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Author (up) Barrera, J.; Carrasco, R.A.; Mondschein, S.; Canessa, G.; Rojas, D. doi  openurl
  Title Operating Room Scheduling under Waiting Time Constraints: the Chilean GES Plan Type Journal Article
  Year 2018 Publication Annals Of Operations Research Abbreviated Journal Ann. Oper. Res.  
  Volume to appear Issue Pages  
  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 wait- ing 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.
 
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  Series Volume Series Issue Edition  
  ISSN 0254-5330 ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number UAI @ eduardo.moreno @ Serial 885  
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