Elective surgery scheduling considering transfer risk in hierarchical diagnosis and treatment system

Abstract

With the aggravation of the shortage of staffing hospital beds, elective surgeries have to be postponed or even cancelled, which directly affects hospital income and patient health. Therefore, we propose a fuzzy scheduling model based on a patient transfer strategy in the hierarchical diagnosis and treatment system to ensure timely surgery. We propose a risk estimation method based on health failure mode and effect analysis to reduce the transfer risk and represent the surgery duration and the length of stay as fuzzy numbers to deal with the uncertainty. Given that solving the fuzzy model is challenging, we propose an equivalent formulation to transform the fuzzy model into a two-stage mixed integer linear programming (TMIP) model, which can reduce the loss of decision-making information. Finally, the column and constraint generation algorithm is used to solve the TMIP model that is suited for the structure of the main problem and subproblem. The experiment shows that the patient transfer strategy can effectively relieve the hospital bed shortage, and its potential can be further released if the transfer risk can be properly assessed. The proposed method for solving the fuzzy model can reduce the information loss comparing traditional methods.