Estimating and planning hospital costs of public hospitals in Brazil.

While the estimate of hospital costs concerns the past, its planning focuses on the future. However, in many low and middle-income countries, public hospitals do not have robust accounting health systems to evaluate and project their expenses. In Brazil, public hospitals are funded based on government estimates of available hospital infrastructure, historical expenditures and population needs. However, these pieces of information are not always readily available for all hospitals. To solve this challenge, we propose a flexible simulation-based optimisation algorithm that integrates this dual task: estimating and planning hospital costs. The method was applied to a network of 17 public hospitals in Brazil to produce the estimates. Setting the model parameters for population needs and future hospital infrastructure can be used as a cost-projection tool for divestment, maintenance, or investment. Results show that the method can aid health managers in hospitals' global budgeting and policymakers in improving fairness in hospitals' financing.

Estimating Brazilian states demands for intensive care unit and clinical hospital beds during the COVID-19 pandemic: development of a predictive model

ABSTRACT BACKGROUND: The fragility of healthcare systems worldwide had not been exposed by any pandemic until now. The lack of integrated methods for bed capacity planning compromises the effectiveness of public and private hospitals' services. OBJECTIVES: To estimate the impact of the COVID-19 pandemic on the provision of intensive care unit and clinical beds for Brazilian states, using an integrated model. DESIGN AND SETTING: Experimental study applying healthcare informatics to data on COVID-19 cases from the official electronic platform of the Brazilian Ministry of Health. METHODS: A predictive model based on the historical records of Brazilian states was developed to estimate the need for hospital beds during the COVID-19 pandemic. RESULTS: The proposed model projected in advance that there was a lack of 22,771 hospital beds for Brazilian states, of which 38.95% were ICU beds, and 61.05% were clinical beds. CONCLUSIONS: The proposed approach provides valuable information to help hospital managers anticipate actions for improving healthcare system capacity.

Estimating Brazilian states' demands for intensive care unit and clinical hospital beds during the COVID-19 pandemic: development of a predictive model.

BACKGROUND: The fragility of healthcare systems worldwide had not been exposed by any pandemic until now. The lack of integrated methods for bed capacity planning compromises the effectiveness of public and private hospitals' services. OBJECTIVES: To estimate the impact of the COVID-19 pandemic on the provision of intensive care unit and clinical beds for Brazilian states, using an integrated model. DESIGN AND SETTING: Experimental study applying healthcare informatics to data on COVID-19 cases from the official electronic platform of the Brazilian Ministry of Health. METHODS: A predictive model based on the historical records of Brazilian states was developed to estimate the need for hospital beds during the COVID-19 pandemic. RESULTS: The proposed model projected in advance that there was a lack of 22,771 hospital beds for Brazilian states, of which 38.95% were ICU beds, and 61.05% were clinical beds. CONCLUSIONS: The proposed approach provides valuable information to help hospital managers anticipate actions for improving healthcare system capacity.

Flexibility evaluation of multiechelon supply chains.

Multiechelon supply chains are complex logistics systems that require flexibility and coordination at a tactical level to cope with environmental uncertainties in an efficient and effective manner. To cope with these challenges, mathematical programming models are developed to evaluate supply chain flexibility. However, under uncertainty, supply chain models become complex and the scope of flexibility analysis is generally reduced. This paper presents a unified approach that can evaluate the flexibility of a four-echelon supply chain via a robust stochastic programming model. The model simultaneously considers the plans of multiple business divisions such as marketing, logistics, manufacturing, and procurement, whose goals are often conflicting. A numerical example with deterministic parameters is presented to introduce the analysis, and then, the model stochastic parameters are considered to evaluate flexibility. The results of the analysis on supply, manufacturing, and distribution flexibility are presented. Tradeoff analysis of demand variability and service levels is also carried out. The proposed approach facilitates the adoption of different management styles, thus improving supply chain resilience. The model can be extended to contexts pertaining to supply chain disruptions; for example, the model can be used to explore operation strategies when subtle events disrupt supply, manufacturing, or distribution.