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. 2022 Dec:84:101450.
doi: 10.1016/j.seps.2022.101450. Epub 2022 Oct 12.

Planning feasible and efficient operational scenarios for a university hospital through multimethodology

Maria Stella de Castro Lobo  1 , Marcos Pereira Estellita Lins  2   3 , Henrique de Castro Rodrigues  3   4 , Gabriel Martins Soares  3
Affiliations

Planning feasible and efficient operational scenarios for a university hospital through multimethodology

Maria Stella de Castro Lobo et al. Socioecon Plann Sci. 2022 Dec.

Abstract

The COVID-19 pandemic required managerial and structural changes inside hospitals to address new admission demands, frequently reducing their care capacity for other diseases. In this regard, this study aims to support the recovery of hospital productivity in the post-pandemic context. The major challenge will be to make use of all the resources the institution has obtained (equipment, beds, temporarily hired human resources) and to increase production to meet the existing repressed demand. To support evidence-based decision-making at a major university hospital in Rio de Janeiro, hospital managers and operations research analysts designed an approach based on multiple methodologies. Besides multimethodology, one important novelty of this study is the application of a productivity frontier function to future scenario planning through the quantitative DEA methodology. Concept maps were used to structure the problem and emphasize stakeholders' perspectives. In sequence, data envelopment analysis (DEA) was applied, as it combines benchmarking best practices and assigns weights to inputs and outputs. To guarantee that the efficiency measurement considers all inputs and outputs before any inclusion of expert judgment, the scope was redirected to full dimensional efficient facet, if any, or to maximum efficient faces. The results indicate that production scenarios proposed by stakeholders based on the Ministry of Health parameters overestimate the viable production framework and that the scenario that maintains temporary human resource contracts is more compatible with quality in health provision, teaching, and research. These findings will serve as a basis for decision-making by the governmental agency that provided temporary contracts. The present methodology can be applied in different settings and scales.

Keywords: Covid-19; Data envelopment analysis; Full dimensional facet; Goal programming; Hospital planning; Public health.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Frontier and proposed scenarios (Sc).
Fig. 2
Fig. 2
Demand planning using expanded resources, 2020–2021.
Fig. 3
Fig. 3
HSs and OR analysts' perspective.
Fig. 4
Fig. 4
Scenario 1: Stakeholder planning (MoH parameters) versus GP-FDEF forecast variables (beds sum ICU and others).
Fig. 5
Fig. 5
Scenario 2: Stakeholder planning (MoH parameters) versus GP-FDEF forecast variables (beds sum ICU and others).
Fig. 6
Fig. 6
Comparison of adjustments between scenarios.
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