业务前沿:公平的数据驱动型设施选址和资源分配,对抗阿片类药物流行

Joyce Luo, Bartolomeo Stellato
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引用次数: 0

摘要

问题定义:阿片类药物流行病是困扰美国数十年的危机。该流行病的一个核心问题是阿片类药物使用障碍 (OUD) 的治疗机会不公平,这使某些人群面临阿片类药物过量的更高风险。方法/结果:我们整合了一个预测动态模型和一个规范优化问题,以计算美国各州的高质量阿片类药物治疗设施和治疗预算分配。我们的预测模型是一个基于微分方程的流行病学模型,能够捕捉到阿片类药物流行的动态变化。我们利用受神经常微分方程启发的过程,将该模型与各州的阿片类药物流行病数据进行拟合,并获得模型中未知参数的估计值。然后,我们将该流行病学模型纳入相应的混合整数优化问题 (MIP),该问题旨在最大限度地减少阿片类药物过量死亡人数和 OUD 患者人数。我们开发了基于麦考密克包络的强松弛方法,以高效计算 MIP 的近似解,其平均优化差距为 3.99%。我们的方法提供了社会经济公平的解决方案,因为它鼓励在社会脆弱性(根据美国疾病控制中心的社会脆弱性指数)和阿片类药物处方率较高的地区进行投资。平均而言,与基线流行病学模型的预测相比,在允许超预算解决方案的情况下,我们的方法可在 2 年后将 OUD 患者人数减少[计算公式:见正文],将接受治疗的人数增加[计算公式:见正文],将阿片类药物相关死亡人数减少[计算公式:见正文]。管理意义:我们的解决方案表明,政策制定者应将增加治疗设施的目标放在设施数量明显少于人口比例且社会地位更脆弱的县。此外,我们还证明,在流行病学和社会经济因素的指导下,我们的优化方法应有助于为这些战略决策提供信息,因为与仅基于人口和社会脆弱性的基准相比,它能为人口健康带来益处:本文已被《制造与amp; 服务运营管理》(Manufacturing & Service Operations Management Frontiers in Operations Initiative)接受:在线附录见 https://doi.org/10.1287/msom.2023.0042 。
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Frontiers in Operations: Equitable Data-Driven Facility Location and Resource Allocation to Fight the Opioid Epidemic
Problem definition: The opioid epidemic is a crisis that has plagued the United States for decades. One central issue of the epidemic is inequitable access to treatment for opioid use disorder (OUD), which puts certain populations at a higher risk of opioid overdose. Methodology/results: We integrate a predictive dynamical model and a prescriptive optimization problem to compute high-quality opioid treatment facility and treatment budget allocations for each U.S. state. Our predictive model is a differential equation-based epidemiological model that captures the dynamics of the opioid epidemic. We use a process inspired by neural ordinary differential equations to fit this model to opioid epidemic data for each state and obtain estimates for unknown parameters in the model. We then incorporate this epidemiological model into a corresponding mixed-integer optimization problem (MIP) that aims to minimize the number of opioid overdose deaths and the number of people with OUD. We develop strong relaxations based on McCormick envelopes to efficiently compute approximate solutions to our MIPs that have a mean optimality gap of 3.99%. Our method provides socioeconomically equitable solutions, as it incentivizes investments in areas with higher social vulnerability (from the U.S. Centers for Disease Control’s Social Vulnerability Index) and opioid prescribing rates. On average, when allowing for overbudget solutions, our approach decreases the number of people with OUD by [Formula: see text], increases the number of people in treatment by [Formula: see text], and decreases the number of opioid-related deaths by [Formula: see text] after 2 years compared with the baseline epidemiological model’s predictions. Managerial implications: Our solutions show that policymakers should target adding treatment facilities to counties that have significantly fewer facilities than their population share and are more socially vulnerable. Furthermore, we demonstrate that our optimization approach, guided by epidemiological and socioeconomic factors, should help inform these strategic decisions, as it yields population health benefits in comparison with benchmarks based solely on population and social vulnerability.History: This paper has been accepted in the Manufacturing & Service Operations Management Frontiers in Operations Initiative.Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.0042 .
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