Operations Research Applications in Health Care Management (eBook)

Prof. Kahraman is a full professor at Istanbul Technical University. His research areas are engineering economics, quality management, statistical decision making, multicriteria decision making, and fuzzy decision making. He published more than 200 journal papers, about 150 conference papers, and 80 book chapters. He guest-edited some issues of many international journals. He is the editor of many international books from Springer and Atlantis Press. He is the member of editorial boards of 20 international journals. He was the vice dean of ITU Management Faculty between 2004-2007 and the head of ITU Industrial Engineering Department between 2010-2013.Y. Ilker Topcu is a Professor of Decision Sciences at Industrial Engineering Department of Istanbul Technical University (ITU) Management Faculty. He completed his Ph.D. studies in Engineering Management (2000) at ITU and visited Leeds University Business School during these studies (1998-1999). Professor Topcu’s research interests include multiple criteria decision making, decision analysis, operations research/management science. He is executive committee member of International Society of Multiple Criteria Decision Making. He has published in several journals.

Preface 6
Contents 9
About the Editors 12
Part I Overview 13
1 A Taxonomy of Operations Research Studies in Healthcare Management 14
1.1 Introduction 14
1.2 OR Studies in Healthcare Management 15
1.3 Necessity for a Taxonomy: A Discussion 16
1.4 A Taxonomy for OR Studies in Healthcare Management 18
1.5 Results of the Taxonomy with Selected Articles 18
1.6 Conclusions and Further Suggestions 21
Appendix 21
References 26
2 A Comprehensive Survey on Healthcare Management 33
2.1 Introduction 33
2.2 Sub-classifications of HCM Studies 34
2.2.1 HCM Papers Making Literature Review 36
2.2.2 Quantitative and Qualitative Techniques in HCM 37
2.2.3 Case Studies in HCM 38
2.2.4 Performance Measurement in HCM 39
2.3 Classification of Techniques Used in Healthcare Management 39
2.3.1 Simulation 39
2.3.2 Multicriteria Decision Making 43
2.3.3 Mathematical Programming 43
2.3.4 Probabilistic and Statistical Decision Making 45
2.3.5 Data Envelopment Analysis (DEA) 46
2.3.6 Data Mining (DM) 46
2.3.7 Economic Decision Making and Engineering Economics 47
2.3.8 Human Factors Engineering 48
2.3.9 Structural Equation Modeling (SEM) 48
2.3.10 Design of Experiments (DOE) 49
2.3.11 System Dynamics 49
2.3.12 Qualitative Approaches 50
2.3.13 Other Approaches 51
2.3.13.1 Cost Analysis in Healthcare 51
2.3.13.2 Quality in Healthcare 51
2.3.13.3 Information Technologies in Healthcare 52
2.3.13.4 Tactical and Strategic Decision-Making in Healthcare 53
2.3.13.5 Lean Management in Healthcare 53
2.3.13.6 Environmental Management in Healthcare 54
2.3.13.7 Risk Analysis in Healthcare 54
2.4 Conclusions 54
References 55
Part II Medical Units in Hospital 62
3 The Real Time Management of Operating Rooms 63
3.1 Introduction 63
3.2 The Management of Elective and Non-elective Patients 66
3.3 Ex-Ante Approach: The Online Solution 67
3.3.1 The RTM with only Elective Patients 67
3.3.2 The RTM with Elective and Non-elective Patients 69
3.4 Ex-Post Approach: The Offline Solution 71
3.5 Quantitative Analysis 74
3.5.1 The Simulated Surgical Clinical Pathway 75
3.5.2 Scenarios and Indices 76
3.5.3 Results 77
3.5.4 Computational Remarks 80
3.6 Sharing Resources Among Surgical Pathways 80
3.6.1 Policies for Sharing ORs 81
3.6.2 Policies for Sharing Overtime 82
3.6.3 Quantitative Analysis 82
3.7 Conclusions 85
References 86
4 Mixed Fuzzy Clustering for Deriving Predictive Models in Intensive Care Units 88
4.1 Introduction 88
4.2 Adverse Events in the ICU 89
4.2.1 Septic Shock: Vasopressors Administration and Mortality 90
4.2.2 Early Readmissions 91
4.3 Mixed Fuzzy Clustering 91
4.4 Fuzzy Modeling Based on Mixed Fuzzy Clustering 93
4.4.1 Takagi-Sugeno Fuzzy Modeling 93
4.4.2 Proposed TS Fuzzy Models 94
4.5 Data Description 95
4.5.1 Data Processing 95
4.5.2 Vasopressors Administration 97
4.5.3 Mortality in Abdominal Septic Shock 98
4.5.4 Readmissions 98
4.6 Results 99
4.6.1 Vasopressors Administration 101
4.6.2 Mortality Prediction 102
4.6.3 Readmissions 103
4.7 Conclusions 103
References 104
5 Operations Research for Occupancy Modeling at Hospital Wards and Its Integration into Practice 107
5.1 Introduction 107
5.2 Hospital Ward Types and Terminology 109
5.2.1 Taxonomy 109
5.2.2 Terminology 111
5.3 Ward-Related OR Models 115
5.3.1 Intensive Care Unit 116
5.3.2 Acute Medical Unit 118
5.3.3 Obstetrics Ward 119
5.3.4 Weekday Ward 122
5.3.5 General Ward 122
5.4 Illustrations of OR Model Use 125
5.4.1 ICU Case Study 125
5.4.2 OBS Case Study 127
5.4.3 AMU Case Study 128
5.4.4 WDW Case Study 130
5.5 Implemented OR Results 132
5.6 Challenges and Directions for Further Research 134
Appendix: OR Model Types 135
References 138
Part III Care Process: Preparedness 144
6 Evaluating Healthcare System Efficiency of OECD Countries: A DEA-Based Study 145
6.1 Introduction 145
6.2 DEA 148
6.3 LE, Infant Mortality and Efficiency 150
6.3.1 2008 Models with Respect to LE and Infant Mortality 151
6.3.2 2012 Models with Respect to LE and Infant Mortality 153
6.3.3 Discussion of Results 154
6.4 Survival from Major Causes of Death and Efficiency 155
6.4.1 2008 Models with Respect to Survival from Major Causes of Death 157
6.4.2 2012 Models with Respect to Survival From Major Causes of Death 157
6.5 Conclusion 159
References 161
7 Healthcare Expenditure Prediction in Turkey by Using Genetic Algorithm Based Grey Forecasting Models 163
7.1 Introduction 163
7.2 Literature Review 165
7.2.1 Health Care Expenditure Literature 165
7.2.2 Grey Forecasting Literature 166
7.3 Grey Forecasting 172
7.3.1 GM (1,1) Model 177
7.3.2 Nonlinear Grey Bernoulli Model 178
7.3.3 Data Set 180
7.4 Methodology 180
7.4.1 Healthcare Expenditure Forecasting with Proposed Models 183
7.5 Conclusion 190
References 191
8 The Impact of Social Networks in Developing and Managing Chronic Care Models 195
8.1 Introduction 195
8.2 The Literature Debate 196
8.2.1 The General Framework 196
8.2.2 The Primary Care Stream 197
8.2.3 The Chronic Care Model and Beyond 198
8.3 Case Study 201
8.3.1 Data and Methods 202
8.4 Discussion of Results 204
8.5 Conclusion 209
A.1 Appendix 1 210
References 211
Part IV Care Process: Precaution 213
9 Design and Planning of Organ Transplantation Networks 214
9.1 Introduction to Organ Transplantation Network Management 214
9.1.1 Importance and Drivers 214
9.1.2 Definitions and Scope 215
9.2 Literature Review 218
9.3 Selected Mathematical Programming Models 224
9.3.1 A Multi-period Location-Allocation Model for Organ Transplant Centers 224
9.3.2 A Credibility-Based Fuzzy Programming Approach to Multi-period Location-Allocation of Organ Transplant Centers Under Uncertainty 230
9.3.3 A Scalable, Data-Driven Method for Designing Fair and Efficient Kidney Allocation Policies 233
9.4 Case Study 237
9.5 Future Research Directions 241
References 242
10 Blood Supply Chain Management and Future Research Opportunities 244
10.1 Introduction 244
10.2 Existing Literature on Blood Supply Chain 248
10.3 Future Research Opportunities 251
10.3.1 Matching Supply with Demand via Donation Tailoring 251
10.3.2 Scheduling Collection Operations 257
10.4 Conclusion 263
References 263
11 Vaccine Supply Management 270
11.1 Introduction 270
11.2 An Introduction to Vaccine Supply Chain Networks 271
11.2.1 Vaccine Supply Chain Effectiveness and Efficiency 272
11.2.2 Vaccine Supply Chain Costs 274
11.3 Vaccine Supply Problems 275
11.3.1 Vaccine Sourcing 275
11.3.2 Vaccine Demand Forecasting 276
11.3.3 Vaccine Shortage 277
11.3.3.1 Vaccine Production 278
11.3.3.2 Purchasing and Distribution 280
11.3.3.3 Provision 280
11.3.4 Vaccine Cold Chains 281
11.4 Vaccine Supply Chain Coordination 282
11.5 Stockpiling Vaccine Supplies for Pandemics 289
11.6 Conclusion Remarks 291
Appendix A 292
References 295
Part V Care Process: Diagnosis and Prognosis 298
12 OR Applications in Disease Screening 299
12.1 Introduction 299
12.1.1 Assessing Population Level Screening 300
12.2 OR Models for Evaluation and Optimization of Screening Policies 302
12.2.1 Modeling at the Individual Level 303
12.2.2 Modeling at the Cohort Level 305
12.2.3 Stochastic Models for Screening Program Evaluation 309
12.2.4 OR Models for Medical Decision Making 310
12.3 OR Models for Management of Screening Services 317
12.3.1 Location Models for Screening Facilities 317
12.3.2 Resource Allocation for Screening Services 319
12.4 Conclusion 321
Appendix 322
References 323
13 Classification of Cancer Data: Analyzing Gene Expression Data Using a Fuzzy Decision Tree Algorithm 328
13.1 Introduction 328
13.2 Related Work 330
13.3 Fuzzy Decision Tree Classifier 331
13.4 Experiments and Results 332
13.4.1 Data Sets 335
13.4.2 Evaluation Measures 335
13.4.3 Comparison Algorithms 335
13.4.4 Experimental Results 337
13.5 Conclusion 341
References 346
Part VI Care Process: Treatment 349
14 Efficiency of Diabetes Treatment 350
14.1 Introduction 350
14.2 Literature Review 352
14.3 Methodology 354
14.3.1 TOPSIS 355
14.3.2 A Neural Network Approach to Predicting Efficiency 356
14.4 Results and Discussion 357
14.5 Conclusion 362
Appendix 1: Contextual Variables and Their Descriptives 365
Appendix 2: Efficiency Ranking 367
References 372
15 A Multiobjective Solution Method for Radiation TreatmentPlanning 377
15.1 Introduction 377
15.2 Background 379
15.3 Problem Formulation 380
15.4 Results 383
15.5 Conclusions 388
References 388
Part VII Medical Issues 391
16 OR Models for Emergency Medical Service (EMS) Management 392
16.1 Introduction to Emergency Medical Services 392
16.2 EMS Strategic Planning Models 395
16.2.1 Backup Coverage Problems (BACOP) 398
16.2.2 Nonlinear Integer Programming Model for Real-Time EMS Vehicle Dispatching Model 400
16.3 EMS Operational Planning Models 404
16.3.1 Joint Ground and Air Emergency Medical Services Coverage Model 406
16.4 EMS Models Under Uncertainty 408
16.5 Case Study 411
16.6 Future Research Directions 414
References 416
17 Health Informatics 419
17.1 Introduction 419
17.2 Optimizational Computing in Bioinformatics 422
17.3 Variational Methods in Image Segmentation 427
17.4 Image Registration 430
17.5 Strategic Reorganization Planning Among Healthcare System Units 434
17.5.1 MCDM in Unit Investment Ordering 435
17.5.2 ANP Method 436
17.5.3 An Example of Private Hospital in Turkey 439
17.5.3.1 The Identification of Criteria and Sub-criteria 439
17.5.3.2 Evaluation of the Problem by ANP 442
17.6 Medical Decision Making: Device Selection Problem 446
17.6.1 MCDM in Medical Decision Making 447
17.6.2 VIKOR Method 447
17.6.3 A Case Study 450
17.6.3.1 Criteria for Medical Imaging Device Selection and Alternatives 450
17.6.3.2 Evaluation of MDS Problem by VIKOR 450
17.7 Conclusion 453
References 455
18 OR Applications in Pharmaceutical Supply Chain Management 457
18.1 Introduction to Pharmaceutical Supply Chain Management 457
18.1.1 Characteristics and Importance of Pharmaceutical Industry 457
18.1.2 Pharmaceutical Supply Chain 459
18.1.2.1 Importance and Drivers 459
18.1.2.2 Characteristics and Scope 460
18.1.2.3 Differences of PSCs with Other SCs 462
18.2 Classification of Problems and Challenges 463
18.2.1 General Aspects 463
18.2.2 Strategic Decisions 465
18.2.2.1 Supply Chain Network Design and Planning 465
18.2.2.2 Capacity Planning 467
18.2.3 Tactical Decisions 468
18.2.3.1 Product Portfolio Selection 469
18.2.3.2 Inventory Management 470
18.2.4 Operational Decisions 471
18.2.5 Integrated Approaches 472
18.3 Solution Approaches and Challenges 473
18.3.1 Finding Solution 474
18.3.2 Uncertainty 475
18.4 *-17pt 477
18.5 Future Research Directions 483
References 484
19 A Categorical DEA Framework for Evaluating Medical Tourism Efficiency of “Top Destinations” 488
19.1 Introduction 488
19.2 Literature Review 490
19.3 Data Envelopment Analysis 492
19.3.1 Data Envelopment Analysis with Categorical Data 493
19.3.1.1 CCR Model with Categorical Variables 493
19.4 Application of the Proposed DEA Framework for Evaluating Medical Tourism Efficiency of Top Destination Countries 494
19.5 Hypothesis Testing 502
19.6 Conclusions 503
References 504
Part VIII Health Care Management 507
20 Healthcare Human Resource Planning 508
20.1 Importance of Healthcare Human Resource Planning 508
20.2 Elements of Healthcare Human Resource Projections 509
20.3 Challenges of Healthcare Human Resource Projections 511
20.4 Healthcare Human Resource Planning Frameworks 513
20.5 Survey of Analytical Methods 515
20.5.1 System Dynamics 515
20.5.2 Linear Programming 515
20.5.3 Data Driven Forecasting 516
20.5.4 Microsimulation 516
20.5.5 Econometrics 517
20.6 Considerations for Selecting Healthcare Human Resource Planning Approach 519
20.7 Case Study 1: Future Requirements for and Supply of Ophthalmologists for an Aging Population in Singapore (Ansah et al. 2015) 521
20.7.1 Background 521
20.7.2 Methods 522
20.7.3 Singapore Eye Care Workforce Model 523
20.7.4 Scenarios 523
20.7.5 Key Findings 524
20.7.6 Insights from the Case Study 525
20.8 Case 2: Using Linear Programming to Optimize the Dental Team Skill-Mix for England (Harper et al. 2013) 526
20.8.1 Background 526
20.8.2 Demand Model 526
20.8.3 Supply Model 527
20.8.4 Optimization of Workforce Skill Mix 527
20.8.5 Results 528
20.8.5.1 Demand Model 528
20.8.5.2 Comparison of Supply and Demand 528
20.8.5.3 Skill-Mix Optimization Model 528
20.8.6 Recommendations 529
20.9 Future Research Directions 530
References 530
21 Lean Healthcare 535
21.1 An Introduction to Lean Management 535
21.1.1 Types of Activities 537
21.1.1.1 Value Added (VA) Activities 537
21.1.1.2 Required Non-value Added (RNVA) or Type I Non-value Added Activities 537
21.1.1.3 Non-value Added (NVA) or Type II Non-value Added Activities 537
21.1.2 Lean Principles 537
21.1.2.1 Value 538
21.1.2.2 Value Stream Mapping 538
21.1.2.3 Flow 538
21.1.2.4 Pull Versus Push 538
21.1.2.5 Perfection 539
21.1.2.6 Respect for People 539
21.2 Healthcare Wastes 539
21.2.1 Over Production 539
21.2.2 Waiting (Delay) 540
21.2.3 Transportation 540
21.2.4 Inappropriate Processing 541
21.2.5 Unnecessary Inventory 541
21.2.6 Unnecessary Motion 541
21.2.7 Defects 542
21.3 Lean Management in Healthcare Systems 542
21.3.1 Lean Tools and Techniques 543
21.3.1.1 Root-Cause Analysis 543
21.3.1.2 Batch Size Reduction 545
21.3.1.3 The A3 Problem-Solving Report 545
21.3.1.4 Takt Time 545
21.3.1.5 Kaizen Blitz (Kaizen Event) 545
21.3.1.6 Quick Changeover 546
21.3.1.7 Total Productive Maintenance (TPM) 547
21.3.1.8 Kanban (Pull) 547
21.3.1.9 Industrial Housekeeping (5S) 547
21.3.1.10 The Five Whys Technique 547
21.3.1.11 Poka-Yoke/Jidoka (Mistake-Proofing) 548
21.3.1.12 Standardized Work 548
21.3.1.13 Visual Controls 548
21.3.2 Lean System from Employees' Perspectives 549
21.3.2.1 Task Identity 549
21.3.2.2 Feedback 550
21.3.2.3 Work Facilitation 550
21.3.2.4 Responsible Autonomy 550
21.3.2.5 Choice Autonomy 550
21.4 Strategic and Operational Challenges in Hospitals 550
21.4.1 Organizational Challenges 551
21.4.2 Defining Waste 551
21.4.3 Cultural Barriers 551
21.4.4 Fear of Losing Jobs 551
21.4.5 Slow Engagement of the Physicians 552
21.4.6 Sustaining Lean System 552
21.4.7 Negative Connotations 552
21.4.8 Defining the Customer 552
21.4.9 Measuring Value 552
21.5 Using Operations Research Tools for Lean Healthcare 553
21.6 Case Studies 555
21.6.1 ThedaCare, Northeastern Wisconsin, USA 555
21.6.2 F. Miulli Hospital, Italy 555
21.6.3 Flinders Medical Centre, Adelaide, Australia 556
21.6.4 A Primary Care Trust of National Health Service, UK 556
21.6.5 Royal Bolton Hospital, Bolton, United Kingdom 556
21.6.6 Three Hospital Sites, New Zealand 557
21.7 Conclusion 557
References 558
22 Procurement Management in Healthcare Systems 561
22.1 Introduction 561
22.1.1 Definitions and Scope 562
22.1.2 Importance, Advantages and Drivers 563
22.2 Characteristics of Procurement Management in Health Systems 564
22.2.1 Limitations: Public and Political Pressures 564
22.2.2 Procurement in Healthcare Supply Chains 565
22.3 Healthcare Procurement Management Problems and Modelling Methods 566
22.3.1 Planning Problems Related to Group Purchasing Organizations (GPOs) 566
22.3.1.1 A Game Theoretic-Based GPO Problem 571
22.3.2 Supplier Selection and Order Splitting 573
22.3.3 Bundling Products 576
22.3.3.1 Supplier Selection and Order Allocation of Bundled Products 577
22.3.4 E-Procurement 579
22.3.5 Performance Measurement 580
22.4 Case Study 582
22.5 Conclusions 586
References 587
Index 591