A multilevel integrative approach to hospital case mix and capacity planning.

Hospital case mix and capacity planning involves the decision making both on patient volumes that can be taken care of at a hospital and on resource requirements and capacity management. In this research, to advance both the hospital resource efficiency and the health care service level, a multilevel integrative approach to the planning problem is proposed on the basis of mathematical programming modeling and simulation analysis. It consists of three stages, namely the case mix planning phase, the master surgery scheduling phase and the operational performance evaluation phase. At the case mix planning phase, a hospital is assumed to choose the optimal patient mix and volume that can bring the maximum overall financial contribution under the given resource capacity. Then, in order to improve the patient service level potentially, the total expected bed shortage due to the variable length of stay of patients is minimized through reallocating the bed capacity and building balanced master surgery schedules at the master surgery scheduling phase. After that, the performance evaluation is carried out at the operational stage through simulation analysis, and a few effective operational policies are suggested and analyzed to enhance the trade-offs between resource efficiency and service level. The three stages are interacting and are combined in an iterative way to make sound decisions both on the patient case mix and on the resource allocation.Health care; Case mix and capacity planning; Master surgery schedule; Multilevel; Resource efficiency; Service level;

Low Power Dynamic Scheduling for Computing Systems

This paper considers energy-aware control for a computing system with two states: "active" and "idle." In the active state, the controller chooses to perform a single task using one of multiple task processing modes. The controller then saves energy by choosing an amount of time for the system to be idle. These decisions affect processing time, energy expenditure, and an abstract attribute vector that can be used to model other criteria of interest (such as processing quality or distortion). The goal is to optimize time average system performance. Applications of this model include a smart phone that makes energy-efficient computation and transmission decisions, a computer that processes tasks subject to rate, quality, and power constraints, and a smart grid energy manager that allocates resources in reaction to a time varying energy price. The solution methodology of this paper uses the theory of optimization for renewal systems developed in our previous work. This paper is written in tutorial form and develops the main concepts of the theory using several detailed examples. It also highlights the relationship between online dynamic optimization and linear fractional programming. Finally, it provides exercises to help the reader learn the main concepts and apply them to their own optimizations. This paper is an arxiv technical report, and is a preliminary version of material that will appear as a book chapter in an upcoming book on green communications and networking.Comment: 26 pages, 10 figures, single spac

Robust measurement-based buffer overflow probability estimators for QoS provisioning and traffic anomaly prediction applications

Suitable estimators for a class of Large Deviation approximations of rare event probabilities based on sample realizations of random processes have been proposed in our earlier work. These estimators are expressed as non-linear multi-dimensional optimization problems of a special structure. In this paper, we develop an algorithm to solve these optimization problems very efficiently based on their characteristic structure. After discussing the nature of the objective function and constraint set and their peculiarities, we provide a formal proof that the developed algorithm is guaranteed to always converge. The existence of efficient and provably convergent algorithms for solving these problems is a prerequisite for using the proposed estimators in real time problems such as call admission control, adaptive modulation and coding with QoS constraints, and traffic anomaly detection in high data rate communication networks

Robust measurement-based buffer overflow probability estimators for QoS provisioning and traffic anomaly prediction applicationm

Suitable estimators for a class of Large Deviation approximations of rare event probabilities based on sample realizations of random processes have been proposed in our earlier work. These estimators are expressed as non-linear multi-dimensional optimization problems of a special structure. In this paper, we develop an algorithm to solve these optimization problems very efficiently based on their characteristic structure. After discussing the nature of the objective function and constraint set and their peculiarities, we provide a formal proof that the developed algorithm is guaranteed to always converge. The existence of efficient and provably convergent algorithms for solving these problems is a prerequisite for using the proposed estimators in real time problems such as call admission control, adaptive modulation and coding with QoS constraints, and traffic anomaly detection in high data rate communication networks

A derivative-free approach for a simulation-based optimization problem in healthcare

Hospitals have been challenged in recent years to deliver high quality care with limited resources. Given the pressure to contain costs,developing procedures for optimal resource allocation becomes more and more critical in this context. Indeed, under/overutilization of emergency room and ward resources can either compromise a hospital's ability to provide the best possible care, or result in precious funding going toward underutilized resources. Simulation--based optimization tools then help facilitating the planning and management of hospital services, by maximizing/minimizing some specific indices (e.g. net profit) subject to given clinical and economical constraints. In this work, we develop a simulation--based optimization approach for the resource planning of a specific hospital ward. At each step, we first consider a suitably chosen resource setting and evaluate both efficiency and satisfaction of the restrictions by means of a discrete--event simulation model. Then, taking into account the information obtained by the simulation process, we use a derivative--free optimization algorithm to modify the given setting. We report results for a real--world problem coming from the obstetrics ward of an Italian hospital showing both the effectiveness and the efficiency of the proposed approach

Optimal Discrete Rate Adaptation for Distributed Real-Time Systems with End-to-End Tasks

Many distributed real-time systems face the challenge of dynamically maximizing system utility in response to fluctuations in system workload. We present the MultiParametric Rate Adaptation (MPRA) algorithm for discrete rate adaptation in distributed real-time systems with end-to-end tasks. The key novelty and advantage of MPRA is that it can efficiently produce optimal solutions in response to workload changes such as dynamic task arrivals. Through oline preprocessing MPRA transforms a NP-hard utility optimization problem to a set of simple linear functions in different regions expressed in term of CPU utilization changes caused by workload variations. At run time MPRA produces optimal solutions by evaluating the linear function for the current region. Analysis and simulation results show that MPRA maximizes system utility in the presence of varying workloads, while reducing the online computation complexity to polynomial time

Network emulation focusing on QoS-Oriented satellite communication

This chapter proposes network emulation basics and a complete case study of QoS-oriented Satellite Communication