Currently, in Chile, more than a quarter-million of patients are waiting for an elective surgical intervention. This is a worldwide reality, and it occurs as the demand for healthcare is vastly superior to the clinical resources in public systems. Moreover, this phenomenon has worsened due to the COVID-19 sanitary crisis. In order to reduce the impact of this situation, patients in the waiting lists are ranked according to a priority. However, the existing prioritization strategies are not necessarily systematized, and they usually respond only to clinical criteria, excluding other dimensions such as the personal and social context of patients. In this paper, we present a decision-support system designed for the prioritization of surgical waiting lists based on biopsychosocial criteria. The proposed system features three methodological contributions; first, an ad-hoc medical record form that captures the biopsychosocial condition of the patients; second, a dynamic scoring scheme that recognizes that patients’ conditions evolve differently while waiting for the required elective surgery; and third, a methodology for prioritizing and selecting patients based on the corresponding dynamic scores and additional clinical criteria. The designed decision-support system was implemented in the otorhinolaryngology unit in the Hospital of Talca, Chile, in 2018. When compared to the previous prioritization methodology, the results obtained from the use of the system during 2018 and 2019 show that this new methodology outperforms the previous prioritization method quantitatively and qualitatively. As a matter of fact, the designed system allowed a decrease, from 2017 to 2019, in the average number of days in the waiting list from 462 to 282 days.
Pharmacy inventory management is a critical process in healthcare centers. On the one hand, effective drug procurement is fundamental for fulfilling the therapeutic requirements of patients. On the other hand, as hospital pharmacies’ purchasing and storage costs comprise an important share in the hospital budgets, efficient inventory management may play a central role in operational cost containment. Therefore, healthcare centers should design and implement decision-aid strategies for planning the purchase of drugs with the aim of avoiding excessive purchasing volumes and optimizing warehouse capacity, while also meeting forecast demand and ensuring critical stock levels. In this study, we present the methodological features of a decision-aid tool for planning the purchases and inventory levels for the controlled medication pharmacy of the Regional Hospital of Talca, Chile. We report the results obtained after 1 year of operation; these results show that our strategy produced more than 7% savings compared to the regular inventory planning strategy and was more effective in preserving critical stock levels. Furthermore, from a computational point of view, our strategy outperforms a recently published approach for a similar application.
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