title: Constrained Optimization Methods in Health Services Research-An Introduction: Report 1 of the ISPOR Optimization Methods Emerging Good Practices Task Force.
abstract: Providing health services with the greatest possible value to patients and society given the constraints imposed by patient characteristics, health care system characteristics, budgets, and so forth relies heavily on the design of structures and processes. Such problems are complex and require a rigorous and systematic approach to identify the best solution. Constrained optimization is a set of methods designed to identify efficiently and systematically the best solution (the optimal solution) to a problem characterized by a number of potential solutions in the presence of identified constraints. This report identifies 1) key concepts and the main steps in building an optimization model; 2) the types of problems for which optimal solutions can be determined in real-world health applications; and 3) the appropriate optimization methods for these problems. We first present a simple graphical model based on the treatment of "regular" and "severe" patients, which maximizes the overall health benefit subject to time and budget constraints. We then relate it back to how optimization is relevant in health services research for addressing present day challenges. We also explain how these mathematical optimization methods relate to simulation methods, to standard health economic analysis techniques, and to the emergent fields of analytics and machine learning.
authors.affiliation: OptumLabs, Boston, MA, USA. Electronic address: William.Crown@optum.com.
authors.forename: William
authors.initials: W
authors.lastname: Crown
authors.affiliation: Scientific Researcher, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Nasuh
authors.initials: N
authors.lastname: Buyukkaramikli
authors.affiliation: Research Fellow, University of Sheffield, Sheffield, UK.
authors.forename: Praveen
authors.initials: P
authors.lastname: Thokala
authors.affiliation: Professor of Management Science, Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, Scotland, UK.
authors.forename: Alec
authors.initials: A
authors.lastname: Morton
authors.affiliation: Assistant Professor, Health Care Policy & Research, Information and Decision Engineering, Mayo Clinic Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
authors.forename: Mustafa Y
authors.initials: MY
authors.lastname: Sir
authors.affiliation: Canada Research Chair, Health Services & Systems Research; Arthur J.E. Child Chair in Rheumatology Research; Director, HTA, Alberta Bone & Joint Health Institute; Associate Professor, Department Community Health Sciences, Faculty of Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Marshall
authors.affiliation: Senior Health Economist, DRG Abacus, Manchester, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Tosh
authors.affiliation: Assistant Professor, Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Padula
authors.affiliation: Professor of Clinical Epidemiology & Health Technology Assessment (HTA); Head, Department of Health Technology & Services Research, University of Twente, Enschede, The Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
authors.affiliation: Vice President and Chief Performance Improvement Officer, Illinois Divisions and HSHS Medical Group, Hospital Sisters Health System (HSHS), Belleville, IL. USA.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Wong
authors.affiliation: Associate Professor - Healthcare Policy & Research, Lead, Information and Decision Engineering, Mayo Clinic Kern Center for the Science of Health Care Delivery, Rochester, MN, USA. Electronic address: Pasupathy.Kalyan@mayo.edu.
authors.forename: Kalyan S
authors.initials: KS
authors.lastname: Pasupathy
mesh_terms: D026683:Advisory Committees; D002017:Budgets; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D004470:Economics, Medical; D006302:Health Services Research; D006801:Humans; D017059:Models, Econometric; D040841:Resource Allocation / Q000191:economics* / Q000379:methods; D012720:Severity of Illness Index
keywords: care delivery; decision making; modeling; policy