Patient-centric design of long-term care networks

Health Care Management Science
Paul IntrevadoLucie Tremblay

Abstract

Long-term care networks may soon buckle under the weight of overwhelming demand. We present two dynamic, large-scale mixed-integer programs for long-term care network design that execute jointly strategic and tactical facility location, modular capacity acquisition, and patient-assignment decisions. The first model is an adaptive network-design model whose focus is more strategic in nature, whereas the second model focuses exclusively on the expansion of an existing long-term care network and incorporates additional tactical decisions such as patient backlogs. Working directly with the president of the Order of Québec Nurses-the provincial organization representing over 75,000 nurses-we incorporate facets such as assignment permanence, as well as develop and measure patient-centric quality-of-life proxies such as geographic mis-assignment and un-assigned patients, the latter of which is quantified via parametric optimization. Various network-design and patient-assignment policies are explored. We conclude that the use of home care as an alternative to long-term care facilities is cost prohibitive under specific conditions. Employing a bisection algorithm, we identify the implicit cost placed on keeping medically stable elderly ...Continue Reading

References

Jul 29, 1998·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·V L GreeneS Laditka
Nov 27, 2009·Health Care Management Science·W L HareA Rutherford
Jul 12, 2012·Health Care Management Science·Teresa CardosoStefan Nickel
Mar 21, 2013·Health Care Management Science·Yue Zhang, Martin L Puterman

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Citations

Feb 24, 2021·Health Care Management Science·B L GarciaN D Kruyt

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