Accumulating Priority Queues & Markov Models for Health Care Wait Times & Health Recovery Modelling

累积优先级队列

• 批准号: RGPIN-2017-05450
• 负责人: Stanford, David
• 金额: $ 2.04万
• 依托单位: University of Western Ontario
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2019
• 资助国家: 加拿大
• 起止时间: 2019-01-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=682047
• 关键词: Accumulating; Priority; Queues; Markov; Models

The work to be described in this proposal intends to build upon the leadership the applicant has taken during the last funding cycle, along with his co-authors, in advancing the theory for what have come to be known as Accumulating Priority Queues(APQ). The importance of the APQ is that it is the first service discipline to balance urgency with the waiting times of customers in the system. initially proposed by Kleinrock in the 1960s, the applicant together with Profs. Taylor (Melbourne) and Ziedins were to first to obtain waiting time distributions for the Accumulating Priority Queue; this was in its single server setting. Extensions with PhD students funded by the applicant's NSERC Discovery Grant in the last cycle have been used to obtain the waiting time distributions for the homogeneous multi-server s exponential case (Sharif et al (2014)) and the harder heterogeneous multi-server exponential case (Li to study a variety of APQ extensions with students during the funding cycle, including the affine case in which arriving customers may obtain an initial priority credit which then further accumulates while they wait. Later, we plan to address the multi-server case where the rate of service depends upon the customer class. ***Accumulating Priority Queues are a modelling tool that has a large potential to improve performance of service systems (among them, health care facilities) that operate under a set of Key Performance Indicators (KPIs). Delay-based KPIs specify a time limit for each class of customer, and a compliance target stipulating the minimum proportion of the customers to commence service by their time limit. By choosing the APQ priority accumulation rates accordingly, one can seek if it is possible to meet a given set of KPIs at a given staffing level of servers.*A series of projects to be pursued under the proposal seeks to identify appropriate objectives for delay-based KPI systems, and to optimise the resulting formulations.***The research program proposes to study other Markovian models in two distinct settings. In the former, we intend to develop multi-faceted networks of queues to address a chronic problem in health care: the moving of patients across the boundary from acute care in a hospital to sub-acute care in a rehabilitation or long term setting. The difficulty in crossing this boundary leads to heavily congested hospital wards that frequently impact upon wait times in Emergency Departments. Meanwhile, patients occupy expensive beds which do not provide the required level of care. ***The second setting of this line of research pertains to Markovian models for health recovery from stroke and other disabling conditions, which lie at the intersection of interest for actuarial and health care organizations. We hope to investigate situations where insurers contain their financial by investing in specific improved health care facilities to ensure timely care. **

本提案中所述的工作旨在建立在申请人在上一个供资周期中与其合著者沿着在推进被称为累积优先权的理论方面所发挥的领导作用的基础上。APQ的重要性在于，它是第一个在系统中平衡紧急性和客户等待时间的服务规则。最初由Kleinrock在20世纪60年代提出，申请人与教授一起。Taylor（墨尔本）和Ziedins首先获得了累积优先队列的等待时间分布;这是在其单服务器设置中。在最后一个周期中，由申请人的NSERC发现基金资助的博士生的扩展被用来获得同质多服务器的指数情况下的等待时间分布（Sharif et al（2014））和更难的异构多服务器指数案例（Li在资助周期内与学生一起研究各种APQ扩展，包括仿射情况，其中到达的客户可以获得初始优先级信用，然后在他们等待时进一步累积该初始优先级信用。稍后，我们计划解决多服务器的情况下，服务的速度取决于客户类。* 累积优先级是一种建模工具，具有很大的潜力来改善根据一套关键绩效指标（KPI）运营的服务系统（其中包括医疗保健设施）的绩效。基于延迟的KPI为每类客户指定时限，并规定在时限内开始服务的客户的最低比例的合规目标。通过相应地选择APQ优先级累积率，可以寻求是否有可能在给定的服务器人员配备水平下满足给定的KPI集合。根据该提案将开展一系列项目，旨在为基于延迟的KPI系统确定适当的目标，并优化由此产生的公式。该研究计划建议在两种不同的环境中研究其他马尔可夫模型。就前者而言，我们打算发展多方面的轮候网络，以解决医疗服务方面的一个长期问题：病人由医院急症护理服务跨境转往亚急症护理服务，接受康复或长期护理。 跨越这一界限的困难导致严重拥挤的医院病房，经常影响急诊室的等待时间。与此同时，病人占用昂贵的病床，无法提供所需的护理水平。* 这一系列研究的第二个背景涉及中风和其他残疾状况的健康恢复的马尔可夫模型，这是精算和医疗保健组织的兴趣交叉点。我们希望调查保险公司通过投资于特定的改善医疗保健设施以确保及时护理来控制其财务状况的情况。 **