Design and Control Principles for Mobile Health Care Operations Management -- The Case of Asthma Control

2005年，美国有650万儿童患有哮喘，这是一种以呼吸困难为特征的慢性呼吸道疾病。由于无法获得常规和持续的卫生保健，儿童哮喘通过急诊室就诊和住院给社区造成严重负担。非营利组织，如移动C.A.R.E.基金会（MCF），通过定期访问美国大都市地区的学校，为儿童哮喘提供移动护理。流动护理需要作出一系列复杂的业务决定，包括病人安排和能力分配，这对确保有效实现社区卫生目标至关重要。本研究调查了流动环境中的业务决策与其对社区健康结果的影响之间的联系。与为初级保健诊所和医院门诊部等传统环境开发的模式相比，研究环境的三个关键方面，即慢性病护理、流动接生和非营利性环境，有必要创建一系列新的业务研究模式，用于保健业务的规划、调度和资源分配。这项研究将在许多层面上产生重大影响。运筹学技术可以大大提高MCF以可持续的方式向芝加哥地区服务不足社区的儿童提供基本保健服务的能力。在经济低迷时期，这种运营改进尤为重要。这些见解将用于创建一套最佳操作实践，以传播给其他组织，这些组织为哮喘以外的慢性疾病运营流动诊所。新的业务模式将有助于日益扩大的保健业务领域，并促进各种环境下的研究，如针对糖尿病、无家可归者和老年人的流动保健，以及非洲的艾滋病毒流动诊所。这项研究将积极吸引研究生和本科生参与分析研究和实地工作。

In 2005, 6.5 million children in the United States suffered from asthma, a chronic respiratory disease characterized by periods of difficulty in breathing. Childhood asthma places severe burden on communities through emergency room visits and hospitalization due to lack of access to routine and continuous health care. Non-profit organizations, such as the Mobile C.A.R.E. Foundation (MCF), provide mobile care for childhood asthma through periodic visits to schools in metropolitan areas across the United States. Mobile care entails a complex array of operational decisions, including patient scheduling and capacity allocation, which are critical to ensuring that community health objectives are met effectively. This research investigates the link between operational decisions in a mobile environment and their impact on the community health outcomes. Three critical aspects of the research setting, chronic care, mobile delivery and non-profit environment, necessitate the creation of a new family of operations research models for planning, scheduling and resource allocation in health care operations compared to those developed for conventional settings such as primary care clinics and hospital outpatient departments. This research will have significant impact at many levels. Operations research techniques can greatly improve the ability of MCF to provide essential health services to children from underserved communities in the Chicago region in a sustainable manner. Such operational improvement is especially critical during an economic downturn. The insights will be used to create a set of operational best practices to be disseminated to other organizations that operate mobile clinics for chronic conditions beyond asthma. The new operations models will contribute to the growing field of health care operations, and stimulate research in settings as varied as mobile health care for diabetes and for homeless and elderly, and mobile HIV clinics in Africa. The research will actively engage graduate and undergraduate students in analytical research and field work.