These are challenging times for decision makers in Departments of Health, strategic health authorities and healthcare organisations. Budgetary constraints, technological change, system reform, immigration and demographic change are putting health services under unprecedented strain. The purpose of this special issue of the EURO Journal on Decision Processes (EJDP) is to explore how modelling can help better understand these challenges, and aid decision makers in choosing appropriate strategic or policy actions.
The popularity of modelling in the area of healthcare is not in doubt: operational researchers, health economists, medical statisticians, epidemiologists and clinical scientists all make use of models as part of their research strategy. The last few years have seen several special issues (Rauner and Vissers 2003; Xie et al. 2010; Brailsford et al. 2012; Weber et al. 2014; Hans and Vliegen 2014), review papers (Brailsford and Harper 2008; Brailsford and Vissers 2011) and books (Brandeau et al. 2004; Vissers and Beech 2005; Ozcan 2005; Zaric 2013; Hunink et al. 2014) concerned with OR modelling in the healthcare sector. This should not come as a surprise: because of the technical difficulty of assessing the effectiveness of medical interventions, the complexity of understanding the dynamics of infectious disease, the multidimensionality of the healthcare product (and thus of the performance of healthcare organisations), not to mention the critical role played by government in either regulating the market or directly replacing it, decision makers in healthcare face formidable challenges in making wise decisions which reflect evidence and scientific knowledge. Using models is particularly important in this domain, particularly for decisions about the introduction of new drugs and medical technologies, which need to be made now, even though statistical and/or real world evidence will not be accumulated for years, and in some cases, it may even be either impossible or unethical to conduct a clinical trial.
The mission of the EJDP specifically is to contribute to understanding of how modelling can support decision making. The four papers included in this special issue directly address that mission. Reddy et al. (2016) present a multicriteria intervention to assist prioritisation of smoking cessation interventions in England, reminding us that decision support models do not need technical sophistication but do require substantial input from stakeholders. Flessa et al. (2015) also present a policy model, but in their case, the model is an infectious disease model of the human papilloma virus (HPV) which causes cervical cancer, and the country concerned is Cambodia. From a more theoretical point of view, Zhang et al. (2015) and Ekin et al. (2015) both provide optimisation modelling frameworks which address critical issues facing healthcare managers and policy makers (interacting stakeholders and risk preference, respectively). They use their frameworks to model, respectively, hospital investment decisions in computer tomography and resource allocation decisions in the US Army hospital network.
The papers in this volume cover a range of geographical settings, from Europe to the US, to Asia; use a variety of technical methods; and address problems arising at multiple levels of the healthcare system, from making decisions about specific disease programmes to managing an entire system of hospitals. At the same time, they underscore the importance of focussing on the needs of decision makers in developing model solutions. We commend these papers to readers of EJDP. We hope that they will receive the attention and interest which they clearly deserve and that this sparks addition research in this area by readers of his journal.
References
Brailsford S, Harper P (2008) OR in health. Eur J Oper Res 185(3):901–904
Brailsford S, Vissers J (2011) OR in healthcare: a European perspective. Eur J Oper Res 212(2):223–234
Brailsford S, Kozan E, Rauner MS (2012) Health care management. Flex Serv Manuf J 24(4):375–378
Brandeau ML, Sainfort F, Pierskalla WP (eds) (2004) Operations research and health care: a handbook of methods and applications, vol 70. Springer Science & Business Media, Berlin
Ekin T, Kocadagli O, Bastian ND, Fulton LV, Griffin PM (2015) Fuzzy decision making in health systems: a resource allocation model. EURO J Decis Process. doi:10.1007/s40070-015-0049-x
Flessa S, Dietz D, Weiderpass E (2015) Health policy support under extreme uncertainty: the case of cervical cancer in Cambodia. EURO J Decis Process. doi:10.1007/s40070-015-0053-1
Hans EW, Vliegen IM (2014) Editorial: special issue of the 2012 conference of the EURO working group Operational Research Applied to Health Services (ORAHS). Oper Res Health Care 3(2):47
Hunink MM, Weinstein MC, Wittenberg E, Drummond MF, Pliskin JS, Wong JB, Glasziou PP (2014) Decision making in health and medicine: integrating evidence and values. Cambridge University Press, Cambridge
Ozcan YA (2005) Quantitative methods in health care management: techniques and applications, vol 4. Wiley, New York
Rauner MS, Vissers JM (2003) OR applied to health services: planning for the future with scarce resources. Eur J Oper Res 150(1):1–2
Reddy BP, Thokala P, Warhurst K, Chambers H, Iliff A, Bowker L, Walters SJ, Duenas A, Kelly MP (2016) Using MCDA to generate and interpret evidence to inform local government investment in public health. EURO J Decis Process. doi:10.1007/s40070-016-0059-3
Vissers J, Beech R (2005) Health operations management: patient flow logistics in health care. Routledge, London
Weber GW, Blazewicz J, Rauner M, Türkay M (2014) Recent advances in computational biology, bioinformatics, medicine, and healthcare by modern OR. CEJOR 22(3):427
Xie X, Gallivan S, Guinet A, Rauner M (2010) Operational research applied to health services: a special volume dedicated to the international conference ORAHS’2007. Ann Oper Res 178(1):1–4
Zaric GS (2013) Operations research and health care policy. Springer, Berlin
Zhang H, Wernz C, Slonim AD (2015) Aligning incentives in health care: a multiscale decision theory approach. EURO J Decis Process. doi:10.1007/s40070-015-0051-3
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Morton, A., Rauner, M. & Zaric, G. Introduction to the special issue. EURO J Decis Process 4, 157–159 (2016). https://doi.org/10.1007/s40070-016-0061-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40070-016-0061-9