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Optimization of the stroke hospital selection strategy and the distribution of endovascular thrombectomy resources

Author

Listed:
  • Chun-Han Wang

    (National Cheng Kung University
    National Tsing Hua University)

  • Yu-Ching Lee

    (National Tsing Hua University)

  • Ming-Ju Hsieh

    (National Taiwan University Hospital)

Abstract

Nowadays, emergency medical technicians (EMTs) decide to send a suspected stroke patient to a primary stroke center (PSC) or to an endovascular thrombectomy (EVT)-capable hospital, based on the Cincinnati Prehospital Stroke Scale (CPSS) and the number of symptoms a patient presents at the scene. Based on existing studies, the patient is likely to have a better functional outcome after three months if the time between the onset of symptoms and receiving EVT treatment is shorter. However, if an acute ischemic stroke (AIS) patient with large vessel occlusion (LVO) is first sent to a PSC, and then needs to be transferred to an EVT-capable hospital, the time to get definitive treatment is significantly increased. For this purpose, We formulate an integer programming model to minimize the expected time to receive a definitive treatment for stroke patients. We then use real-world data to verify the validity of the model. Also, we expand our model to find the optimal redistribution and centralization of EVT resources. It will enable therapeutic teams to increase their experience and skills more efficiently within a short period of time.

Suggested Citation

  • Chun-Han Wang & Yu-Ching Lee & Ming-Ju Hsieh, 2024. "Optimization of the stroke hospital selection strategy and the distribution of endovascular thrombectomy resources," Health Care Management Science, Springer, vol. 27(2), pages 254-267, June.
    • Handle: RePEc:kap:hcarem:v:27:y:2024:i:2:d:10.1007_s10729-023-09663-2
    DOI: 10.1007/s10729-023-09663-2
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    References listed on IDEAS

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    1. Evrim Didem Güneş & Stefan Nickel, 2015. "Location Problems in Healthcare," Springer Books, in: Gilbert Laporte & Stefan Nickel & Francisco Saldanha da Gama (ed.), Location Science, edition 127, chapter 0, pages 555-579, Springer.
    2. B. L. Garcia & R. Bekker & R. D. Mei & N. H. Chavannes & N. D. Kruyt, 2021. "Optimal patient protocols in regional acute stroke care," Health Care Management Science, Springer, vol. 24(3), pages 515-530, September.
    3. E D Güneş & H Yaman, 2010. "Health network mergers and hospital re-planning," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 275-283, February.
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