采用新的管理方法。本文强调了将运筹学(OR)方法应用于医疗管理可带来的显著益处。它展示了排队论如何为管理者提供有关等待时间过长的原因以及等待时间与容量之间关系的见解。它提供了一个案例研究,介绍了如何使用包括马尔可夫决策过程、线性规划和模拟在内的多种运筹学方法来优化具有多个优先级的患者的调度。该研究表明,通过应用这种方法,通过明智地利用加班形式的应急能力,可以实现等待时间目标。文章最后给出了一些政策见解。