Modelo de gestión de listas de espera centrado en oportunidad y justicia

Julio, Cristian; Wolff, Patricio; Yarza, María Vegoña

doi:10.4067/s0034-98872016000600014

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…In Chile, the government has injected resources to minimize, in part, the problem of waiting lists, but it has not been enough. Some authors have tried to solve the problem with management tools, such as the proposal by Silva-Aravena et al [14], Cisneros [45], Julio et al [46]. Like the international literature, the works try to improve management through the opinion of physicians and to represent this experience with ad-hoc mathematical tools to show the reality of each health service in a particular way.…”

Section: Prioritization Systems In Chile: Recent Evidencementioning

confidence: 99%

Dynamic Surgical Waiting List Methodology: A Networking Approach

Silva-Aravena

Morales

2022

Mathematics

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In Chile and the world, the supply of medical hours to provide care has been reduced due to the health crisis caused by COVID-19. As of December 2021, the outlook has been critical in Chile, both in medical and surgical care, where 1.7 million people wait for care, and the wait for surgery has risen from 348 to 525 days on average. This occurs mainly when the demand for care exceeds the supply available in the public system, which has caused serious problems in patients who will remain on hold and health teams have implemented management measures through prioritization measures so that patients are treated on time. In this paper, we propose a methodology to work in net for predicting the prioritization of patients on surgical waiting lists (SWL) embodied with a machine learning scheme for a high complexity hospital (HCH) in Chile. That is linked to the risk of each waiting patient. The work presents the following contributions; The first contribution is a network method that predicts the priority order of anonymous patients entering the SWL. The second contribution is a dynamic quantification of the risk of waiting patients. The third contribution is a patient selection protocol based on a dynamic update of the SWL based on the components of prioritization, risk, and clinical criteria. The optimization of the process was measured by a simulation of the total times of the system in HCH. The prioritization strategy proposed savings of medical hours allowing 20% additional surgeries to be performed, thus reducing SWL by 10%. The risk of waiting patients could drop by up to 8% annually. We hope to implement this methodology in real health care units.

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Section: Prioritization Systems In Chile: Recent Evidencementioning

confidence: 99%

Dynamic Surgical Waiting List Methodology: A Networking Approach

Silva-Aravena

Morales

2022

Mathematics

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“…In Chile, some strategies have been developed to support the management of waiting lists. For example, Julio et al [56] proposed a management model based on clinical components that measure the timeliness and fairness in the prioritization of patients. Martinez et al [57] proposed a statistical survival model to predict the risk of patient mortality.…”

Section: Strategies For Patients' Prioritizationmentioning

confidence: 99%

An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach

et al. 2022

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The coronavirus pandemic has intensified the strain on medical care processes, especially waiting lists for patients under medical management. In Chile, the pandemic has caused an increase of 52,000 people waiting for care. For this reason, a high-complexity hospital (HCH) in Chile devised a decision support system (DSS) based on multi-criteria decision-making (MCDM), which combines management criteria, such as critical events, with clinical variables that allow prioritizing the population of chronic patients on the waiting list. The tool includes four methodological contributions: 1) pattern recognition through the analysis of anonymous patient data that allows critical patients to be characterized; 2) a score of the critical events suffered by the patients; 3) a score based on clinical criteria; and 3) a dynamic–hybrid methodology for patient selection that links critical events with clinical criteria and with the risk levels of patients on the waiting list. The methodology allowed to 1) characterize the most critical patients and triple the evaluation of medical records; 2) save medical hours during the prioritization process; 3) reduce the risk levels of patients on the waiting list; and 4) reduce the critical events in the first month of implementation, which could have been caused by the DSS and medical decision-making. This strategy was effective (even during a pandemic period).

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“…Their results showed that doctors in general prioritized patients according to the severity of their condition, even when no formal policy for prioritization is in place. In [ 40 ], a rule-based prioritization criterion was implemented to improve the management of waiting lists, considering waiting time and justice. The study demonstrated that timeliness considerations are insufficient to manage waiting lists properly and that justice should be included in the prioritization models.…”

Section: Introductionmentioning

confidence: 99%

The Waiting Game – How Cooperation Between Public and Private Hospitals Can Help Reduce Waiting Lists

Acuna

Zayas‐Castro

Feijoo

et al. 2021

Health Care Manag Sci

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Prolonged waiting to access health care is a primary concern for nations aiming for comprehensive effective care, due to its adverse effects on mortality, quality of life, and government approval. Here, we propose two novel bargaining frameworks to reduce waiting lists in two-tier health care systems with local and regional actors. In particular, we assess the impact of 1) trading patients on waiting lists among hospitals, the 2) introduction of the role of private hospitals in capturing unfulfilled demand, and the 3) hospitals’ willingness to share capacity on the system performance. We calibrated our models with 2008–2018 Chilean waiting list data. If hospitals trade unattended patients, our game-theoretic models indicate a potential reduction of waiting lists of up to 37 % . However, when private hospitals are introduced into the system, we found a possible reduction of waiting lists of up to 60 % . Further analyses revealed a trade-off between diagnosing unserved demand and the additional expense of using private hospitals as a back-up system. In summary, our game-theoretic frameworks of waiting list management in two-tier health systems suggest that public–private cooperation can be an effective mechanism to reduce waiting lists. Further empirical and prospective evaluations are needed.

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Modelo de gestión de listas de espera centrado en oportunidad y justicia

Cited by 5 publications

References 15 publications

Dynamic Surgical Waiting List Methodology: A Networking Approach

Dynamic Surgical Waiting List Methodology: A Networking Approach

An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach

The Waiting Game – How Cooperation Between Public and Private Hospitals Can Help Reduce Waiting Lists

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