Managing the intake of new patients into a physician panel over time

This article focuses on balancing supply and demand for physicians and panel patients on a tactical level to ensure a manageable workload for the physician and access to care for patients. Patients are part of the physician’s panel if they visit the physician somewhat regularly. For the first time, we propose deterministic integer linear programs that decide on the intake of new patients into panels over time, taking into account the future panel development. The main objective is to minimize the deviation between the expected panel workload and the physician’s capacity over time. We classify panel patients with respect to age and the number of visits in a period and assume a transition probability from one visit category to another from one period to the next. We can include stationary patient attributes and consider several physicians together. The programs work with aggregation levels for the new patients’ demand concerning the patient attributes. We conduct experiments with parameters based on real-world data. We consider the transition between visit categories and the new patients’ demand to be stochastic in a discrete-event simulation. We define upper bounds on the number of patients in a patient class to be accepted in a period through solving the programs several times with different demand inputs. Even in this uncertain environment, we can significantly reduce the expected differences between workload and capacity over time, taking into account several future periods instead of one. Using a detailed classification of new patients decreases the expected differences further

Novel heavy-traffic regimes for large-scale service systems

We introduce a family of heavy-traffic regimes for large scale service systems, presenting a range of scalings that include both moderate and extreme heavy traffic, as compared to classical heavy traffic. The heavy-traffic regimes can be translated into capacity sizing rules that lead to Economies-of-Scales, so that the system utilization approaches 100% while congestion remains limited. We obtain heavy-traffic approximations for stationary performance measures in terms of asymptotic expansions, using a non-standard saddle point method, tailored to the specific form of integral expressions for the performance measures, in combination with the heavy-traffic regimes

Biopsychosocial Assessment and Ergonomics Intervention for Sustainable Living: A Case Study on Flats

This study proposes an ergonomics-based approach for those who are living in small housings (known as flats) in Indonesia. With regard to human capability and limitation, this research shows how the basic needs of human beings are captured and analyzed, followed by proposed designs of facilities and standard living in small housings. Ninety samples were involved during the study through in- depth interview and face-to-face questionnaire. The results show that there were some proposed of modification of critical facilities (such as multifunction ironing work station, bed furniture, and clothesline) and validated through usability testing. Overall, it is hoped that the proposed designs will support biopsychosocial needs and sustainability

Solving Multi-objective Integer Programs using Convex Preference Cones

Esta encuesta tiene dos objetivos: en primer lugar, identificar a los individuos que fueron víctimas de algún tipo de delito y la manera en que ocurrió el mismo. En segundo lugar, medir la eficacia de las distintas autoridades competentes una vez que los individuos denunciaron el delito que sufrieron. Adicionalmente la ENVEI busca indagar las percepciones que los ciudadanos tienen sobre las instituciones de justicia y el estado de derecho en Méxic