Development of Heuristic Optimization Methods and Experimental Simulation Design for the Components ...

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" Development of Heuristic Optimization Methods and Experimental Simulation Design for the Components and Resources of Healthcare "
Atalan, Abdulkadir Dönmez, Cem Çağrı

Document Type	:	Latin Dissertation
Language of Document	:	English
Record Number	:	1109791
Doc. No	:	TLpq2476812245
Main Entry	:	Atalan, Abdulkadir
	:	Dönmez, Cem Çağrı
Title & Author	:	Development of Heuristic Optimization Methods and Experimental Simulation Design for the Components and Resources of Healthcare\ Atalan, AbdulkadirDönmez, Cem Çağrı
College	:	Marmara Universitesi (Turkey)
Date	:	2019
student score	:	2019
Degree	:	Ph.D.
Abstract	:	Healthcare is one of the largest and fastest growing businesses besides manufacturing. Most of the countries, especially the U.S. do not have a global or local healthcare system but have a unique and complex system for healthcare service and delivery. This complexity causes many problems such as poor-quality service, duplicates, wrong treatment, high waiting time, medication error, etc. In health systems around the world, there are two types of problems that belong to health institutions. First, the waiting times for treating patients in public health facilities are very high. For this reason, patient dissatisfaction and state health spending are increasing disproportionately. The second problem belongs to private health institutions. In such health institutions, the waiting time of the patients is low, but the cost of the treatment is high. This means that patients have to pay a lot of money from their pocket to wait less. Because of this, the number of patients treated annually in private health institutions is decreasing and their annual income is decreasing. In order to solve such problems positively, the use of optimization method which is mathematical modelling is inevitable. This thesis consists of three chapters. There are two structures in healthcare system worldwide; these are public and private healthcare systems. There are many components that built up health systems. Especially, patients, governments as the main rules and laws maker for health care, healthcare providers and private healthcare sectors (private healthcare insurance companies, private hospitals, resources of private healthcare) are at the center of the healthcare system. In the section that constitutes the first part of the thesis, optimization models are developed by comparing healthcare systems both at the monopoly level and interactively. Intuitive mathematical models developed for health systems aim to achieve optimum results. The second part of the thesis is related to the management of healthcare resources. The aim of this research is to apply discrete event simulation approach based on optimization modelling and design of experiment (DOE) technique to derivate strategies and analyze situations to find optimum solutions in a healthcare department. Since healthcare systems have a stochastic structure, mathematical modeling is usually expressed by closed formulas. It is common to use simulation techniques of systems that cannot be mathematically modeled explicitly. However, with this study, the scenarios of the resources were created, and intuitive mathematical models were developed for each situation. Thus, the objectives of these applications are the minimization the waiting time of the patients, and the maximization the number of treated patients. In addition to this section, a simulation model to reduce the density of the emergency service with advanced nurses employed in the emergency services have been developed in Turkey. In the third chapter, the quality of health systems of countries is questioned. A statistical optimization model has been developed to create a global healthcare competitiveness index (GHCI) covering 53 countries with a gross domestic product per capita of over US usd 10,000. GHCI determines the ease or difficulty of receiving services for patients from healthcare systems of considered countries. Factors considered to be influential on the GHCI were identified and significance levels were analyzed statistically. Then, the desirability equation that is formed in the factors has been established to form the objective function in the optimization model. This section of the thesis has determined the optimum values of the factors for countries to be able to compete in healthcare service. Having those factors with optimum values is an indicator of higher quality of healthcare systems. According to the data obtained through the developed methods, the best solutions were obtained by comparing the scenarios and criteria for the decision variables within the healthcare system. In all three parts of the thesis, all the components included in the healthcare system are benefited with the results obtained by this research. It is aimed that the patient factor is addressed in the center of healthcare systems was benefit more.
Subject	:	Health care management
	:	Operations research
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