Managing a patient waiting list with time-dependent priority and adverse events

¹ Assistant Professor, College of Business Administration, Ewha Womans University, 52 Ewhayeodae-gil, Seoul, 120-750, Korea
dmin@ewha.ac.kr
² Professor, School of Industrial Engineering, Purdue University, 315 N. Grant Street, West Lafayette, IN, 47906, USA
yih@purdue.edu

Received: 8 November 2012
Accepted: 15 October 2013

Abstract

This paper addresses the problem of managing a waiting list for elective surgery to decide the number of patients selected from the waiting list and to schedule them in accordance with the operating room capacity in the next period. The waiting list prioritizes patients not only by their initial urgency level but also by their waiting time. Selecting elective surgery patients requires a balance between the waiting time for urgent patients and that for less urgent patients. The problem is formulated as an infinite horizon Markov Decision Process. Further, the study proposes a scheduling procedure based on structural properties of an optimal policy by taking a sampling-based finite horizon approximation approach. Finally, we examine the performance of the policy under various conditions.