Logistics for diagnostic testing: An adaptive decision-support framework
Logistics for diagnostic testing: An adaptive decision-support framework
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DOI：
10.1016/j.ejor.2023.05.028
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发表时间：
2023-07-25
影响因子：
6.4
通讯作者：
Nickel，Stefan
中科院分区：
文献类型：
--
作者：
Bakker，Hannah;Bindewald，Viktor;Nickel，Stefan
在大流行的每个阶段，诊断检测是有效遏制疫情的基本组成部分。测试样品在测试设施中收集，然后在专门的实验室进行分析。在高收入国家，卫生保健提供者往往是私营的，从检测设施到实验室的样品分配由个别利益攸关方决定。虽然这种分散的系统在正常时期有效地匹配了供需，但分散的疫情，例如在COVID-19大流行期间遇到的疫情，导致对诊断能力的需求不平衡。由于没有协调实体将检测设施的需求与实验室能力相匹配，当地的积压工作迅速增加，从而增加了等待检测结果的时间，从而阻碍了随后的遏制努力。为了通过改善物流活动来缓解不稳定的区域疫情的影响，我们开发了一个滚动地平线框架，该框架根据当前测试样本的数量反复解决数学规划快照问题。该程序动态适应大流行活动产生的需求，支持而不是取代分散的业务，以便使检测请求与现有实验室能力相匹配。我们提出了针对具体问题的绩效指标，并以2020年德国COVID-19疫情为例，对我们的流程质量进行了评估。实验结果表明，协调机制有可能支持与诊断检测相关的后勤工作，从而减少PCR检测结果的等待时间。即使分散分配过程中的干预措施只是为了应对大流行病活动的增加，也取得了重大进展。
Diagnostic testing is a fundamental component in effective outbreak containment during every phase of a pandemic. Test samples are collected at testing facilities and subsequently analyzed at specialized laboratories. In high-income countries where health care providers are often privately owned, the assignments of samples from testing facilities to laboratories are determined by individual stakeholders. While this decentralized system effectively matches supply and demand during normal times, dispersed outbreaks, e.g., as encountered during the COVID-19 pandemic, lead to imbalanced requests for diagnostic capacity. With no coordinating entity in place to match demands at testing facilities to laboratory capacities, local backlogs build up rapidly thus increasing waiting times for test results and thus impeding subsequent containment efforts. To ease the impact of erratic regional outbreaks through improved logistics activities, we develop a rolling horizon framework which repeatedly solves a mathematical programming snapshot problem based on the current number of test samples. The procedure dynamically adapts to requirements resulting from the pandemic activity and supports rather than replaces decentralized operations in order to match testing requests with available laboratory capacities. We present problem-specific performance indicators and assess the quality of our procedure in a case study based on the COVID-19 outbreak in 2020 in Germany. Experimental results demonstrate the potential of coordinating mechanisms to support the logistics related to diagnostic testing and hence to reduce waiting times for PCR test results. Significant improvements are achieved even when interventions in the decentralized assignment process only occur in response to increased pandemic activity.