Expanding resources of endovascular thrombectomy: An optimization model.
Background/purpose: Recently optimized models for selecting the locations of hospitals capable of providing endovascular thrombectomy (EVT) did not consider the accuracy of the prehospital stroke scale assessment and possibility of secondary transport. Our study aimed to propose a new model for sele...
| Publicado en: | Journal of the Formosan Medical Association Vol. 121; no. 5; pp. 978 - 986 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
May2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156470231&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156470231 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09296646 3O8P jtl: Journal of the Formosan Medical Association issn: 09296646 maglogo: N pubinfo: dt: May2022 vid: 121 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 156470231 156470231 NLM34353719 156470231 10.1016/j.jfma.2021.07.015 NLM34353719 156470231 ppf: 978 ppct: 8 formats: tig: atl: Expanding resources of endovascular thrombectomy: An optimization model. aug: au: Wang, Chun-Han Liu, Ting-Yu Chiang, Wen-Chu Tang, Sung-Chun Tsai, Li-Kai Lee, Chung-Wei Lin, Yen-Heng Jeng, Jiann-Shing Ma, Matthew Huei-Ming Hsieh, Ming-Ju Lee, Yu-Ching affil: Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan sug: subj: Stroke Surgery Cerebral Ischemia Therapy Thrombectomy Hospitals Treatment Outcomes Patient Care ab: Background/purpose: Recently optimized models for selecting the locations of hospitals capable of providing endovascular thrombectomy (EVT) did not consider the accuracy of the prehospital stroke scale assessment and possibility of secondary transport. Our study aimed to propose a new model for selecting existing hospitals with intravenous thrombolysis capability to become EVT-capable hospitals.Methods: A sequential order was provided to upgrade hospitals providing intravenous thrombolysis, using a mixed integer programming model based on current medical resource allocation. In addition, we drafted a centralized plan to redistribute existing EVT resources by redetermining locations of EVT-capable hospitals. Using historical data of 7679 on-scene patients with suspected stroke, the model was implemented to determine the hospital that maximizes the number of patients receiving EVT treatment within call-to-definitive-treatment time.Results: All suspected stroke patients were sent to EVT-capable hospitals directly under the current medical resource allocation model. After upgrading one additional hospital to become an EVT-capable hospital, the percentage of patients receiving definitive treatment within the standard call-to-definitive-treatment time was elevated from 68.82% to 72.97%. In the model, assuming that there is no hospital providing EVT, all patients suspected of stroke will be sent to EVT-capable hospitals directly after upgrading three or more hospitals to be able to provide treatment.Conclusion: All patients eligible for acute stroke treatment are sent to EVT-capable hospitals in the simulation under the current medical resource allocation model. This model can be utilized to provide insights for capacity redistribution in other regions. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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