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疫情爆发期间,在重症监护病房和住院床位需求不确定的情况下进行择期手术安排。

Elective surgery scheduling under uncertainty in demand for intensive care unit and inpatient beds during epidemic outbreaks.

作者信息

Dai Zongli, Perera Sandun C, Wang Jian-Jun, Mangla Sachin Kumar, Li Guo

机构信息

School of Economics and Management, Dalian University of Technology, Dalian 116024, China.

College of Business, University of Nevada, Reno, NV 89557, USA.

出版信息

Comput Ind Eng. 2023 Feb;176:108893. doi: 10.1016/j.cie.2022.108893. Epub 2022 Dec 12.

Abstract

Amid the epidemic outbreaks such as COVID-19, a large number of patients occupy inpatient and intensive care unit (ICU) beds, thereby making the availability of beds uncertain and scarce. Thus, elective surgery scheduling not only needs to deal with the uncertainty of the surgery duration and length of stay in the ward, but also the uncertainty in demand for ICU and inpatient beds. We model this surgery scheduling problem with uncertainty and propose an effective algorithm that minimizes the operating room overtime cost, bed shortage cost, and patient waiting cost. Our model is developed using fuzzy sets whereas the proposed algorithm is based on the differential evolution algorithm and heuristic rules. We set up experiments based on data and expert experience respectively. A comparison between the fuzzy model and the crisp (non-fuzzy) model proves the usefulness of the fuzzy model when the data is not sufficient or available. We further compare the proposed model and algorithm with several extant models and algorithms, and demonstrate the computational efficacy, robustness, and adaptability of the proposed framework.

摘要

在COVID-19等疫情爆发期间,大量患者占用了住院和重症监护病房(ICU)床位,从而使得床位的可用性变得不确定且稀缺。因此,择期手术安排不仅需要应对手术时长和病房住院时间的不确定性,还需应对ICU和住院床位需求的不确定性。我们对这个具有不确定性的手术安排问题进行建模,并提出一种有效的算法,该算法能使手术室加班成本、床位短缺成本和患者等待成本最小化。我们的模型是使用模糊集开发的,而所提出的算法基于差分进化算法和启发式规则。我们分别基于数据和专家经验进行实验设置。模糊模型与清晰(非模糊)模型之间的比较证明了在数据不足或不可用时模糊模型的有用性。我们进一步将所提出的模型和算法与几种现有模型和算法进行比较,并展示了所提出框架的计算效率、稳健性和适应性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f1/9742073/1482a739754d/gr1_lrg.jpg

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