Araştırma Makalesi
BibTex RIS Kaynak Göster

DEVELOPING OPTIMIZATION MODELS TO EVALUATE HEALTHCARE SYSTEMS

Yıl 2020, Cilt: 38 Sayı: 2, 853 - 873, 01.06.2021

Öz

This study investigated the use of public and private healthcare systems separately and interactively to find solutions to various problems the healthcare sector has faced including waiting time, cost, and quality of service. Patients, private and public healthcare providers, funders, and governments that make rules about healthcare were defined as components of healthcare systems in this study. Mathematical optimization models were developed by deriving scenarios to balance the components of healthcare systems. In addition to derivation of scenarios related to types of healthcare systems and decision variables, including copayment, treatment cost, reimbursement, and premium, numerical studies for the healthcare components were performed to determine which healthcare systems were useful. The minimum fee payable by patients for the easy access to healthcare schemes was calculated. While there was no remarkable change in the waiting time of the patients in the private healthcare system, the waiting time were reduced by 48.70% in the public healthcare system among the findings. The amount of reimbursement decreased significantly as a result of the interaction of healthcare systems. By reducing the amount of co-payment to the amount charged by the public healthcare system, it has been ensured that private healthcare providers treat more patients. Based on computational analyses, because of the agreements provided between the components, we have advocated that public and private healthcare systems must be unified to provide greater benefits for all the components of healthcare.

Kaynakça

  • [1] Emanuel EJ (2018) The real cost of the US health care system. Jama 319:983–985
  • [2] Plath SJ, Bratby JA, Poole L, et al (2018) Nurse practitioners in the emergency department: Establishing a successful service. Collegian. https://doi.org/10.1016/J.COLEGN.2018.11.005
  • [3] Kumar AKS, Chen LC, Choudhury M, et al (2011) Financing health care for all: Challenges and opportunities. Lancet. https://doi.org/10.1016/S0140-6736(10)61884-3
  • [4] Andel C, Davidow SL, Hollander M, Moreno DA (2012) The economics of health care quality and medical errors. J Health Care Finance. https://doi.org/10.1111/j.1553-2712.2008.00254.x
  • [5] Cabrera E, Taboada M, Iglesias ML, et al (2011) Optimization of Healthcare Emergency Departments by Agent-Based Simulation. Procedia Comput Sci 4:1880–1889
  • [6] Ahmed MA, Alkhamis TM (2009) Simulation optimization for an emergency department healthcare unit in Kuwait. Eur J Oper Res 198:936–942
  • [7] Pellegrini LC, Rodriguez-Monguio R, Qian J (2014) The US healthcare workforce and the labor market effect on healthcare spending and health outcomes. Int J Health Care Finance Econ. https://doi.org/10.1007/s10754-014-9142-0
  • [8] Atalan A, Dönmez CÇ (2018) Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilim Derg 30:318–338. https://doi.org/10.7240/marufbd.395255
  • [9] Yang X (2019) Health expenditure, human capital, and economic growth: an empirical study of developing countries. Int J Heal Econ Manag 1–14. https://doi.org/10.1007/s10754-019-09275-w
  • [10] Fisher ES, Wennberg DE, Stukel TA, et al (2003) The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care. Ann Intern Medç 138:288–298
  • [11] Dansky KH, Miles J (1997) Patient satisfaction with ambulatory healthcare services: Waiting time and filling time. Hosp Heal Serv Adm 42:165–177
  • [12] Alexander GC, Casalino LP, Meltzer DO (2003) Patient-Physician Communication About Out-of-Pocket Costs. JAMA 290:953–958
  • [13] F. FJ, Everett KC, E. BC, et al (1993) Reducing Health Care Costs by Reducing the Need and Demand for Medical Services. N Engl J Med 329:321–325
  • [14] Cabrera E, Luque E, Taboada M, et al (2012) ABMS optimization for emergency departments. In: Proceedings - Winter Simulation Conference
  • [15] Serrano V, Spencer-Bonilla G, Boehmer KR, Montori VM (2017) Minimally Disruptive Medicine for Patients with Diabetes. Curr. Diab. Rep.
  • [16] Austin A, Wetle V (2016) The United States Health Care System: Combining Business, Health, and Delivery, 3rd ed. PRENTICE HALL
  • [17] Mihaylova B, Briggs A, O’Hagan A, Thompson SG (2011) Review of Statistical Methods for Analysing Healthcare Resources and Costs. Health Econ 20:897–916. https://doi.org/10.1002/hec.1653
  • [18] Schneider M-J (2016) Introduction to public health. Jones & Bartlett Publishers
  • [19] Hancock T (2018) Reducing the cost of inequality. C Can Med Assoc J 190:E92–E92
  • [20] Sessions K, Hassan A, McLeod TG, Wieland ML (2018) Health Insurance Status and Eligibility Among Patients who Seek Healthcare at a Free Clinic in the Affordable Care Act Era. J Community Health 43:263–267
  • [21] Siciliani L, Stanciole A, Jacobs R (2009) Do waiting times reduce hospital costs? J Health Econ 28:771–780
  • [22] Brekke KR, Siciliani L, Straume OR (2008) Competition and waiting times in hospital markets. J Public Econ 92:1607–1628
  • [23] Trzeciak S, Rivers EP (2003) Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J 20:402–405
  • [24] Brekke KR, Levaggi R, Siciliani L, Straume OR (2014) Patient mobility, health care quality and welfare. J Econ Behav Organ 105:140–157
  • [25] Andritsos DA, Tang CS (2014) Introducing competition in healthcare services: The role of private care and increased patient mobility. Eur J Oper Res 234:898–909. https://doi.org/10.1016/j.ejor.2013.11.022
  • [26] Danis M, Biddle AK, Goold SD (2002) Insurance Benefit Preferences of the Low-income Uninsured. J Gen Intern Med 17:125–133
  • [27] Ibrahim MD, Hocaoglu MB, Numan B, Daneshvar S (2018) Estimating efficiency of Directive 2011/24/EU cross-border healthcare in member states. J Comp Eff Res
  • [28] Hartlapp M (2018) Integrating across policy sectors: how the wider public impacts on the drafting process of EU trans-border healthcare. Int Rev Adm Sci 84:486–502
  • [29] Verra SE, Kroeze R, Ruggeri K (2016) Facilitating safe and successful cross-border healthcare in the European Union. Health Policy (New York) 120:718–727
  • [30] Sunol R, P G, A. J (2008) Cross-border care and healthcare Quality Improvement in Europe: The MARQulS research project. Qual Saf Heal Care 18:i1–i2
  • [31] Atalan A, Donmez C (2019) Employment of Emergency Advanced Nurses of Turkey: A Discrete-Event Simulation Application. Processes 7:48. https://doi.org/10.3390/pr7010048
  • [32] Cochran JK, Roche KT (2009) A multi-class queuing network analysis methodology for improving hospital emergency department performance. Comput Oper Res 36:1497–1512
  • [33] Ajami S, Ketabi S, MahmoodAbadi HB (2013) Reducing Waiting Time in Emergency Department at Ayatollah-Kashani Hospital Using Simulation. J Heal Adm 16:84–94
  • [34] Beaulieu H, Ferland JA, Gendron B, Michelon P (2000) Health Care Management Science. Kluwer Academic Publishers, pp 193–200
  • [35] Topal B, Şahin H (2017) Sağlık sektöründe müşteri memnuniyetinin ölçümü: Simav Devlet Hastanesi örneği. Int J Econ Policy Emerg Econ 2:15–30
  • [36] Atalan A (2018) Türkiye Sağlık Ekonomisi için İstatistiksel Çok Amaçlı Optimizasyon Modelinin Uygulanması. İşletme Ekon ve Yönetim Araştırmaları Derg 1:34–51
  • [37] Mutlu M, Tuzkaya G, Sennaroğlu B (2017) Multi-Criteria Decision Making Techniques for Healthcare Service Quality Evaluation: A Literature Review. Sigma J Eng Nat Sci 35:501–512
  • [38] Barnett JC, Berchick ER (2017) Health Insurance Coverage in the United States: 2016
  • [39] SGK (2020) Turkiye Cumhuriyeti Sosyal Guvenlik Kurumu.
Yıl 2020, Cilt: 38 Sayı: 2, 853 - 873, 01.06.2021

Öz

Kaynakça

  • [1] Emanuel EJ (2018) The real cost of the US health care system. Jama 319:983–985
  • [2] Plath SJ, Bratby JA, Poole L, et al (2018) Nurse practitioners in the emergency department: Establishing a successful service. Collegian. https://doi.org/10.1016/J.COLEGN.2018.11.005
  • [3] Kumar AKS, Chen LC, Choudhury M, et al (2011) Financing health care for all: Challenges and opportunities. Lancet. https://doi.org/10.1016/S0140-6736(10)61884-3
  • [4] Andel C, Davidow SL, Hollander M, Moreno DA (2012) The economics of health care quality and medical errors. J Health Care Finance. https://doi.org/10.1111/j.1553-2712.2008.00254.x
  • [5] Cabrera E, Taboada M, Iglesias ML, et al (2011) Optimization of Healthcare Emergency Departments by Agent-Based Simulation. Procedia Comput Sci 4:1880–1889
  • [6] Ahmed MA, Alkhamis TM (2009) Simulation optimization for an emergency department healthcare unit in Kuwait. Eur J Oper Res 198:936–942
  • [7] Pellegrini LC, Rodriguez-Monguio R, Qian J (2014) The US healthcare workforce and the labor market effect on healthcare spending and health outcomes. Int J Health Care Finance Econ. https://doi.org/10.1007/s10754-014-9142-0
  • [8] Atalan A, Dönmez CÇ (2018) Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilim Derg 30:318–338. https://doi.org/10.7240/marufbd.395255
  • [9] Yang X (2019) Health expenditure, human capital, and economic growth: an empirical study of developing countries. Int J Heal Econ Manag 1–14. https://doi.org/10.1007/s10754-019-09275-w
  • [10] Fisher ES, Wennberg DE, Stukel TA, et al (2003) The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care. Ann Intern Medç 138:288–298
  • [11] Dansky KH, Miles J (1997) Patient satisfaction with ambulatory healthcare services: Waiting time and filling time. Hosp Heal Serv Adm 42:165–177
  • [12] Alexander GC, Casalino LP, Meltzer DO (2003) Patient-Physician Communication About Out-of-Pocket Costs. JAMA 290:953–958
  • [13] F. FJ, Everett KC, E. BC, et al (1993) Reducing Health Care Costs by Reducing the Need and Demand for Medical Services. N Engl J Med 329:321–325
  • [14] Cabrera E, Luque E, Taboada M, et al (2012) ABMS optimization for emergency departments. In: Proceedings - Winter Simulation Conference
  • [15] Serrano V, Spencer-Bonilla G, Boehmer KR, Montori VM (2017) Minimally Disruptive Medicine for Patients with Diabetes. Curr. Diab. Rep.
  • [16] Austin A, Wetle V (2016) The United States Health Care System: Combining Business, Health, and Delivery, 3rd ed. PRENTICE HALL
  • [17] Mihaylova B, Briggs A, O’Hagan A, Thompson SG (2011) Review of Statistical Methods for Analysing Healthcare Resources and Costs. Health Econ 20:897–916. https://doi.org/10.1002/hec.1653
  • [18] Schneider M-J (2016) Introduction to public health. Jones & Bartlett Publishers
  • [19] Hancock T (2018) Reducing the cost of inequality. C Can Med Assoc J 190:E92–E92
  • [20] Sessions K, Hassan A, McLeod TG, Wieland ML (2018) Health Insurance Status and Eligibility Among Patients who Seek Healthcare at a Free Clinic in the Affordable Care Act Era. J Community Health 43:263–267
  • [21] Siciliani L, Stanciole A, Jacobs R (2009) Do waiting times reduce hospital costs? J Health Econ 28:771–780
  • [22] Brekke KR, Siciliani L, Straume OR (2008) Competition and waiting times in hospital markets. J Public Econ 92:1607–1628
  • [23] Trzeciak S, Rivers EP (2003) Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J 20:402–405
  • [24] Brekke KR, Levaggi R, Siciliani L, Straume OR (2014) Patient mobility, health care quality and welfare. J Econ Behav Organ 105:140–157
  • [25] Andritsos DA, Tang CS (2014) Introducing competition in healthcare services: The role of private care and increased patient mobility. Eur J Oper Res 234:898–909. https://doi.org/10.1016/j.ejor.2013.11.022
  • [26] Danis M, Biddle AK, Goold SD (2002) Insurance Benefit Preferences of the Low-income Uninsured. J Gen Intern Med 17:125–133
  • [27] Ibrahim MD, Hocaoglu MB, Numan B, Daneshvar S (2018) Estimating efficiency of Directive 2011/24/EU cross-border healthcare in member states. J Comp Eff Res
  • [28] Hartlapp M (2018) Integrating across policy sectors: how the wider public impacts on the drafting process of EU trans-border healthcare. Int Rev Adm Sci 84:486–502
  • [29] Verra SE, Kroeze R, Ruggeri K (2016) Facilitating safe and successful cross-border healthcare in the European Union. Health Policy (New York) 120:718–727
  • [30] Sunol R, P G, A. J (2008) Cross-border care and healthcare Quality Improvement in Europe: The MARQulS research project. Qual Saf Heal Care 18:i1–i2
  • [31] Atalan A, Donmez C (2019) Employment of Emergency Advanced Nurses of Turkey: A Discrete-Event Simulation Application. Processes 7:48. https://doi.org/10.3390/pr7010048
  • [32] Cochran JK, Roche KT (2009) A multi-class queuing network analysis methodology for improving hospital emergency department performance. Comput Oper Res 36:1497–1512
  • [33] Ajami S, Ketabi S, MahmoodAbadi HB (2013) Reducing Waiting Time in Emergency Department at Ayatollah-Kashani Hospital Using Simulation. J Heal Adm 16:84–94
  • [34] Beaulieu H, Ferland JA, Gendron B, Michelon P (2000) Health Care Management Science. Kluwer Academic Publishers, pp 193–200
  • [35] Topal B, Şahin H (2017) Sağlık sektöründe müşteri memnuniyetinin ölçümü: Simav Devlet Hastanesi örneği. Int J Econ Policy Emerg Econ 2:15–30
  • [36] Atalan A (2018) Türkiye Sağlık Ekonomisi için İstatistiksel Çok Amaçlı Optimizasyon Modelinin Uygulanması. İşletme Ekon ve Yönetim Araştırmaları Derg 1:34–51
  • [37] Mutlu M, Tuzkaya G, Sennaroğlu B (2017) Multi-Criteria Decision Making Techniques for Healthcare Service Quality Evaluation: A Literature Review. Sigma J Eng Nat Sci 35:501–512
  • [38] Barnett JC, Berchick ER (2017) Health Insurance Coverage in the United States: 2016
  • [39] SGK (2020) Turkiye Cumhuriyeti Sosyal Guvenlik Kurumu.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Mühendislik
Bölüm Research Articles
Yazarlar

Abdulkadir Atalan Bu kişi benim 0000-0003-0924-3685

Nergis Feride Kaplan Dönmez Bu kişi benim 0000-0003-3182-7812

Cem Çağrı Dönmez Bu kişi benim 0000-0003-3289-7134

Yayımlanma Tarihi 1 Haziran 2021
Gönderilme Tarihi 8 Ocak 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 38 Sayı: 2

Kaynak Göster

Vancouver Atalan A, Kaplan Dönmez NF, Dönmez CÇ. DEVELOPING OPTIMIZATION MODELS TO EVALUATE HEALTHCARE SYSTEMS. SIGMA. 2021;38(2):853-7.

IMPORTANT NOTE: JOURNAL SUBMISSION LINK https://eds.yildiz.edu.tr/sigma/