자료유형 | 학위논문 |
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서명/저자사항 | Stochastic Models of Patient Access Management in Healthcare. |
개인저자 | Kilinc, Derya. |
단체저자명 | Arizona State University. Industrial Engineering. |
발행사항 | [S.l.]: Arizona State University., 2019. |
발행사항 | Ann Arbor: ProQuest Dissertations & Theses, 2019. |
형태사항 | 238 p. |
기본자료 저록 | Dissertations Abstracts International 81-02B. Dissertation Abstract International |
ISBN | 9781085692076 |
학위논문주기 | Thesis (Ph.D.)--Arizona State University, 2019. |
일반주기 |
Source: Dissertations Abstracts International, Volume: 81-02, Section: B.
Advisor: Gel, Esma. |
이용제한사항 | This item must not be sold to any third party vendors.This item must not be added to any third party search indexes. |
요약 | This dissertation addresses access management problems that occur in both emergency and outpatient clinics with the objective of allocating the available resources to improve performance measures by considering the trade-offs. Two main settings are considered for estimating patient willingness-to-wait (WtW) behavior for outpatient appointments with statistical analyses of data: allocation of the limited booking horizon to patients of different priorities by using time windows in an outpatient setting considering patient behavior, and allocation of hospital beds to admitted Emergency Department (ED) patients. For each chapter, a different approach based on the problem context is developed and the performance is analyzed by implementing analytical and simulation models. Real hospital data is used in the analyses to provide evidence that the methodologies introduced are beneficial in addressing real life problems, and real improvements can be achievable by using the policies that are suggested.This dissertation starts with studying an outpatient clinic context to develop an effective resource allocation mechanism that can improve patient access to clinic appointments. I first start with identifying patient behavior in terms of willingness-to-wait to an outpatient appointment. Two statistical models are developed to estimate patient WtW distribution by using data on booked appointments and appointment requests. Several analyses are conducted on simulated data to observe effectiveness and accuracy of the estimations. Then, this dissertation introduces a time windows based policy that utilizes patient behavior to improve access by using appointment delay as a lever. The policy improves patient access by allocating the available capacity to the patients from different priorities by dividing the booking horizon into time intervals that can be used by each priority group which strategically delay lower priority patients.Finally, the patient routing between ED and inpatient units to improve the patient access to hospital beds is studied. The strategy that captures the trade-off between patient safety and quality of care is characterized as a threshold type. Through the simulation experiments developed by real data collected from a hospital, the achievable improvement of implementing such a strategy that considers the safety-quality of care trade-off is illustrated. |
일반주제명 | Operations research. Health sciences. Behavioral psychology. |
언어 | 영어 |
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