On Classification of Healthcare Problems in ORMS Studies

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Hi everyone, after a long time I would like to write about the classification of the healthcare problems that I have been thinking for a while. Personally, I am interested in application based OR studies especially in healthcare. Since healthcare problems have been considered one of the research area in OR/MS for a long time (a survey in healthcare studies for OR/MS was published in 1978 [3]), the healthcare problems are needed to be classified for OR/MS researchers to see the nature of the problems easily.

I read 3 literature reviews related the classification of healthcare problems in OR/MS as [1], [2], [4]. Actually, all these three are comprehensive thus help us to see the problems precisely and learn new problem types. Especially, in my opinion [1] is very beneficial for healthcare researchers, because it gives the general idea about the nature of healthcare problems and what kind of research conducted so far in a smooth way. In this paper, they categorize the problems as follows:

  • Ambulatory care services
  • Emergency care services
  • Surgical care services
  • Inpatient care services
  • Home care services
  • Residential care services

and all these classes are analyzed in strategic, tactical and operational (offline and online) decision making objectives.

However, when I try to generalize the classification of healthcare problems in my mind, different way of doing it confused me. I studied an organ transplantation system in my MS thesis and I tried to categorize this problem using their classification. At [1] they do not consider organ transplantation problems in any classification and in their subsections. At [4], they consider organ transplantation problems under specialized and preventive healthcare. At [2], the paper’s objective is to classify the healthcare problems that uses the analytic hierarchy process and they consider organ transplantation as a main class of problems in healthcare.

My question is, can we make standardized classification as in animal or plants classification? In [5], the animals are classified as follows:

  • Kingdom – There are two basic kingdoms, the plant and animal kingdoms. There is a third with animals that bridge the plant and animal kingdom.
  • Phylum – Within the plant and animal kingdoms are big groupings called phylum or phyla. Animals are grouped into phyla that have broad similar characteristics.
  • Classes – These are a finer division of a phyla.
  • Orders – These are divisions of classes.
  • Families – These are divisions of
  • Genera – These are the divisions of families.
  • Species – These are the divisions of genera

So, can we adapt similar approach to our classifications? There are some challenges when it comes to categorize healthcare problems systematically. Consider study [1]; they have a subsection as “regional coverage” under each main section. Nature of these covering problems are all same, because we need the cover a region under some constraints. It can be hospital, ambulance, emergency departments, operating rooms, home care systems etc. but the main principles of these problems are same. So, instead of putting “regional coverage” as a subsection under all problem classes, perhaps we can consider it as a main section. This type of classification has some drawbacks too, but it could help researchers to see new application areas similar to their studies. So, we need experience and insight to make a better classification.

Do you know that kind of standardized classifications in OR/MS studies?

By the way, I think the idea of classification can be applied to other research areas of OR/MS as well. But it’s another day’s topic.

References

[1] Hulshof, P.J.H, Kortbeek, N., Boucherie, R.J., Hans, E. W., Bakker, P. J.M. (2012). Taxonomic classification of planning decisions in health care: a structured review of the state of the art in OR/MS. Health Systems 1, 129-175

[2] Liberatore, M. J. and Nydick, R. L., 2008. They Analytic hierarchy process in medical and health care decision making: A literature review. European Journal of Operational Research 189, 194-207

[3] Papageorgiou, J.C., 1978. Some operations research applications to problems of health care systems (a survey). International Journal Biomedical Computation 9, 2, 101- 14

[4] Rais, A. and Viana, A., 2011. Operations research in healthcare: a survey. International Transactions in Operational Research 18(1), 1-31

[5] http://www.mcwdn.org/Animals/Classification.html

Pelin Cay

PhD student at Lehigh University, ISE department. Interested in optimization and healthcare system integration.