IDEAS home Printed from https://ideas.repec.org/a/gam/jmathe/v11y2023i3p659-d1049166.html
   My bibliography  Save this article

Collaborative Decision Model for Allocating Intensive Care Units Beds with Scarce Resources in Health Systems: A Portfolio Based Approach under Expected Utility Theory and Bayesian Decision Analysis

Author

Listed:
  • Eduarda Asfora Frej

    (CDSID—Center for Decision Systems and Information Development, Universidade Federal de Pernambuco, UFPE, Avenida Acadêmico Hélio Ramos, s/n—Cidade Universitária, Recife CEP 50740-530, PE, Brazil)

  • Lucia Reis Peixoto Roselli

    (CDSID—Center for Decision Systems and Information Development, Universidade Federal de Pernambuco, UFPE, Avenida Acadêmico Hélio Ramos, s/n—Cidade Universitária, Recife CEP 50740-530, PE, Brazil)

  • Alexandre Ramalho Alberti

    (CDSID—Center for Decision Systems and Information Development, Universidade Federal de Pernambuco, UFPE, Avenida Acadêmico Hélio Ramos, s/n—Cidade Universitária, Recife CEP 50740-530, PE, Brazil)

  • Murilo Amorim Britto

    (IMIP—Instituto de Medicina Integral Professor Fernando Figueira, R. dos Coelhos, 300—Boa Vista, Recife CEP 50070-550, PE, Brazil)

  • Evônio de Barros Campelo Júnior

    (Hospital das Clínicas, Universidade Federal de Pernambuco, Avenida Prof. Moraes Rego, 1235—Cidade Universitária, Recife CEP 50670-901, PE, Brazil)

  • Rodrigo José Pires Ferreira

    (CDSID—Center for Decision Systems and Information Development, Universidade Federal de Pernambuco, UFPE, Avenida Acadêmico Hélio Ramos, s/n—Cidade Universitária, Recife CEP 50740-530, PE, Brazil)

  • Adiel Teixeira de Almeida

    (CDSID—Center for Decision Systems and Information Development, Universidade Federal de Pernambuco, UFPE, Avenida Acadêmico Hélio Ramos, s/n—Cidade Universitária, Recife CEP 50740-530, PE, Brazil)

Abstract

The COVID-19 pandemic has brought health systems to the brink of collapse in several regions around the world, as the demand for health care has outstripped the capacity of their services, especially regarding intensive care. In this context, health system managers have faced a difficult question: who should be admitted to an intensive care unit (ICU), and who should not? This paper addresses this decision problem using Expected Utility Theory and Bayesian decision analysis. In order to estimate the chances of survival for patients, a structured protocol has been proposed conjointly with physicians, based on the Sequential Organ Failure Assessment (SOFA) score. A portfolio selection approach is proposed to support tackling the ICU allocation problem. A simulation study shows that the proposed approach is more advantageous than other approaches already presented in the literature, with respect to the number of lives saved. The patients’ probabilities of survival inside and outside the ICU are important parameters of the model. However, assessing such probabilities can be a difficult task for health professionals. In order to give due treatment to the imprecise information regarding these probabilities, a Monte Carlo simulation is used to estimate the probabilities of recommending a patient be admitted to the ICU is the most appropriate decision, given the conditions presented. The methodology was implemented in an Information and Decision System called SIDTriagem, which is available online for free. With regards to managerial implications, SIDTriagem has a great potential to help in the response to public health emergencies systems as it facilitates rational decision-making regarding allocating ICU beds when resources are scarce.

Suggested Citation

  • Eduarda Asfora Frej & Lucia Reis Peixoto Roselli & Alexandre Ramalho Alberti & Murilo Amorim Britto & Evônio de Barros Campelo Júnior & Rodrigo José Pires Ferreira & Adiel Teixeira de Almeida, 2023. "Collaborative Decision Model for Allocating Intensive Care Units Beds with Scarce Resources in Health Systems: A Portfolio Based Approach under Expected Utility Theory and Bayesian Decision Analysis," Mathematics, MDPI, vol. 11(3), pages 1-15, January.
    • Handle: RePEc:gam:jmathe:v:11:y:2023:i:3:p:659-:d:1049166
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7390/11/3/659/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/2227-7390/11/3/659/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Robert T. Clemen & James E. Smith, 2009. "On the Choice of Baselines in Multiattribute Portfolio Analysis: A Cautionary Note," Decision Analysis, INFORMS, vol. 6(4), pages 256-262, December.
    2. Selain K. Kasereka & Glody N. Zohinga & Vogel M. Kiketa & Ruffin-Benoît M. Ngoie & Eddy K. Mputu & Nathanaël M. Kasoro & Kyamakya Kyandoghere, 2023. "Equation-Based Modeling vs. Agent-Based Modeling with Applications to the Spread of COVID-19 Outbreak," Mathematics, MDPI, vol. 11(1), pages 1-21, January.
    3. Hui Cao & Simin Huang, 2012. "Principles of Scarce Medical Resource Allocation in Natural Disaster Relief," Medical Decision Making, , vol. 32(3), pages 470-476, May.
    4. Lawrence Phillips & Carlos Bana e Costa, 2007. "Transparent prioritisation, budgeting and resource allocation with multi-criteria decision analysis and decision conferencing," Annals of Operations Research, Springer, vol. 154(1), pages 51-68, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marttunen, Mika & Haara, Arto & Hjerppe, Turo & Kurttila, Mikko & Liesiö, Juuso & Mustajoki, Jyri & Saarikoski, Heli & Tolvanen, Anne, 2023. "Parallel and comparative use of three multicriteria decision support methods in an environmental portfolio problem," European Journal of Operational Research, Elsevier, vol. 307(2), pages 842-859.
    2. Liesiö, Juuso & Kee, Taeyoung & Malo, Pekka, 2024. "Modeling project interactions in multiattribute portfolio decision analysis: Axiomatic foundations and practical implications," European Journal of Operational Research, Elsevier, vol. 316(3), pages 988-1000.
    3. Liesiö, Juuso & Salo, Ahti & Keisler, Jeffrey M. & Morton, Alec, 2021. "Portfolio decision analysis: Recent developments and future prospects," European Journal of Operational Research, Elsevier, vol. 293(3), pages 811-825.
    4. Juuso Liesiö, 2014. "Measurable Multiattribute Value Functions for Portfolio Decision Analysis," Decision Analysis, INFORMS, vol. 11(1), pages 1-20, March.
    5. Liesiö, Juuso & Punkka, Antti, 2014. "Baseline value specification and sensitivity analysis in multiattribute project portfolio selection," European Journal of Operational Research, Elsevier, vol. 237(3), pages 946-956.
    6. Morton, Alec, 2015. "Measurement issues in the evaluation of projects in a project portfolio," European Journal of Operational Research, Elsevier, vol. 245(3), pages 789-796.
    7. Barbara Bini & Milena Vainieri & Sabina Nuti, 2015. "Definizione delle priorit? di intervento in sanit?: approcci socio-tecnici a confronto," MECOSAN, FrancoAngeli Editore, vol. 2015(93), pages 49-73.
    8. L. Robin Keller & Ali Abbas & Manel Baucells & Vicki M. Bier & David Budescu & John C. Butler & Philippe Delquié & Jason R. W. Merrick & Ahti Salo & George Wu, 2010. "From the Editors..," Decision Analysis, INFORMS, vol. 7(4), pages 327-330, December.
      • L. Robin Keller & Manel Baucells & Kevin F. McCardle & Gregory S. Parnell & Ahti Salo, 2007. "From the Editors..," Decision Analysis, INFORMS, vol. 4(4), pages 173-175, December.
      • L. Robin Keller & Manel Baucells & John C. Butler & Philippe Delquié & Jason R. W. Merrick & Gregory S. Parnell & Ahti Salo, 2008. "From the Editors..," Decision Analysis, INFORMS, vol. 5(4), pages 173-176, December.
      • L. Robin Keller & Manel Baucells & John C. Butler & Philippe Delquié & Jason R. W. Merrick & Gregory S. Parnell & Ahti Salo, 2009. "From the Editors ..," Decision Analysis, INFORMS, vol. 6(4), pages 199-201, December.
    9. Gomes, Luís S. & Santos, Sérgio P. & Coelho, Luís Serra & Rebelo, Efigénio L., 2023. "Using MCDA to assist an Intermunicipal community develop a resilience strategy in face of the pandemic caused by the SARS-CoV-2," Socio-Economic Planning Sciences, Elsevier, vol. 87(PB).
    10. Xiang Chu & QiuYan Zhong, 2015. "Post-earthquake allocation approach of medical rescue teams," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 79(3), pages 1809-1824, December.
    11. William B. Haskell & Wenjie Huang & Huifu Xu, 2018. "Preference Elicitation and Robust Optimization with Multi-Attribute Quasi-Concave Choice Functions," Papers 1805.06632, arXiv.org.
    12. Kurth, Margaret & Keisler, Jeffrey M. & Bates, Matthew E. & Bridges, Todd S. & Summers, Jeffrey & Linkov, Igor, 2017. "A portfolio decision analysis approach to support energy research and development resource allocation," Energy Policy, Elsevier, vol. 105(C), pages 128-135.
    13. Mingers, John, 2011. "Soft OR comes of age--but not everywhere!," Omega, Elsevier, vol. 39(6), pages 729-741, December.
    14. Barbati, M. & Figueira, J.R. & Greco, S. & Ishizaka, A. & Panaro, S., 2023. "A multiple criteria methodology for priority based portfolio selection," Socio-Economic Planning Sciences, Elsevier, vol. 88(C).
    15. Aris Angelis & Mark Thursz & Vlad Ratziu & Alastair O’Brien & Lawrence Serfaty & Ali Canbay & Ingolf Schiefke & Joao Bana e Costa & Pascal Lecomte & Panos Kanavos, 2020. "Early Health Technology Assessment during Nonalcoholic Steatohepatitis Drug Development: A Two-Round, Cross-Country, Multicriteria Decision Analysis," Medical Decision Making, , vol. 40(6), pages 830-845, August.
    16. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.
    17. Schilling, Martin S. & Mulford, Matthew, 2007. "In search of value-for-money in collective bargaining: an analytic-interactive mediation process," LSE Research Online Documents on Economics 22694, London School of Economics and Political Science, LSE Library.
    18. Sanjay Mehrotra & Hamed Rahimian & Masoud Barah & Fengqiao Luo & Karolina Schantz, 2020. "A model of supply‐chain decisions for resource sharing with an application to ventilator allocation to combat COVID‐19," Naval Research Logistics (NRL), John Wiley & Sons, vol. 67(5), pages 303-320, August.
    19. Meinard, Y. & Tsoukiàs, A., 2019. "On the rationality of decision aiding processes," European Journal of Operational Research, Elsevier, vol. 273(3), pages 1074-1084.
    20. Ramiro Sanchez-Lopez & Carlos Bana e Costa & Bernard Baets, 2012. "The MACBETH approach for multi-criteria evaluation of development projects on cross-cutting issues," Annals of Operations Research, Springer, vol. 199(1), pages 393-408, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jmathe:v:11:y:2023:i:3:p:659-:d:1049166. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.