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Operations research in intensive care unit management: a literature review

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Abstract

The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality. As a consequence, numerous papers on the topic exist. The goal of this paper is to provide the first structured literature review on how OR/MS may support ICU management. We start our review by illustrating the important role the ICU plays in the hospital patient flow. Then we focus on the ICU management problem (single department management problem) and classify the literature from multiple angles, including decision horizons, problem settings, and modeling and solution techniques. Based on the classification logic, research gaps and opportunities are highlighted, e.g., combining bed capacity planning and personnel scheduling, modeling uncertainty with non-homogenous distribution functions, and exploring more efficient solution approaches.

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Notes

  1. APACHE II (Acute Physiology and Chronic Health Evaluation II): a severity-of-disease classification system [90], one of several ICU scoring systems. It is applied within 24 h of admission of a patient to an ICU: an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death.

  2. Kendall’s notation is used to characterize queueing systems [91]. It is given by A/S/c/K/N/D, where A indicates the distribution of inter-arrival time, S indicates the distribution of service time, C indicates the number of servers, K indicates the system capacity, N indicates the size of the customer population, and D indicates the queue’s discipline.

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Authors and Affiliations

  1. Universitäres Zentrum für Gesundheitswissenschaften am Klinikum Augsburg (UNIKA-T), Universitätsstraße 16, 86159, Augsburg, Germany

    Jie Bai, Jan Schoenfelder & Jens O. Brunner

  2. School of Business and Economics, University of Augsburg, Universitätsstraße 16, 86159, Augsburg, Germany

    Jie Bai, Jan Schoenfelder & Jens O. Brunner

  3. Faculty of Management, Economics and Social Science, University of Cologne, Albertus-Magnus-Platz, 50923, Köln, Germany

    Andreas Fügener

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  1. Jie Bai
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  4. Jens O. Brunner
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Correspondence to Andreas Fügener.

Appendix

Appendix

Table 6

Table 6 Framework for ICU management
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Table 7

Table 7 Modeling methods of uncertainties
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Table 8

Table 8 Modeling methods and solution approaches
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Bai, J., Fügener, A., Schoenfelder, J. et al. Operations research in intensive care unit management: a literature review. Health Care Manag Sci 21, 1–24 (2018). https://doi.org/10.1007/s10729-016-9375-1

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