Miniguano-Trujillo Andrés, Salazar Fernanda, Torres Ramiro, Arias Patricio, Sotomayor Koraima
Maxwell Institute for Mathematical Sciences, The University of Edinburgh, Bayes Centre, 47 Potterrow, Edinburgh, United Kingdom.
Department of Mathematics - Escuela Politécnica Nacional, Quito, Ecuador.
Health Care Manag Sci. 2021 Jun;24(2):286-304. doi: 10.1007/s10729-020-09543-z. Epub 2021 Apr 11.
The Covid-19 pandemic challenges healthcare systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and prevents mental health disorders. Many countries are offering diverse and accessible services of tele-psychological intervention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis intervention with a single tele-psychotherapy session. The statistical analyses showed that professionals and healthcare workers in contact with Covid-19 patients or with a confirmed diagnosis had a significant relationship with suicide risk, sadness, experiential avoidance, and perception of severity. Moreover, some Covid-19-related variables were found to be predictors of sadness and suicide risk as unveiled via path analysis. This allowed categorizing patients according to their screening and grouping therapists according to their qualifications. With this stratification, a multi-periodic optimization model and a heuristic are proposed to find an adequate assignment of patients to therapists over time. The integer programming model was validated with real-world data, and its results were applied in a volunteer program in Ecuador.
新冠疫情给全球医疗系统带来挑战,同时严重影响心理健康。因此,危机时期对心理援助的需求不断增加,这就需要早期有效的干预。这有助于公众和一线工作者的福祉,并预防心理健康障碍。许多国家都在提供多样化且易于获得的远程心理干预服务;厄瓜多尔也不例外。本研究结合统计分析和离散优化技术,以解决在单次远程心理治疗中为危机干预将患者分配给治疗师的问题。统计分析表明,与新冠患者接触或确诊的专业人员和医护人员与自杀风险、悲伤情绪、经验性回避以及严重程度认知之间存在显著关系。此外,通过路径分析发现,一些与新冠相关的变量是悲伤情绪和自杀风险的预测因素。这使得能够根据筛查结果对患者进行分类,并根据资质对治疗师进行分组。基于这种分层,提出了一个多周期优化模型和一种启发式方法,以随着时间推移为患者找到合适的治疗师分配方案。整数规划模型通过实际数据进行了验证,其结果应用于厄瓜多尔的一个志愿者项目中。