title: Decision Support for the Capacity Management of Bronchoscopy Devices: Optimizing the Cost-Efficient Mix of Reusable and Single-Use Devices Through Mathematical Modeling.
abstract: Increasing costs of material resources challenge hospitals to stay profitable. Particularly in anesthesia departments and intensive care units, bronchoscopes are used for various indications. Inefficient management of single- and multiple-use systems can influence the hospitals' material costs substantially. Using mathematical modeling, we developed a strategic decision support tool to determine the optimum mix of disposable and reusable bronchoscopy devices in the setting of an intensive care unit.
  
  
  
  A mathematical model with the objective to minimize costs in relation to demand constraints for bronchoscopy devices was formulated. The stochastic model decides whether single-use, multi-use, or a strategically chosen mix of both device types should be used. A decision support tool was developed in which parameters for uncertain demand such as mean, standard deviation, and a reliability parameter can be inserted. Furthermore, reprocessing costs per procedure, procurement, and maintenance costs for devices can be parameterized.
  
  
  
  Our experiments show for which demand pattern and reliability measure, it is efficient to only use reusable or disposable devices and under which circumstances the combination of both device types is beneficial.
  
  
  
  To determine the optimum mix of single-use and reusable bronchoscopy devices effectively and efficiently, managers can enter their hospital-specific parameters such as demand and prices into the decision support tool.The software can be downloaded at: https://github.com/drdanielgartner/bronchomix/.
authors.affiliation: From the *Klinikum rechts der Isar, Technische Universität München, Klinik für Anaesthesiologie, München, Germany; †School of Mathematics, Cardiff University, United Kingdom; and ‡Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, München, Germany.
authors.forename: Günther M
authors.initials: GM
authors.lastname: Edenharter
authors.forename: Daniel
authors.initials: D
authors.lastname: Gartner
authors.forename: Dominik
authors.initials: D
authors.lastname: Pförringer
mesh_terms: D020680:Bronchoscopes / Q000191:economics*; D001999:Bronchoscopy / Q000191:economics* / Q000295:instrumentation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D004209:Disposable Equipment / Q000191:economics*; D017743:Equipment Reuse / Q000191:economics*; D006301:Health Services Needs and Demand / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics; D018803:Models, Economic; D020380:Needs Assessment / Q000191:economics; D013269:Stochastic Processes