مدیریت خدمات بهداشتی: یک رویکرد سیستمی مبتنی بر داده ۲۰۱۹
Healthcare Service Management: A Data-Driven Systems Approach 2019

Healthcare service systems are of profound importance in promoting the public health and wellness of people. This book introduces a data-driven complex systems modeling approach (D2CSM) to systematically understand and improve the essence of healthcare service systems. In particular, this data-driven approach provides new perspectives on health service performance by unveiling the causes for service disparity, such as spatio-temporal variations in wait times across different hospitals.

The approach integrates four methods -- Structural Equation Modeling (SEM)-based analysis; integrated projection; service management strategy design and evaluation; and behavior-based autonomy-oriented modeling -- to address respective challenges encountered in performing data analytics and modeling studies on healthcare services. The thrust and uniqueness of this approach lies in the following aspects:

• Ability to explore underlying complex relationships between observed or latent impact factors and service performance.
• Ability to predict the changes and demonstrate the corresponding dynamics of service utilization and service performance.
• Ability to strategically manage service resources with the adaptation of unpredictable patient arrivals.
• Ability to figure out the working mechanisms that account for certain spatio-temporal patterns of service utilization and performance.

To show the practical effectiveness of the proposed systematic approach, this book provides a series of pilot studies within the context of cardiac care in Ontario, Canada. The exemplified studies have unveiled some novel findings, e.g., (1) service accessibility and education may relieve the pressure of population size on service utilization; (2) functionally coupled units may have a certain cross-unit wait-time relationship potentially because of a delay cascade phenomena; (3) strategically allocating time blocks in operating rooms (ORs) based on a feedback mechanism may benefit OR utilization; (4) patients’ and hospitals’ autonomous behavior, and their interactions via wait times may bear the responsible for the emergence of spatio-temporal patterns observed in the real-world cardiac care system. Furthermore, this book presents an intelligent healthcare decision support (iHDS) system, an integrated architecture for implementing the data-driven complex systems modeling approach to developing, analyzing, investigating, supporting and advising healthcare related decisions.

In summary, this book provides a data-driven systematic approach for addressing practical decision-support problems confronted in healthcare service management. This approach will provide policy makers, researchers, and practitioners with a practically useful way for examining service utilization and service performance in various ``what-if" scenarios, inspiring the design of effectiveness resource-allocation strategies, and deepening the understanding of the nature of complex healthcare service systems.