Truong Van-Anh, Wang Xinshang, Liu Nan
Department of Industrial Engineering and Operations Research, Columbia University, New York, NY, USA.
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA.
Prod Oper Manag. 2019 Jul;28(7):1735-1756. doi: 10.1111/poms.13012. Epub 2019 Feb 21.
Motivated by the shortcoming of current hospital scheduling and capacity planning methods which often model different units in isolation, we introduce the first dynamic multi-day scheduling model that integrates information about capacity usage at more than one location in a hospital. In particular, we analyze the first dynamic model that accounts for patients' length-of-stay and downstream census in scheduling decisions. Via a simple and innovative variable transformation, we show that the optimal number of patients to be allowed in the system is increasing in the state of the system and in the downstream capacity. Moreover, the total system cost exhibits decreasing marginal returns as the capacity increases at any location independently of another location. Through numerical experiments on realistic data, we show that there is substantial value in making integrated scheduling decisions. In contrast, localized decision rules that only focus on a single location of a hospital can result in up to 60% higher expenses.
鉴于当前医院排班和容量规划方法的缺点,即这些方法通常孤立地对不同科室进行建模,我们引入了首个动态多日排班模型,该模型整合了医院多个地点的容量使用信息。具体而言,我们分析了首个在排班决策中考虑患者住院时长和下游人口普查的动态模型。通过一个简单且创新的变量变换,我们表明系统中允许的最佳患者数量会随着系统状态和下游容量的增加而增加。此外,无论在任何一个地点容量增加(与其他地点无关),系统总成本都呈现出边际收益递减的情况。通过对实际数据进行数值实验,我们表明做出综合排班决策具有巨大价值。相比之下,仅关注医院单个地点的局部决策规则可能导致费用高出多达60%。