International Perspectives in Health Care Logistics

Speaker: Rainer Kolisch

Title: Hospital-wide flow management of elective patients

Abstract: We consider the problem of planning the flow of elective patients in a hospital. For each patient the Diagnosis-related group (DRG) and the clinical pathway are given. The DRG and the length of stay determine the revenue the hospital will receive for a patient. The clinical pathway of a patient defines the clinical procedures to be performed and precedence relations between them. Resources such as diagnostic devices, the operating theater, and beds which are required by the procedures within the clinical pathways are limited. This problem is closely related to admission planning but instead of deciding on the number of patients for fixed schedules we decide for a fixed number of patients on the schedule (patient flow) of each patient. To this end we model the problem as a resource-constrained multi-project scheduling problem (RCMPSP) with minimum and maximum time lags. We propose a zero-one programming formulation with the objective to maximize the DRG-based contribution margin taking into account limited resources.  In a computational study where we employ data from a midsize hospital we can show that solving the zero-one programming formulation with standard optimization software can be done fast enough for practical applications. Furthermore, we show that the solutions obtained with our approach considerably improve the solutions currently employed in the hospital.