战略性地安置志愿响应系统除颤器。

IF 2.3 3区 医学 Q2 HEALTH POLICY & SERVICES Health Care Management Science Pub Date : 2024-09-10 DOI:10.1007/s10729-024-09685-4
Robin Buter, Arthur Nazarian, Hendrik Koffijberg, Erwin W Hans, Remy Stieglis, Rudolph W Koster, Derya Demirtas
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引用次数: 0

摘要

志愿救援者系统(VRS)可向附近的非专业救援者发出警报,并引导他们前往发生紧急情况的地点。这种系统可应用于院外心脏骤停,在这种情况下,早期心肺复苏(CPR)和使用自动体外除颤器(AED)进行除颤对于提高存活率至关重要。然而,由于位置选择不当,许多自动体外除颤器仍未得到充分利用,而其他地区则缺乏足够的自动体外除颤器覆盖范围。在本文中,我们提出了一种全面的数据驱动算法方法,用于优化在自愿救护系统中使用的(额外的)公共入口自动体外除颤器的部署。除了二进制整数编程(BIP)公式外,我们还考虑了两种启发式方法,即贪婪和贪婪随机化自适应搜索程序(GRASP),以解决部分覆盖的渐进最大覆盖位置(MCLP)问题,从而部署自动体外除颤器。我们为步行、骑自行车或开车的志愿者开发了符合实际的逐步递减覆盖函数。使用核密度估计法估算心脏骤停的空间概率分布,作为模型的输入并评估解决方案。我们将这一方法应用于荷兰的 29 个真实世界实例(城市)。结果表明,对于大型问题实例,GRASP 可以在比精确方法更短的时间内获得接近最优的解决方案。结果表明,迁移现有的自动体外除颤器可将所有城市的加权平均覆盖率从 36% 提高到 49%,相对提高幅度从 1% 到 175%。对于大多数城市来说,战略性地增设 5 到 10 台自动体外除颤器就能大幅提高覆盖率。
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Strategic placement of volunteer responder system defibrillators.

Volunteer responder systems (VRS) alert and guide nearby lay rescuers towards the location of an emergency. An application of such a system is to out-of-hospital cardiac arrests, where early cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED) are crucial for improving survival rates. However, many AEDs remain underutilized due to poor location choices, while other areas lack adequate AED coverage. In this paper, we present a comprehensive data-driven algorithmic approach to optimize deployment of (additional) public-access AEDs to be used in a VRS. Alongside a binary integer programming (BIP) formulation, we consider two heuristic methods, namely Greedy and Greedy Randomized Adaptive Search Procedure (GRASP), to solve the gradual Maximal Covering Location (MCLP) problem with partial coverage for AED deployment. We develop realistic gradually decreasing coverage functions for volunteers going on foot, by bike, or by car. A spatial probability distribution of cardiac arrest is estimated using kernel density estimation to be used as input for the models and to evaluate the solutions. We apply our approach to 29 real-world instances (municipalities) in the Netherlands. We show that GRASP can obtain near-optimal solutions for large problem instances in significantly less time than the exact method. The results indicate that relocating existing AEDs improves the weighted average coverage from 36% to 49% across all municipalities, with relative improvements ranging from 1% to 175%. For most municipalities, strategically placing 5 to 10 additional AEDs can already provide substantial improvements.

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来源期刊
Health Care Management Science
Health Care Management Science HEALTH POLICY & SERVICES-
CiteScore
7.20
自引率
5.60%
发文量
40
期刊介绍: Health Care Management Science publishes papers dealing with health care delivery, health care management, and health care policy. Papers should have a decision focus and make use of quantitative methods including management science, operations research, analytics, machine learning, and other emerging areas. Articles must clearly articulate the relevance and the realized or potential impact of the work. Applied research will be considered and is of particular interest if there is evidence that it was implemented or informed a decision-making process. Papers describing routine applications of known methods are discouraged. Authors are encouraged to disclose all data and analyses thereof, and to provide computational code when appropriate. Editorial statements for the individual departments are provided below. Health Care Analytics Departmental Editors: Margrét Bjarnadóttir, University of Maryland Nan Kong, Purdue University With the explosion in computing power and available data, we have seen fast changes in the analytics applied in the healthcare space. The Health Care Analytics department welcomes papers applying a broad range of analytical approaches, including those rooted in machine learning, survival analysis, and complex event analysis, that allow healthcare professionals to find opportunities for improvement in health system management, patient engagement, spending, and diagnosis. We especially encourage papers that combine predictive and prescriptive analytics to improve decision making and health care outcomes. The contribution of papers can be across multiple dimensions including new methodology, novel modeling techniques and health care through real-world cohort studies. Papers that are methodologically focused need in addition to show practical relevance. Similarly papers that are application focused should clearly demonstrate improvements over the status quo and available approaches by applying rigorous analytics. Health Care Operations Management Departmental Editors: Nilay Tanik Argon, University of North Carolina at Chapel Hill Bob Batt, University of Wisconsin The department invites high-quality papers on the design, control, and analysis of operations at healthcare systems. We seek papers on classical operations management issues (such as scheduling, routing, queuing, transportation, patient flow, and quality) as well as non-traditional problems driven by everchanging healthcare practice. Empirical, experimental, and analytical (model based) methodologies are all welcome. Papers may draw theory from across disciplines, and should provide insight into improving operations from the perspective of patients, service providers, organizations (municipal/government/industry), and/or society. Health Care Management Science Practice Departmental Editor: Vikram Tiwari, Vanderbilt University Medical Center The department seeks research from academicians and practitioners that highlights Management Science based solutions directly relevant to the practice of healthcare. Relevance is judged by the impact on practice, as well as the degree to which researchers engaged with practitioners in understanding the problem context and in developing the solution. Validity, that is, the extent to which the results presented do or would apply in practice is a key evaluation criterion. In addition to meeting the journal’s standards of originality and substantial contribution to knowledge creation, research that can be replicated in other organizations is encouraged. Papers describing unsuccessful applied research projects may be considered if there are generalizable learning points addressing why the project was unsuccessful. Health Care Productivity Analysis Departmental Editor: Jonas Schreyögg, University of Hamburg The department invites papers with rigorous methods and significant impact for policy and practice. Papers typically apply theory and techniques to measuring productivity in health care organizations and systems. The journal welcomes state-of-the-art parametric as well as non-parametric techniques such as data envelopment analysis, stochastic frontier analysis or partial frontier analysis. The contribution of papers can be manifold including new methodology, novel combination of existing methods or application of existing methods to new contexts. Empirical papers should produce results generalizable beyond a selected set of health care organizations. All papers should include a section on implications for management or policy to enhance productivity. Public Health Policy and Medical Decision Making Departmental Editors: Ebru Bish, University of Alabama Julie L. Higle, University of Southern California The department invites high quality papers that use data-driven methods to address important problems that arise in public health policy and medical decision-making domains. We welcome submissions that develop and apply mathematical and computational models in support of data-driven and model-based analyses for these problems. The Public Health Policy and Medical Decision-Making Department is particularly interested in papers that: Study high-impact problems involving health policy, treatment planning and design, and clinical applications; Develop original data-driven models, including those that integrate disease modeling with screening and/or treatment guidelines; Use model-based analyses as decision making-tools to identify optimal solutions, insights, recommendations. Articles must clearly articulate the relevance of the work to decision and/or policy makers and the potential impact on patients and/or society. Papers will include articulated contributions within the methodological domain, which may include modeling, analytical, or computational methodologies. Emerging Topics Departmental Editor: Alec Morton, University of Strathclyde Emerging Topics will handle papers which use innovative quantitative methods to shed light on frontier issues in healthcare management and policy. Such papers may deal with analytic challenges arising from novel health technologies or new organizational forms. Papers falling under this department may also deal with the analysis of new forms of data which are increasingly captured as health systems become more and more digitized.
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