Optimal hospital care scheduling during the SARS-CoV-2 pandemic
File(s)COVID_OR_Paper_Revision_3_OO-2.pdf (3.68 MB)
Accepted version
Author(s)
Type
Journal Article
Abstract
The COVID-19 pandemic has seen dramatic demand surges for hospital care that have placed a severe strain on health systems worldwide. As a result, policy makers are faced with the challenge of managing scarce hospital capacity so as to reduce the backlog of non-COVID patients whilst maintaining the ability to respond to any potential future increases in demand for COVID care. In this paper, we propose a nation-wide prioritization scheme that models each individual patient as a dynamic program whose states encode the patient’s health and treatment condition, whose actions describe the available treatment options, whose transition probabilities characterize the stochastic evolution of the patient’s health and whose rewards encode the contribution to the overall objectives of the health system. The individual patients’ dynamic programs are coupled through constraints on the available resources, such as hospital beds, doctors and nurses. We show that the overall problem can be modeled as a grouped weakly coupled dynamic program for which we determine near-optimal solutions through a fluid approximation. Our case study for the National Health Service in England shows how years of life can be gained by prioritizing specific disease types over COVID patients, such as injury & poisoning, diseases of the respiratory system, diseases of the circulatory system, diseases of the digestive system and cancer.
Date Issued
2023-10-01
Date Acceptance
2022-06-12
Citation
Management Science, 2023, 69 (10), pp.5923-5947
ISSN
0025-1909
Publisher
Institute for Operations Research and Management Sciences
Start Page
5923
End Page
5947
Journal / Book Title
Management Science
Volume
69
Issue
10
Copyright Statement
Copyright © 2023, INFORMS
Identifier
https://pubsonline.informs.org/doi/10.1287/mnsc.2023.4679
Publication Status
Published
Date Publish Online
2023-02-21