Healthcare Management Research Articles

Analisis Pelaksanaan Rujukan Pasien Rawat Jalan Peserta BPJS Kesehatan di Puskesmas Mataram

The referral system is a healthcare management system that carries out the transfer of mutually accountable responsibilities for a specific medical case or health problem either vertically, meaning from a less capable unit to a more capable unit, or horizontally, meaning among units of similar capabilities. The referral system regulates the flow of where someone with a particular health problem should seek examination for their health issues. The purpose of this research is to analyze the Implementation of Outpatient Referral for Participants of the Health Social Security Agency (BPJS Kesehatan) at Mataram Community Health Center. The method used in this research employs a qualitative descriptive approach to gain an overview of the analysis of outpatient referral implementation for BPJS Kesehatan participants at Mataram Community Health Center. Descriptive means that the data collected are in the form of words, images, and not numerical values. The findings of the research indicate that the implementation of outpatient referral at the Community Health Center shows that it has not fully run smoothly. Patient knowledge varies, with some understanding and others not understanding. The facilities and infrastructure are still lacking, some diseases diagnosed under code 144 are still referred, many referrals are initiated by the patients themselves, and there are outpatient referrals from outside healthcare facilities.

Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5

BackgroundMultiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households.MethodsData used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019–21. Data sets of men (15–54 years) and women (15–49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results.ResultsA prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33–0.39)), urban areas (AOR 1.11 (1.02–1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81–0.97)), and ST (AOR 1.30 (1.17–1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress.ConclusionA 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.

"Nobody does checkups back there": A qualitative study of refugees' healthcare needs in the United States from stakeholders' perspectives.

The number of refugees globally grew to 35.3 million in 2022, and many refugees are exposed to various health risks along their migration journey. As a result, they may arrive in host communities with numerous health issues, including communicable diseases and chronic and mental health conditions. Navigating the healthcare system in a host country proves to be a significant challenge for them, leading to delayed care. This qualitative study explored the convolute healthcare needs of refugees in the United States by soliciting insights from stakeholders involved in refugee resettlement and healthcare. In-depth interviews were conducted with fifteen stakeholders who work closely with refugees, including healthcare providers, cultural/clinical health navigators supporting refugees, staff from refugee resettlement agencies and governmental entities, and researchers studying refugee health. Following informed consent, interviews were audio-recorded, transcribed verbatim, and imported into MAXQDA 2022 (VERBI Software) for thematic analysis. The results revealed key themes, including the heterogeneity of refugee populations, limited awareness of preventive healthcare, high prevalence and suboptimal management of chronic conditions, complexity of the healthcare system, lack of follow-up, and language barriers. Further research is warranted concerning the long-term health of refugee populations in the United States. Additionally, more tailored programs involving peer educators are recommended to support refugee communities in navigating the complex healthcare system in the host country.

Privacy Preserving Authentication of IoMT in Cloud Computing

INTRODUCTION: The Internet of Medical Things (IoMT) blends the healthcare industry with the IoT ecosystem and enables the creation, collection, transmission, and analysis of medical data through IoT networking. IoT networks consist of various healthcare IT systems, healthcare sensors, and healthcare management software. OBJECTIVES: The IoMT breathes new life into the healthcare system by building a network that is intelligent, accessible, integrated, and effective. Privacy-preserving authentication in IoMT is difficult due to the distributed communication environment of heterogeneous IoMT devices. Although there has been numerous research on potential IoMT device authentication methods, there is still more to be done in terms of user authentication to deliver long-term IoMT solutions. However, password handling is one of the big challenges of IoMT. METHODS: In this paper, we present an IoMT-related online password-less authentication technique that is quick, effective, and safe. In order to offer cross-platform functionality, the article includes a simulation of FIDO2/WebAuthn, one of the most recent standards for a password-less authentication mechanism. RESULTS: This makes it easier to secure user credentials and improve them while preserving anonymity. The IoMT device authentication process and registration process delays are also assessed. CONCLUSION: Results and simulations show that the efficacy of the proposed mechanism with quick authentication on cloud servers may be accomplished with the fewest registration and authentication procedures, regardless of device setup.

A portable microfluidic electrochemical sensor with nonlinear fit strategy for wide-range uric acid detection

In this work, we have developed a portable electrochemical sensing device controlled by a smartphone through Bluetooth, which was applied for regular uric acid (UA) monitoring in prevention and healthcare management. On the core lies a nonlinear fitting model (I = k·(N − exp(−K·cbulk + b))) which is proposed for the first time and given from the differential equation based on the theoretical analysis. We believe this model can reflect the intrinsic relationship between the obtained current and the bulk analyte concentration, therefore leading to an expanding UA detection range (10-fold) compared to the widely used linear standard curve model and reducing the requirements for the modification of the electrode materials. Besides, the integration of the microfluidic chip promoted the removal of UA oxidation products at the electrode surface, yielding excellent sensing stability with a relative standard deviation (RSD) lower than 1 % during 10 consecutive runs. Consequently, we acquired the relationship between Square Wave Voltammetry (SWV) current and UA concentration (I = 15.27*(2.05 − exp(−0.00108*(cbulk − 663.5))), R2 = 0.9999) in the range of 5 to 1000 μM with a limit of detection (LoD) of 2.4 μM using a completely unmodified screen-printed carbon electrode (SPCE). Proof of concept experiments using 25× diluted human urine spiked with UA yielded a recovery rate of 87.5–101.4 % and a satisfactory selectivity result, which is within the value expected for clinical use, indicating the potential of the developed instrument and nonlinear fitting model for urinary UA detection.

Analysis of healthcare provider management of immune-related adverse events and concordance with NCCN Guidelines.

11136 Background: Immune checkpoint inhibitors (ICIs) are a mainstay of treatment for many cancers but can cause immune-related adverse events (irAEs) that require prompt recognition and management. In 2017, we developed an online interactive decision support tool [www.clinicaloptions.com/immuneAEtool] for healthcare providers (HCPs) with case-specific recommendations for managing irAEs from a medical oncology expert. In 2019 and 2023, we updated the tool to offer recommendations from the latest National Comprehensive Cancer Network (NCCN) Guidelines. Here, we report a comparison of self-reported irAE management from HCPs using the 2023 tool vs NCCN recommendations and a comparison of practice patterns between the 2023 and 2019 tools. Methods: To use the online tool, HCPs entered the affected organ system, symptom grade/severity, and their planned management strategy. The tool showed the NCCN management recommendation for that irAE and then asked if the recommendation changed their intended management approach. Results: From July to December 2023, 172 HCPs entered 241 case scenarios into the tool; 53% treated <10 patients/month with ICIs, and 38% of HCPs practiced in the United States. The most common irAEs involved the gastrointestinal (GI)/hepatobiliary (hep)/pancreatic (29% of cases) or dermatologic/oral (19%) systems. Overall, the planned irAE management strategy of HCPs matched the NCCN recommendations in 55% of cases, an increase from the 49% concordance rate in our 2019 analysis. In the current analysis, the lowest concordance was observed for infusion-related reactions (20%), musculoskeletal irAEs (46%), and dermatologic/oral mucosa irAEs (46%; Table). Furthermore, US HCPs had a lower overall concordance rate (46%) than non-US HCPs (66%). Approximately one half (56%) of all HCPs indicated that the NCCN recommendations in the tool changed their management plan. Conclusions: These data suggest that many HCPs are challenged to optimally manage irAEs and are not managing their patients in concordance with NCCN guidelines. A detailed analysis of HCP irAE management vs NCCN recommendations, including by organ system and severity, along with a comparison of 2023 vs 2019 practice patterns, will be presented. [Table: see text]

EROS: Engendering reproductive health within oncologic survivorship—ECOG-ACRIN E1Q11 paradoxical provision of reproductive health.

11123 Background: For the 10% of women diagnosed with cancer in the reproductive age, reproductive health (RH) is a critical component of oncologic survivorship. RH includes oncocontraception (OC), oncofertility (OF) and sexuality. Guidelines segregate these components resulting in fragmented reproductive health care management. Methods: The EROS trial is a clustered randomized trial performed at 17 NCI Community Oncology Research Program (NCORP) sites (including 8 NCORP sites and 9 Minority/Underserved NCORP sites) from 2016-2023. Eligible subjects included reproductively capable women aged 15-55 with new cancer diagnosis. Intervention included RH didactics and decision aids. Childbearing interest was dichotomous, not completed childbearing (including either pregnant or future childbearing interest) or completed childbearing. The objective of this study is to determine provision of OC and OF referral by providers at the baseline visit based on patient’s self-reported childbearing interest at study entry. Chi-square tests were used to compare distribution differences in the referral status (receipt: yes vs. no) between treatment arms. Results: The EROS study enrolled 420 subjects. Of the 63.6% (267/420) completed childbearing, 62.4% (58/93) in the intervention arm and 40.2% (70/174) in the non-intervention arm received an OC referral (p=0.0006), whereas 98.9% (92/93) in the intervention arm and 93.7% (163/174) in the non-intervention arm received an OF referral (p=0.0487). Of the 36.4% (153/420) not completed childbearing, 48.3% (28/58) in the intervention arm and 33.72% (32/95) in the non-intervention arm received an OC referral (p=0.0729), while 77.6% (45/58) in the intervention arm and 70.5% (67/95) in the non-intervention arm received an OF referral (p=0.3388). Conclusions: While the intervention increased the rates of provision of oncocontraception and oncofertility for patients with completed childbearing, our study shows provision of oncofertility referrals at a markedly higher rate than oncontraception. Referral patterns were inconsistent with patient need particularly in completed (receiving OF referral) or delayed childbearing (not receiving OC referral) interest of the patient. The bias favoring oncofertility referral may reflect oncology guidelines emphasizing this aspect of reproductive health despite comprehensive needs of patient.

Assessing the relevance and requirement of a prostate cancer passport: A patient-centric survey.

e23037 Background: Prostate cancer, a prevalent malignancy among men worldwide, necessitates a multifaceted approach to its management, encompassing diagnosis, treatment, and post-treatment care. The absence of a consolidated and accessible cancer information for prostate cancer patients prompts an exploration into the necessity and potential benefits of a dedicated Prostate Cancer Passport. This survey-based study seeks to elucidate patient perspectives and assess the demand for it. Methods: We Surveyed prostate cancer patients attending St James Hospital Medical Oncology OPD and day ward. The survey methodology integrated a diverse cohort of individuals representing varying demographics, encompassing age groups and socio-economic backgrounds. Questions were structured to gauge patient awareness, preferences, and perceived benefits associated with the adoption of a Prostate Passport. The survey was structured to gauge patient awareness levels regarding existing health record systems, preferences for a specialized Prostate Cancer Passport, and anticipated benefits associated with its implementation Furthermore, the survey seeked to elucidate potential concerns, barriers to adoption, and the anticipated impact on patient-provider interactions. Results: The survey’s findings indicate a significant interest among participants in the implementation of a specialized platform like the Prostate Passport, with more than 65% expressing enthusiasm about its potential benefits in improving healthcare management. However, 20% of patients reported not receiving any prostate cancer information booklet from their healthcare providers. Additionally, 30% of participants expressed dissatisfaction with communication with their medical team, while over 40% lacked confidence in their understanding of prostate cancer. Nevertheless, concerns related to data security were raised by more than 25% of patients, and approximately 23% identified potential barriers to adoption, such as interoperability with existing healthcare systems and ease of access across different healthcare settings. However, concerns regarding data security were highlighted by over 25% of patients and about 23% of patients identified interoperability with existing healthcare systems, and ease of access across various healthcare settings as potential barriers to adoption. Conclusions: The survey outcomes offer valuable perspectives on the distinct requirements and preferences of individuals facing prostate cancer. This data is crucial for customizing the Prostate Cancer Passport's design and functionalities to effectively cater to those needs. Our initial iteration of the prostate cancer passport has been completed and will be distributed to our oncology patients in the upcoming week. We plan to conduct a feedback survey in six months to gather insights and further enhance the passport based on user experiences.

Sustainability of healthcare supply chain management: a panoramic approach through SLR and bibliometric

PurposeThe healthcare sector increasingly recognizes how critical sustainable supply chains are to lowering environmental impact, boosting productivity and satisfying public expectations for morally and responsibly provided healthcare. Consequently, the current study aims to thoroughly evaluate the literature on the sustainability of healthcare supply chain management.Design/methodology/approachThe paper uses a systematic literature review (SLR) technique and bibliometric review to examine the benefactions of different authors, nations and organizations to healthcare sustainability through bibliometric and network analyses.FindingsThe study concludes that the healthcare industry may advance sustainability on all levels by incorporating technology into the fundamentals of sustainability. Patient care is given priority in this proposed approach, which can also help healthcare executives create strategies that support efficient healthcare supply chains.Research limitations/implicationsThe research study can serve as a basis for future investigations into additional healthcare management domains, where integrating a sustainable supply chain can yield superior and observable results and bridge deficiencies in management protocols.Originality/valueUsing bibliometric visualization, this study shows the relevance of sustainability in the healthcare supply chain. By identifying its advantages, present-day circumstances, applications and prospective future research fields, the study took up the review and relevance of sustainability in many parts of the healthcare industry.

The Future of Patient Data Security: Exploring Emerging Technologies and Collaborative Approaches

Abstract: The protection of sensitive patient data has become a paramount concern in the increasingly digital landscape of the healthcare industry. As healthcare organizations adopt electronic health records and face a growing array of cyber threats, they must navigate a complex regulatory environment, including the Health Insurance Portability and Accountability Act (HIPAA), while implementing robust strategies to safeguard personal health information (PHI). This article provides a comprehensive overview of the challenges and best practices in healthcare data protection, examining the current regulatory framework, the various threats to patient data—such as cyber-attacks, insider threats, and human error—and the key strategies and technologies for enhancing security, including encryption, access controls, and employee training. The article also explores the potential of emerging technologies, such as block chain and artificial intelligence, in revolutionizing healthcare data management and security, and emphasizes the importance of collaboration among stakeholders, including healthcare providers, technology vendors, policymakers, and patients. By recapping the main challenges and strategies discussed, offering insights into the future of data protection in healthcare, and issuing a call to action for prioritizing patient data security, this article serves as a valuable resource for healthcare organizations seeking to strengthen their data protection measures and maintain patient trust in the digital age.

Users' Perceptions of Access to and Quality of Unified Health System Services in Brazil: A Cross-Sectional Study and Implications to Healthcare Management Challenges.

Evaluating the access to and quality of healthcare services from the users' perspective is an important assessment process to identify priorities. This study assessed the profile of health service usage and the views of the Unified Health System (SUS) users about the access to and quality of SUS public health services. A cross-sectional study was conducted with participants from the Coastal Lowlands Region of the Rio de Janeiro State/Brazil, between August and November 2023. The association between categorical variables was analyzed using the Pearson Chi-Square test, using R software 4.3. A total of 200 individuals were interviewed using a 66-question survey instrument. Participants who reported using SUS services more frequently rated this system as essential (p-value = 0.031). However, overall, 64% of participants rated the quality of care to be very bad/bad and 34.9% rated access as very bad/bad. Access was considered poor by respondents who used public services rarely or sometimes (p-value = 0.002). In terms of accessing SUS services consultations provided by specialists (e.g., neurologists), these were available only in another municipality (p-value = 0.001). Many participants were SUS dependent for health services, and gaps and weaknesses were observed regarding users' perspectives of the access to and quality of SUS health care. Policymakers should prioritize evaluations and dialogue with the community to make SUS services responsive and to optimize value-for-money in health service planning.

Enhancing AI competence in health management: students’ experiences with ChatGPT as a learning Tool

BackgroundThe healthcare industry has had to adapt to significant shifts caused by technological advancements, demographic changes, economic pressures, and political dynamics. These factors are reshaping the complex ecosystem in which healthcare organizations operate and have forced them to modify their operations in response to the rapidly evolving landscape. The increase in automation and the growing importance of digital and virtual environments are the key drivers necessitating this change. In the healthcare sector in particular, processes of change, including the incorporation of artificial intelligent language models like ChatGPT into daily life, necessitate a reevaluation of digital literacy skills.MethodsThis study proposes a novel pedagogical framework that integrates problem-based learning with the use of ChatGPT for undergraduate healthcare management students, while qualitatively exploring the students’ experiences with this technology through a thematic analysis of the reflective journals of 65 students.ResultsThrough the data analysis, the researcher identified five main categories: (1) Use of Literacy Skills; (2) User Experiences with ChatGPT; (3) ChatGPT Information Credibility; (4) Challenges and Barriers when Working with ChatGPT; (5) Mastering ChatGPT-Prompting Competencies. The findings show that incorporating digital tools, and particularly ChatGPT, in medical education has a positive impact on students’ digital literacy and on AI Literacy skills.ConclusionsThe results underscore the evolving nature of these skills in an AI-integrated educational environment and offer valuable insights into students’ perceptions and experiences. The study contributes to the broader discourse about the need for updated AI literacy skills in medical education from the early stages of education.

THE EFFECT OF PERCEIVED FUTURE EMPLOYABILITY ON FUTURE ANXIETY: A STUDY ON HEALTHCARE MANAGEMENT STUDENTS

This study aims to analyze the effect of perceived future employability on future anxiety of undergraduate and associate degree students studying healthcare management in Turkish universities. In addition, whether there is a difference between students’ perceived future employability and future anxiety levels in the context of demographic variables was also investigated. As a result of the findings, it was determined that perceived future employability has a negative and statistically significant but low effect on future anxiety. The effect of the sub-dimensions of the perceived future employability scale on future anxiety was also examined, and it was found that the dimensions of perceived future communication network, expected reputation of the educational institution and perceived future skills predicted future anxiety negatively and statistically significantly. In the context of demographic variables, a statistically significant difference was found only in the gender variable. Future anxiety of women is higher than that of men. Within the framework of these results, it is possible to say that the perceived future employability levels of undergraduate and associate degree students studying healthcare management in Turkish universities are high, and most of their future concerns are shaped by different factors.

Healthcare entrepreneurship: An integrative framework for future research

Healthcare entrepreneurship is of growing interest, but the area of research is not well defined and is disparate across disciplines. We take an integrative approach to examine the similarities and differences between the literature for the two parent domains (healthcare management and entrepreneurship). We present findings from an interdisciplinary four-phase Delphi study and propose a new framework to guide future research. Our proposed healthcare entrepreneurship framework not only reflects variations in key factors, such as actors, activities, processes and outcomes within the parent disciplines, but also suggests gaps, connections and future opportunities for research. Actionable summary and highlightsSince COVID-19, there has been an influx of healthcare entrepreneurial ventures, but, within a volatile market, mixed success. We find that healthcare entrepreneurship is different from work in healthcare or entrepreneurship alone. For healthcare entrepreneurs to achieve their targeted health outcomes as well as their operational and profitability outcomes, all stakeholders need to work together. For the clinician-turned-entrepreneur and the serial entrepreneur now in healthcare, we provide three actionable insights to address some of the practical challenges in healthcare entrepreneurship.1.We advise that venture teams include individuals from both entrepreneurship and healthcare backgrounds to shorten the learning curve, particularly as they develop the evidence base for the offering. Contacting entrepreneurship accelerators or university tech transfer and commercialization offices for which one may have had previous affiliations can be one approach to securing such team members.2.Healthcare entrepreneurs should consider how to include end-user or patient participation to create new healthcare solutions. Working with relevant patient advocacy groups can be one approach and may help to increase the relevance and patient-centeredness of the solution.3.Healthcare entrepreneurs may need to develop new business models and revenue streams. While healthcare is a human right, it requires financing to sustain offerings. One may strengthen one's “business and calling” mindset via joining healthcare entrepreneurship organizations for medical professionals, accelerators, and other local programs that support such entrepreneurial engagement in healthcare.In addition to these insights for healthcare entrepreneurs, we include practical insights for other key actors. Corporations may incentivize partnerships that normalize co-produced innovations. Venture capitalists might develop novel funding mechanisms linked to non-traditional outcomes. Non-profit organizations can serve as interdisciplinary conveners to raise awareness of healthcare entrepreneurship needs. Policy makers might consider ways to create business environments with competitive, yet reasonable, cost and pricing structures.

Exploration of Hospital Management and Organization Strategies: A Literature Review of Health Services

Background - Healthcare management strategy and organization encompasses the principles and practices used to operate healthcare facilities efficiently and effectively. It involves the planning, implementation, and coordination of various activities to ensure the delivery of high-quality patient care while optimising resource utilisation. The literature review in healthcare provides valuable insights into various aspects of hospital management strategy and organization. Objective - This article aims to find out the importance of management and organizational strategies in service businesses (hospitals) and related factors, so as to create improved human resource performance related to achieving effective and efficient organizational goals to face business competition and can be an organizational strategy in creating job satisfaction, can perform well and can create a competitive advantage for organizations in health services. Research Methode - The method used is the identification of previous articles with a total of 29 articles in the time span of 2000-2023. Search data for literature review was conducted in international journals to support the theory and take the topic of Management and Organizational articles, found 234,347 articles, scope Innovation, 2000-2023, Business, management and accounting, article, organization and management, English found 1,239 articles, Qualitative - 363 articles, Strategic - 134 articles, Performance - 95 articles, Effectiveness - 52 articles, Leadership, Health - 35 articles. Furthermore, articles that do not fit the topic will be ignored. Researchers only use data bases from Scopus and Web of Science because researchers only look for quality articles and the results are more accurate and very credible sources, because the results can be used as references and policies. Results - The importance of the role of management and organization in hospitals and can have a major impact on healthcare organizations. As explained in previous research that Management has a big role to improve hospital performance in an organization. The importance of management and organizational performance as they relate to each other. Human resources (HR) provide special attention in personal development and impact on performance in creating a health service. Conclusion - Management and organization are important in the hospital business because human resources are the driving force of the service business. Good management and organization can create professional and talented human resources results that can improve performance and will have an impact on organizational goals, and services to patients can run well which has an impact on the main objectives of the hospital. Management can be seen from several things including training and development, management practices, organizational climate, and other things that have a relationship in creating effective and efficient management so as to provide optimal results for the organization. Managerial Implications - The healthcare management needs to pay more attention to the evaluation of healthcare operational activities and feedback provided by patient families, the hospital management needs to increase the frequency of its discussions with employees to maintain excellent service quality for patient families, and the hospital management leaders need to set an example and encourage their employees to maintain a good organizational culture in order to maintain their service image.

Enchancing Health Records Security Through Blockchain Protocols

The traditional health record sharing system faces challenges in security, privacy, and efficient sharing. "Sec-Health" protocol, a blockchain-based solution, addresses these issues by integrating advanced cryptographic techniques. Its structured workflow includes setup, storage, sharing, and emergency access phases, ensuring controlled access and data integrity. Through blockchain and IPFS networks, users register securely in the setup phase. Health records are encrypted and stored in the blockchain network during storage. Access in the sharing phase is controlled by cryptographic material, allowing only authorized users. The emergency access phase ensures immediate and legitimate access during critical situations. Patients have dynamic control over their records through access revocation. Overall, Sec-Health offers a dynamic solution that enhances security, privacy, and collaboration in healthcare data management. Keywords: Blockchain, Healthcare, Records, Security

Role of metaheuristic algorithms in healthcare: A comprehensive investigation across clinical diagnosis, medical imaging, operations management, and public health

Abstract Metaheuristic algorithms have emerged in recent years as effective computational tools for addressing complex optimization problems in many areas, including healthcare. These algorithms can efficiently search through large solution spaces and locate optimal or near-optimal responses to complex issues. Although metaheuristic algorithms are crucial, previous review studies have not thoroughly investigated their applications in key healthcare areas such as clinical diagnosis and monitoring, medical imaging and processing, healthcare operations and management, as well as public health and emergency response. Numerous studies also failed to highlight the common challenges faced by metaheuristics in these areas. This review thus offers a comprehensive understanding of metaheuristic algorithms in these domains, along with their challenges and future development. It focuses on specific challenges associated with data quality and quantity, privacy and security, the complexity of high-dimensional spaces, and interpretability. We also investigate the capacity of metaheuristics to tackle and mitigate these challenges efficiently. Metaheuristic algorithms have significantly contributed to clinical decision-making by optimizing treatment plans and resource allocation and improving patient outcomes, as demonstrated in the literature. Nevertheless, the improper utilization of metaheuristic algorithms may give rise to various complications within medicine and healthcare despite their numerous benefits. Primary concerns comprise the complexity of the algorithms employed, the challenge in understanding the outcomes, and ethical considerations concerning data confidentiality and the well-being of patients. Advanced metaheuristic algorithms can optimize the scheduling of maintenance for medical equipment, minimizing operational downtime and ensuring continuous access to critical resources.

Prediction-Driven Surge Planning with Application to Emergency Department Nurse Staffing

Determining emergency department (ED) nurse staffing decisions to balance quality of service and staffing costs can be extremely challenging, especially when there is a high level of uncertainty in patient demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by using demand forecasts. In this work, we study a two-stage prediction-driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) nurse staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing and identify the importance of balancing demand uncertainty versus system stochasticity. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Last, we develop a unified framework that combines parameter estimation, real-time demand forecasts, and nurse staffing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework has the potential to reduce annual staffing costs by 10%–16% ($2 M–$3 M) while guaranteeing timely access to care. This paper was accepted by David Simchi-Levi, healthcare management. Funding: J. Dong was partially supported by the Division of Civil, Mechanical and Manufacturing Innovation [Grant CMMI-1944209]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2021.02781 .

Generation rate of hospital solid waste from different services: A case study in the province of Bagua, northern Peru

The objective of this research was to evaluate the unit generation rate of solid hospital waste at the Gustavo Lanatta Lujan Bagua Support Hospital (HAB). The calculations were based on the weights of hospital waste disposed periodically to the biosafety cell located 7 km from the city of Bagua since 2015. Nineteen services were identified and grouped into three areas: hospitalization area, emergency area and gynecology area, studied according to the group classification of Peruvian regulations. The results show that 92.77 kg/day-1 are generated, 62.26 % are biocontaminated waste, 26.45 % are common waste, 7.7 % are sharp-sharp waste and 3.6 % are special waste. It was also found that only 73.56 % is disposed of in the hospital's biosafety cell. In this sense, this study will contribute to promote the reduction of the entry of hazardous substances into the stream of an adequate waste management and save workers and the environment in the Amazon Region. Therefore, awareness should be raised at all levels of society through various means of communication and education, so that the risks of spreading health hazards can be minimized by improving hospital waste management. In addition, healthcare waste management should be implemented, taking into account the parameters to be monitored, the economic resources to be managed and the national plans for healthcare waste.

Trivial State Fuzzy Processing for Error Reduction in Healthcare Big Data Analysis towards Precision Diagnosis.

There is a significant public health concern regarding medical diagnosis errors, which are a major cause of mortality. Identifying the root cause of these errors is challenging, and even if one is identified, implementing an effective treatment to prevent their recurrence is difficult. Optimization-based analysis in healthcare data management is a reliable method for improving diagnostic precision. Analyzing healthcare data requires pre-classification and the identification of precise information for precision-oriented outcomes. This article introduces a Cooperative-Trivial State Fuzzy Processing method for significant data analysis with possible derivatives. Trivial State Fuzzy Processing operates on the principle of fuzzy logic-based processing applied to structured healthcare data, focusing on mitigating errors and uncertainties inherent in the data. The derivatives are aided by identifying and grouping diagnosis-related and irrelevant data. The proposed method mitigates invertible derivative analysis issues in similar data grouping and irrelevance estimation. In the grouping and detection process, recent knowledge of the diagnosis progression is exploited to identify the functional data for analysis. Such analysis improves the impact of trivial diagnosis data compared to a voluminous diagnosis history. The cooperative derivative states under different data irrelevance factors reduce trivial state errors in healthcare big data analysis.