scholarly journals Optimization-driven framework to understand health care network costs and resource allocation

2021 ◽  
Author(s):  
Fernanda Bravo ◽  
Marcus Braun ◽  
Vivek Farias ◽  
Retsef Levi ◽  
Christine Lynch ◽  
...  
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Labor Cost ◽  
Consolidation Process ◽  
Capacity Decisions ◽  
Trade Offs ◽  
Network Building ◽  
Network Costs ◽  
Site Network ◽  
Delivery Networks

AbstractIn the last several decades, the U.S. Health care industry has undergone a massive consolidation process that has resulted in the formation of large delivery networks. However, the integration of these networks into a unified operational system faces several challenges. Strategic problems, such as ensuring access, allocating resources and capacity efficiently, and defining case-mix in a multi-site network, require the correct modeling of network costs, network trade-offs, and operational constraints. Unfortunately, traditional practices related to cost accounting, specifically the allocation of overhead and labor cost to activities as a way to account for the consumption of resources, are not suitable for addressing these challenges; they confound resource allocation and network building capacity decisions. We develop a general methodological optimization-driven framework based on linear programming that allows us to better understand network costs and provide strategic solutions to the aforementioned problems. We work in collaboration with a network of hospitals to demonstrate our framework applicability and important insights derived from it.

Biosecurity and Public Health Ethics Issues Raised by Biological Threats

2019 ◽  
pp. 773-785
Author(s):  
Nicholas Evans ◽  
Thomas Inglesby
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Infectious Diseases ◽  
Ethical Issues ◽  
Emerging Infectious Diseases ◽  
Biological Weapon ◽  
Ethical Values ◽  
Dual Use ◽  
Health Concerns ◽  
Trade Offs

This chapter introduces ethical issues that arise in the context of biosecurity: policies and actions intended to prevent the development or emergence, or mitigate the consequences, of serious biological threats. These threats could include deliberate biological weapon attacks (bioterrorism), pandemics, emerging infectious diseases, or major laboratory accidents. The basic values that underpin these public health concerns are first introduced. Ethical issues that arise before, during, and following a biosecurity crisis are then examined, including issues of resource allocation, dual-use research, and the possibility of quarantine. Their resolution requires trade-offs among different ethical values, including utility, fairness, and liberty.

scholarly journals A Multi-Commodity Flow Problem for Fair Resource Allocation in Multi-Path Video Delivery Networks

2020 ◽  
Vol 53 (2) ◽  
pp. 7386-7391
Author(s):  
Luca De Cicco ◽  
Gioacchino Manfredi ◽  
Vittorio Palmisano ◽  
Saverio Mascolo
Keyword(s):  
Resource Allocation ◽  
Flow Problem ◽  
Video Delivery ◽  
Commodity Flow ◽  
Delivery Networks

Procedural Protections for Patients in Capitated Health Plans

1996 ◽  
Vol 22 (2-3) ◽  
pp. 301-330
Author(s):  
Eleanor D. Kinney
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Health Maintenance Organizations ◽  
Data Systems ◽  
American Health Care System ◽  
Health Maintenance ◽  
Integrated Delivery ◽  
Provider Organization ◽  
Delivery Networks

In the American health care system, payers are rapidly moving toward the use of capitation as the preferred method for paying for health care services for sponsored patients. n capitation, the payer pays a provider organization a set rate per patient to care for a group of patients. The provider organization assumes the risk of the actual costs of caring for these covered lives. The theory of capitation is that providers, by assuming risk, will have incentives to contain their costs.The provider entity that provides the care can take many corporate forms. A capitated provider can be a small group of physicians with admitting privileges at a single hospital or a complex integrated delivery network comprised of hospitals, physicians, and other health care professionals and institutions with integrated case management and data systems. Currently such integrated delivery networks assume a variety of organizational forms, ranging from traditional staff model health maintenance organizations (HMOs) in which physicians are employees of the health plan to physician hospital organizations (PHOs) in which physicians and hospitals join together for purposes of contracting with payers. Hospitals and physicians belonging to their medical staffs are motivated to form integrated delivery networks or other consolidated business organizations in order to contract with payers that seek providers willing to accept financial risk for the care of sponsored patients. Providers join such arrangements out of fear of losing patients if they do not.

scholarly journals Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California

2020 ◽  
pp. 1-7
Author(s):  
Asha Devereaux ◽  
Holly Yang ◽  
Gilbert Seda ◽  
Viji Sankar ◽  
Ryan C. Maves ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Resource Allocation ◽  
San Diego ◽  
Scarce Resource ◽  
Successful Implementation ◽  
Regional Health ◽  
Incident Command ◽  
Regional Health Care ◽  
Crisis Care

ABSTRACT Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.

scholarly journals Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.

2020 ◽  
Author(s):  
Mais HM Iflaifel ◽  
Rosemary Lim ◽  
Kath M Ryan ◽  
Clare Crowley
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Safety Management ◽  
Hand Search ◽  
Trade Offs ◽  
Time Work ◽  
Management Paradigms ◽  
Resilience Training ◽  
Traditional Approaches ◽  
Standard Strategy

Abstract Background Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a deductive thematic approach. Results Twenty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups) and indirect (e.g. observations). Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, as well as in the methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.

scholarly journals Etica e allocazione delle risorse in sanità

2010 ◽  
Vol 59 (6) ◽  
Author(s):  
D. Sacchini ◽  
P. Refolo ◽  
R. Minacori ◽  
N. Comoretto ◽  
M.L. Di Pietro ◽  
...  
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
The Past ◽  
The Subject

Il contributo ripercorre il dibattito sul tema dell’etica e allocazione delle risorse in ambito sanitario negli ultimi sessant’anni di pubblicazioni della Rivista “Medicina e Morale”. Al richiamo di alcune fonti documentative che certificano l’inserimento di questa tematica fra gli oggetti di indagine della disciplina bioetica, segue una breve rassegna dei contenuti di tutti gli scritti della Rivista sulla materia, una discussione degli elementi che li contraddistinguono e l’indicazione delle prospettive di pubblicazione auspicabili. ---------- The article deals with the debate on ethics and resource allocation in health care over the past sixty years of the Journal “Medicina e Morale” publications. The reference to some documental sources certifying the inclusion of this issue among the objects of investigation of bioethics discipline is followed by a brief overview of the contents of all text of the Journal on the subject, a discussion of the elements that mark them and the indication of the prospects of publication that are desirable.

scholarly journals Value-based provider payment: towards a theoretically preferred design

2018 ◽  
Vol 15 (1) ◽  
pp. 94-112 ◽  
Author(s):  
Daniëlle Cattel ◽  
Frank Eijkenaar ◽  
Frederik T. Schut
Keyword(s):  
Health Care ◽  
Pay For Performance ◽  
Empirical Studies ◽  
Risk Profile ◽  
Provider Group ◽  
Payment Incentives ◽  
Trade Offs ◽  
Provider Payment ◽  
Group 2 ◽  
The Relationship

AbstractWorldwide, policymakers and purchasers are exploring innovative provider payment strategies promoting value in health care, known as value-based payments (VBP). What is meant by ‘value’, however, is often unclear and the relationship between value and the payment design is not explicated. This paper aims at: (1) identifying value dimensions that are ideally stimulated by VBP and (2) constructing a framework of a theoretically preferred VBP design. Based on a synthesis of both theoretical and empirical studies on payment incentives, we conclude that VBP should consist of two components: a relatively large base payment that implicitly stimulates value and a relatively small payment that explicitly rewards measurable aspects of value (pay-for-performance). Being the largest component, the base payment design is essential, but often neglected when it comes to VBP reform. We explain that this base payment ideally (1) is paid to a multidisciplinary provider group (2) for a cohesive set of care activities for a predefined population, (3) is fixed, (4) is adjusted for the population’s risk profile and (5) includes risk-mitigating measures. Finally, some important trade-offs in the practical operationalisation of VBP are discussed.

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