Preferred Post-acute Provider Network: An Approach to Build Care Coordination Between Acute Care and Post-Acute Care Facilities

The rate of patient discharge to post-acute care (PAC) facilities has grown abruptly in the last few years, contributing to increased healthcare costs. Although PAC benefits include better clinical outcomes and lower readmission and mortality, the variation in referral patterns raises concerns about substandard care and inflated costs. To mitigate these issues, building a preferred PAC provider network (PPN) as a partnership between acute care hospitals (ACH) and PAC providers is a long due necessity. However, the formation of this integrated network is complex involving uncertainty from various aspects. It requires a clear understanding of referral patterns to PAC providers, PAC quality performance, and PAC providers capacity and ability to serve patients from specific geographies and varying acuity levels. To carry out an investigative effort to address these complexities is the overarching theme of this research. This research develops a data-driven standardized predictive model to help providers predict the PAC destination and quantify the risk factors influencing PAC referral. The study applies multinomial logistic regression to develop the predictive model. This study further investigates the common and interrelated risk factors for readmission and length of stay of the patients in acute hospitals with an association of PAC destinations. The last part of this research formulates an operational planning and resource adjustment model to build a PAC PPN leveraging the information and analysis extracted from the predictive referral model. The proposed model is a two-stage stochastic mixed-integer model considering the uncertainty in the number of available nurses and discharged patients. The study uses Binary first stage algorithm to solve the model and generate the decision-making parameters. The results indicate that PAC PPN could facilitate smooth transitions between care settings increasing access to PAC, which is beneficial for reducing patient cost ensuring continuous quality care. Effective care coordination between hospital and PAC entities is crucial to ensure the avail ability of PAC service for its maximum utilization. The proposed PPN model, which involves a contract agreement between ACHs and PACs within a region, would strengthen this care coordination and thus be a powerful strategic approach in improving patient outcomes

Uncertain Supply Chain Management A state of art review on optimization techniques in just in time

With the development of faster means of communication, better quality computers and rapid transportation systems, manufacturing is no longer restricted at local level, but has become global in character. As a manufacturing company has to become competitive for its survival, it has to supply products of consistent high quality at reliable and reduced delivery time. Market also demands more product variants that means reduced lot size and high flexibility in operations. Manpower cost has also risen. All these factors tend to increase the product cost. However, the industry has to maintain the cost at a reasonable level. Confronting these challenges, companies worldwide are forced to find ways to reduce costs, improve quality, and meet the everchanging needs of their customers. One successful solution has been the adoption of Justintime (JIT) manufacturing strategy in which many functional areas of a company such as manufacturing, engineering, marketing, purchasing etc. are involved. In this paper, literature review on research works based on JIT was carried out and presented. The introductory section deals with the philosophy of JIT, and the concept involved in Kanban optimization and later this paper reviews literature on optimization Technique in JIT implementation

A literature review on inventory modeling with reliability consideration

Inventories are the materials stored either waiting for processing or experiencing processing and in some cases for future delivery. Inventories are treated both as blessings and evil. As they are like money placed in a drawer, assets tied up in investments, incurring costs for the care of the stored material and also subject to spoilage and obsolescence there have been a spate of programs developed by industries, all aimed at reducing inventory levels and increasing efficiency on the shop floor. Nevertheless, they do have positive purposes such as stable source of input required for production, less replenishment and may reduce ordering costs because of economies of scale. Finished goods inventories provide for better customer service. So formulating a suitable inventory model is one of the major concerns for an industry. Again considering reliability of any process is an important trend in the current research activities. Inventory models could be both deterministic and probabilistic and both of which must account for the reliability of the associated production process. This paper discusses the major works in the field of inventory modeling driven by reliability considerations, which ranges from the very beginning to latest works just published