Dai Zongli, Wang Jian-Jun, Shi Jim Junmin
School of Economics and Management, Dalian University of Technology, Dalian 116024, China.
Tuchman School of Management, New Jersey Institute of Technology, Newark, NJ 07102, United States.
Comput Ind Eng. 2022 Jul;169:108210. doi: 10.1016/j.cie.2022.108210. Epub 2022 May 3.
During the COVID-19 period, randomly arrived patients flooded into the hospital, which caused staffing beds to be occupied. Then, elective surgeries could not be carried out timely. It not only affects the health of patients but also affects hospital income. The key to the above problem is how to deal with uncertainty, which is one of the most difficult problems faced in the field of optimization. Specifically, surgery duration, length of stay, the arrival time of emergency patients, and whether they are infected with the SARS-CoV-2 virus are uncertain. Therefore, we propose a bed configuration to ensure that elective patients are not affected by non-elective patients such as COVID-19 patients. More importantly, we propose a planning model based on robust optimization and fuzzy set theory, which for the first time consider different categories of uncertainty in the same healthcare system. Given that the problem is more complex than the classical surgical scheduling problem, which is NP-hard in most cases, we propose a hybrid algorithm (GA-VNS-H) based on genetic algorithm, variable neighborhood search, and heuristics for problem traits. Specifically, the heuristic for operating room allocation is used to improve the efficiency, the genetic algorithm and variable neighborhood can improve the global and local search capabilities, respectively, and the adaptive mechanism can reduce the algorithm solution time. Experiments show that the algorithm has better calculation efficiency and solution accuracy. In addition, the elective surgery planning model under the new bed configuration model can effectively cope with the uncertain environment of COVID-19.
在新冠疫情期间,随机前来的患者涌入医院,导致床位被占用。于是,择期手术无法及时开展。这不仅影响患者健康,还影响医院收入。上述问题的关键在于如何应对不确定性,这是优化领域面临的最难题之一。具体而言,手术时长、住院时间、急诊患者的到达时间以及他们是否感染新冠病毒都是不确定的。因此,我们提出一种床位配置方案,以确保择期患者不受新冠患者等非择期患者的影响。更重要的是,我们提出一种基于鲁棒优化和模糊集理论的规划模型,该模型首次在同一医疗系统中考虑了不同类别的不确定性。鉴于该问题比经典手术调度问题更复杂,在大多数情况下是NP难问题,我们针对问题特点提出一种基于遗传算法、可变邻域搜索和启发式算法的混合算法(GA-VNS-H)。具体来说,用于手术室分配的启发式算法可提高效率,遗传算法和可变邻域分别可提高全局和局部搜索能力,自适应机制可减少算法求解时间。实验表明,该算法具有较好的计算效率和求解精度。此外,新床位配置模型下的择期手术规划模型能够有效应对新冠疫情的不确定环境。