Submitted:
26 June 2023
Posted:
27 June 2023
You are already at the latest version
Abstract
Keywords:
1. Introduction
- ➢
- Hospital with a high volume of activities;
- ➢
- Reach the limits of capacity;
- ➢
- Heavily utilized and aged infrastructure.
2. A Review of the Literature
2.1. Cardiac care and its supply chain as the medical devices
2.2. Supply chain in healthcare and influencer factors
2.2.1. Innovation in medical device
2.2.2. Regulation and strategies towards cost reduction
2.2.3. Analyzing the value and comparative effectiveness of research
2.2.4. Preferences and clinician incentives
2.3. Post-Pandemic health services research and supply chain perspective
2.3.1. Risk assessment in supply chain
2.3.2. Identifying the risk of resource dependency
2.3.3. Integration of the supply chain
2.4. Approaches to examining access and justice in healthcare/Healthcare Disparities
2.4.1. First strategy: Philosophical reflection
2.4.2. Second strategy: Based on real world solution
2.4.3. Third strategy: Based on lay persons’ perceptions of justice
2.4.4. Fourth strategy: investigation into the application of justice theories to actual policymaking
3. Robust Optimisation Protocol for General Integer and Mlip
3.1. Bounded uncertainty
- (i)
- would it be possible for nominal problems,
- (ii)
- if we have true values (say ) of uncertain parameters from intervals (3), therefore, we should meet in-equality constraints with the error of Max , wherein would be explained as a certain level of in-feasibility.
3.2. Symmetric uncertainty
- (i)
- would it be possible for the nominal problems,
- (ii)
- for each event probability of a limited violation; that is,
4. Site Selection Model for Qeh
- ➢
- Develop a utilization matrix;
- ➢
- Specify constraints;
- ➢
- Apply a robust optimisation protocol approach to select the best site.
4.1. Utilization Matrix
4.2. Constraints
5. Robust Optimisation
5.1. Robust optimisation protocol to schedule under uncertainty
5.1.1. Instance 1. Uncertainties via a Poisson distribution during the processing time
5.1.2. Instance 2. Uncertainty via a smooth distribution in the demand of the goods
5.1.3. Instance 3. Uncertainty via normal distribution in the market price
5.2. Computational outputs and discussion
6. Conclusion
| 1 | location Allocation Problem |
| 2 | Vehicle Routing Problem |
| 3 | Location-Routing Problem |
| 4 | Queen Elizabeth Hospital |
| 5 | Supply chains |
| 6 | Supply Chain Management |
| 7 | American Hospital Association |
| 8 | Supply Chain Resilience |
| 9 | Strategic National Stockpiles |
| 10 | Just-In-Time |
| 11 | Wall Street Journal |
| 12 | Advanced Medical Technologies Association |
| 13 | Department of Commerce |
| 14 | GPOs |
| 15 | Coherent normative analysis |
| 16 | Normal distributions |
| 17 | Binomial dispersion |
| 18 | General discrete distribution |
| 19 | Integer linear programming |
| 20 | Robust Counterpart |
| 21 | For more information about protocol formulation, see our other paper at (Heydari, M. et al., 2021). |
| 22 | State-Task Network |
| 23 | Binary variables |
| 24 | Continuous variables |
| 25 | Making choices about which treatments are covered by insurance and which are not is referred to as prioritising, or, negatively, as rationing. All insurance systems require these judgments, but publicly supported government systems are the most challenging. Cost-effectiveness analysis (CEA), which aims to "produce" the greatest number of quality-adjusted life years with a given government budget, is the dominant technique for making these judgments. This conventional method prioritises effectiveness above justice. But this is the very reason why it poses challenging justice questions. Individual patients will have uneven access to healthcare if they can pay for non-reimbursed therapies out of pocket. The same holds true in a less severe scenario when patients are required to make significant copayments for treatments that are only partially covered. The problem presented by uncommon diseases is particular. The so-called orphan pharmaceuticals, or medications for rare diseases, are rarely covered by insurance, and without government funding, the research and development of these medications is typically not profitable. However, it is challenging to argue that people with rare genetic disorders shouldn't be treated just because they are few from an ethical standpoint. |
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| Units | Adaptability | Process period | Capacity |
|---|---|---|---|
| Heater | Heating | 1.0 | 100 |
| Reactor 1 | R 1, 2, 3 | 2.0, 2.0, 1.0 | 50 |
| Reactor 2 | Reactions 1, 2, 3 | 2.0, 2.0, 1.0 | 80 |
| Separator | Separation | 2.0 | 200 |
| States | Initial Amount | Price | Storage |
| Feed A | Unbounded | 0 | Unbounded |
| Feed B | Unbounded | 0 | Unbounded |
| Feed C | Unbounded | 0 | Unbounded |
| Hot A | 0 | 0 | 100 |
| IntAB | 0 | 0 | 200 |
| IntBC | 0 | 0 | 150 |
| ImpureE | 0 | 0 | 200 |
| Product 1 | 0 | 10.0 | Unbounded |
| Product 2 | 0 | 10.0 | Unbounded |
| RS | NS | |
|---|---|---|
| Benefit CPU time (s) BIN variables CON variables Constraints |
2887.19 | 3638.75 |
| 11.33 | 0.46 | |
| 96 | 96 | |
| 442 | 442 | |
| 777 | 553 |
| RS | NS | |
|---|---|---|
| Make-span CPU time (s) BIN variables23 CON variables24 Constraints |
8.174 | 8.007 |
| 0.02 | 0.02 | |
| 60 | 60 | |
| 280 | 280 | |
| 409 | 375 |
| RS | NS | |
|---|---|---|
| Benefit CPU time (s) BIN variables CON variables Constraints |
966.97 | 1088.75 |
| 0.05 | 0.02 | |
| 60 | 60 | |
| 280 | 280 | |
| 334 | 334 |
| Units | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mission | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| 1 | 0 | 0 | 0 | 9.5 | -- | -- | -- | -- | -- | -- |
| 2 | -- | -- | -- | -- | 0 | 0 | 0.95 | -- | -- | -- |
| 3 | -- | -- | -- | -- | -- | -- | -- | 12 | 12.8 | 12.5 |
| 4 | 0 | 10 | 10 | 10 | -- | -- | -- | -- | -- | -- |
| 5 | -- | -- | -- | -- | 0.575 | 0.575 | 0.725 | -- | -- | -- |
| 6 | -- | -- | -- | -- | -- | -- | -- | 12 | 12.8 | 12.5 |
| 7 | 6.09 | 6.09 | 6.09 | 11.1 | -- | -- | -- | -- | -- | -- |
| 8 | -- | -- | -- | -- | 0.6 | 0.6 | 0.8 | -- | -- | -- |
| 9 | -- | -- | -- | -- | -- | -- | -- | 12.5 | 13.8 | 12.9 |
| 10 | 6.09 | 6.09 | 6.09 | 11.1 | -- | -- | -- | -- | -- | -- |
| 11 | -- | -- | -- | -- | 0.6 | 0.6 | 0.8 | -- | -- | -- |
| 12 | -- | -- | -- | -- | -- | -- | -- | 12.5 | 13.8 | 12.9 |
| 13 | 6.09 | 6.09 | 6.09 | 11.1 | 0.6 | 0.6 | 0.8 | -- | -- | -- |
| 14 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
| 15 | -- | -- | -- | -- | -- | -- | -- | 12.5 | 13.8 | 12.9 |
| 16 | -- | -- | -- | -- | 0.6 | 0.6 | 0.8 | -- | -- | -- |
| 17 | -- | -- | -- | -- | -- | -- | -- | 12.5 | 13.8 | 12.9 |
| 18 | 0 | 8.5 | 8.5 | 0 | -- | -- | -- | -- | -- | -- |
| 19 | -- | -- | -- | -- | -- | -- | -- | 0 | 15 | 16 |
| 20 | 0 | 0 | 8.38 | 9.5 | -- | -- | -- | -- | -- | -- |
| Mission | Unit | NVs | Uncertainty | Rang | Mean | SD. |
|---|---|---|---|---|---|---|
| 1 | 4 | 9.5 | N | -- | 9.912 | 0.523 |
| 7,10,13 | 1-3 | 6.09 | N | -- | 6.153 | 0.152 |
| 7,10,13 | 4 | 11.1 | B | 10.1-11.3 | -- | -- |
| 20 | 3 | 8.38 | B | 8.00-10.42 | -- | -- |
| 2 | 7 | 0.95 | N | -- | 0.9611 | 0.112 |
| 8,11,14,16 | 5-6 | 0.60 | B | 0.344-0.853 | -- | -- |
| 3,6 | 9 | 12.8 | B | 10.5-19.3 | -- | -- |
| 9,12,15,17 | 9 | 13.8 | B | 12.0-16.3 | -- | -- |
| 9,12,15,17 | 10 | 12.9 | N | -- | 12.100 | 0.760 |
| RS | NS | |
|---|---|---|
| Obj BIN variables CON variables Constraints CPU time (s) Nodes |
105.76 | 121.37 |
| 930 | 930 | |
| 6161 | 6005 | |
| 22931 | 18907 | |
| 5910 | 3880 | |
| 35640 | 15230 |
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