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Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors
A two-tiered ambulance system, consisting of advanced and basic life support for emergency and nonemergency patient care, respectively, can provide a cost-efficient emergency medical service. However, such a system requires accurate classification of patient severity to avoid complications. Thus, th...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925822/ https://www.ncbi.nlm.nih.gov/pubmed/31885833 http://dx.doi.org/10.1155/2019/6031789 |
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author | Park, Seong Hyeon Lee, Young Hoon |
author_facet | Park, Seong Hyeon Lee, Young Hoon |
author_sort | Park, Seong Hyeon |
collection | PubMed |
description | A two-tiered ambulance system, consisting of advanced and basic life support for emergency and nonemergency patient care, respectively, can provide a cost-efficient emergency medical service. However, such a system requires accurate classification of patient severity to avoid complications. Thus, this study considers a two-tiered ambulance dispatch and redeployment problem in which the average patient severity classification errors are known. This study builds on previous research into the ambulance dispatch and redeployment problem by additionally considering multiple types of patients and ambulances, and patient classification errors. We formulate this dynamic decision-making problem as a semi-Markov decision process and propose a mini-batch monotone-approximate dynamic programming (ADP) algorithm to solve the problem within a reasonable computation time. Computational experiments using realistic system dynamics based on historical data from Seoul reveal that the proposed approach and algorithm reduce the risk level index (RLI) for all patients by an average of 11.2% compared to the greedy policy. In this numerical study, we identify the influence of certain system parameters such as the percentage of advanced-life support units among all ambulances and patient classification errors. A key finding is that an increase in undertriage rates has a greater negative effect on patient RLI than an increase in overtriage rates. The proposed algorithm delivers an efficient two-tiered ambulance management strategy. Furthermore, our findings could provide useful guidelines for practitioners, enabling them to classify patient severity in order to minimize undertriage rates. |
format | Online Article Text |
id | pubmed-6925822 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-69258222019-12-29 Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors Park, Seong Hyeon Lee, Young Hoon J Healthc Eng Research Article A two-tiered ambulance system, consisting of advanced and basic life support for emergency and nonemergency patient care, respectively, can provide a cost-efficient emergency medical service. However, such a system requires accurate classification of patient severity to avoid complications. Thus, this study considers a two-tiered ambulance dispatch and redeployment problem in which the average patient severity classification errors are known. This study builds on previous research into the ambulance dispatch and redeployment problem by additionally considering multiple types of patients and ambulances, and patient classification errors. We formulate this dynamic decision-making problem as a semi-Markov decision process and propose a mini-batch monotone-approximate dynamic programming (ADP) algorithm to solve the problem within a reasonable computation time. Computational experiments using realistic system dynamics based on historical data from Seoul reveal that the proposed approach and algorithm reduce the risk level index (RLI) for all patients by an average of 11.2% compared to the greedy policy. In this numerical study, we identify the influence of certain system parameters such as the percentage of advanced-life support units among all ambulances and patient classification errors. A key finding is that an increase in undertriage rates has a greater negative effect on patient RLI than an increase in overtriage rates. The proposed algorithm delivers an efficient two-tiered ambulance management strategy. Furthermore, our findings could provide useful guidelines for practitioners, enabling them to classify patient severity in order to minimize undertriage rates. Hindawi 2019-12-09 /pmc/articles/PMC6925822/ /pubmed/31885833 http://dx.doi.org/10.1155/2019/6031789 Text en Copyright © 2019 Seong Hyeon Park and Young Hoon Lee. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Park, Seong Hyeon Lee, Young Hoon Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title | Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title_full | Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title_fullStr | Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title_full_unstemmed | Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title_short | Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors |
title_sort | two-tiered ambulance dispatch and redeployment considering patient severity classification errors |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925822/ https://www.ncbi.nlm.nih.gov/pubmed/31885833 http://dx.doi.org/10.1155/2019/6031789 |
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