Scheduling surgeries is a challenging task due to the fundamental uncertainty of the clinical environment, as well as the risks and costs associated with under- and over-booking. We investigate neural regression algorithms to estimate the parameters of surgery case durations, focusing on the issue of heteroscedasticity. We seek to simultaneously estimate the duration of each surgery, as well as a surgery-specific notion of our uncertainty about its duration. Estimating this uncertainty can lead to more nuanced and effective scheduling strategies, as we are able to schedule surgeries more efficiently while allowing an informed and case-specific margin of error. Using surgery records %from the UC San Diego Health System, from a large United States health system we demonstrate potential improvements on the order of 20% (in terms of minutes overbooked) compared to current scheduling techniques. Moreover, we demonstrate that surgery durations are indeed heteroscedastic. We show that models that estimate case-specific uncertainty better fit the data (log likelihood). Additionally, we show that the heteroscedastic predictions can more optimally trade off between over and under-booking minutes, especially when idle minutes and scheduling collisions confer disparate costs.
翻译:由于临床环境的基本不确定性,以及订票不足和超时的风险和成本,手术的切换是一项艰巨的任务。我们调查神经回归算法,以估计外科病例持续时间参数,重点是血压问题。我们试图同时估计每次外科手术的持续时间,以及我们对其持续时间的不确定性的外科特定概念。估计这种不确定性可能导致更加细微和有效的时间安排战略,因为我们能够更有效地安排外科手术,同时允许出现知情和具体案例的误差幅度。我们使用美国大型保健系统的外科记录来估计外科手术病例持续时间的参数,我们展示了与当前时间安排技术相比20%左右(超时数分钟)的潜在改进。此外,我们证明外科手术的持续时间确实具有超时性。我们展示了对具体案例不确定性进行估计的模型更适合数据(可能性 ) 。 此外,我们显示,从美国圣地亚哥联合医院卫生系统的外科预测中可以更优化地交换超时程和低位记录之间的交易,特别是当头和低位时。