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Author Barrera, J.; Carrasco, R.A.; Mondschein, S.; Canessa, G.; Rojas-Zalazar, D.
Title Operating room scheduling under waiting time constraints: the Chilean GES plan Type
Year 2020 Publication Annals Of Operations Research Abbreviated Journal Ann. Oper. Res.
Volume 286 Issue 1-2 Pages (up) 501-527
Keywords Scheduling; Operating theater; Operating room scheduling
Abstract In 2000, Chile introduced profound health reforms to achieve a more equitable and fairer system (GES plan). The reforms established a maximum waiting time between diagnosis and treatment for a set of diseases, described as an opportunity guarantee within the reform. If the maximum waiting time is exceeded, the patient is referred to another (private) facility and receives a voucher to cover the additional expenses. This voucher is paid by the health provider that had to do the procedure, which generally is a public hospital. In general, this reform has improved the service for patients with GES pathologies at the expense of patients with non-GES pathologies. These new conditions create a complicated planning scenario for hospitals, in which the hospital's OR Manager must balance the fulfillment of these opportunity guarantees and the timely service of patients not covered by the guarantee. With the collaboration of the Instituto de Neurocirugia, in Santiago, Chile, we developed a mathematical model based on stochastic dynamic programming to schedule surgeries in order to minimize the cost of referrals to the private sector. Given the large size of the state space, we developed an heuristic to compute good solutions in reasonable time and analyzed its performance. Our experimental results, with both simulated and real data, show that our algorithm performs close to optimum and improves upon the current practice. When we compared the results of our heuristic against those obtained by the hospital's OR manager in a simulation setting with real data, we reduced the overtime from occurring 21% of the time to zero, and the non-GES average waiting list's length from 71 to 58 patients, without worsening the average throughput.
Address [Barrera, Javiera; Carrasco, Rodrigo A.; Mondschein, Susana; Canessa, Gianpiero] Univ Adolfo Ibanez, Fac Engn & Sci, Santiago, Chile, Email: javiera.barrera@uai.cl;
Corporate Author Thesis
Publisher Springer Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0254-5330 ISBN Medium
Area Expedition Conference
Notes WOS:000511564300021 Approved
Call Number UAI @ eduardo.moreno @ Serial 1104
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