Locating trauma centers considering patient safety.

Bi-objective optimization Operations research in health services Patient safety Trauma center location

Journal

Health care management science
ISSN: 1572-9389
Titre abrégé: Health Care Manag Sci
Pays: Netherlands
ID NLM: 9815649

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 17 04 2020
accepted: 13 07 2021
pubmed: 14 1 2022
medline: 26 5 2022
entrez: 13 1 2022
Statut: ppublish

Résumé

Trauma continues to be the leading cause of death and disability in the U.S. for those under the age of 44, making it a prominent public health problem. Recent literature suggests that geographical maldistribution of Trauma Centers (TCs), and the resultant increase of the access time to the nearest TC, could impact patient safety and increase disability or mortality. To address this issue, we introduce the Trauma Center Location Problem (TCLP) that determines the optimal number and location of TCs in order to improve patient safety. We model patient safety through a surrogate measure of mistriages, which refers to a mismatch in the injury severity of a trauma patient and the destination hospital. Our proposed bi-objective optimization model directly accounts for the two types of mistriages, system-related under-triage (srUT) and over-triage (srOT), both of which are estimated using a notional tasking algorithm. We propose a heuristic based on the Particle Swarm Optimization framework to efficiently derive a near-optimal solution to the TCLP for realistic problem sizes. Based on 2012 data from the state of Ohio, we observe that the solutions are sensitive to the choice of weights for srUT and srOT, volume requirements at a TC, and the two thresholds used to mimic EMS decisions. Using our approach to optimize that network resulted in over 31.5% reduction in the objective with only 1 additional TC; redistribution of the existing 21 TCs led to 30.4% reduction.

Identifiants

pubmed: 35025053
doi: 10.1007/s10729-021-09576-y
pii: 10.1007/s10729-021-09576-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

291-310

Subventions

Organisme : United States National Science Foundation
ID : CMMI#2100979
Organisme : US National Science Foundation
ID : CMMI#1761022

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Sagarkumar Hirpara (S)

Department of Industrial Engineering, University of Louisville, 304 JB Speed Building, 132 Eastern Parkway, Louisville, KY, 40292, USA.

Monit Vaishnav (M)

Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, USA.

Pratik J Parikh (PJ)

Department of Industrial Engineering, University of Louisville, 304 JB Speed Building, 132 Eastern Parkway, Louisville, KY, 40292, USA. pratik.parikh@louisville.edu.

Nan Kong (N)

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.

Priti Parikh (P)

Department of Surgery, Wright State University, Dayton, OH, USA.

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