Hospital volume allocation: integrating decision maker and patient perspectives

Area of Science:

• Healthcare Management
• Health Services Research
• Operations Research

Background:

• Healthcare systems face challenges with the scattering of surgical interventions across facilities, potentially impacting quality due to the volume-outcome association.
• Optimizing surgical intervention planning is crucial for improving patient outcomes and ensuring healthcare system efficiency.

Purpose of the Study:

• To propose an approach for planning surgical intervention volumes to ensure low adjusted mortality rates.
• To integrate patient choices and decision-maker plans for improved healthcare outcomes and patient adherence.
• To analyze optimal solutions from decision-maker, patient, and combined perspectives.

Main Methods:

• Developed a planning approach that incorporates patient choice interactions with decision-maker planning.
• Applied the approach to a case study of colon cancer interventions in Italy (2014).
• Compared optimal solutions derived from single-actor perspectives versus a simultaneous, multi-actor perspective.

Main Results:

• Considering patient behavior alongside policy maker plans led to variations in planned hospital volumes for surgical interventions.
• Personal patient preferences and lack of information about hospital quality were identified as key factors influencing these variations.
• The integrated approach demonstrated potential for enhancing both health outcomes and patient adherence.

Conclusions:

• Healthcare planning requires a dual perspective, integrating patient preferences and decision-maker strategies for optimal resource allocation.
• Patient adherence and health outcomes are significantly influenced by factors beyond policy decisions, including individual choices and information availability.
• This approach provides a framework for more effective and patient-centered healthcare planning in surgical services.