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STOR Colloquium: Mor Armony, NYU
May 3 @ 3:30 pm - 4:30 pm
Hospitalization versus Home Care: Balancing Mortality and Infection Risks for Hematology Patients
Previous research has shown that early discharge of patients may hurt their medical outcomes. However, in many cases, the “optimal” length of stay (LOS) and the best location for treatment of the patient are not obvious. A case in point is hematology patients, for whom this is a critical decision. These patients are hospitalized on a regular basis for chemotherapy treatments and it is debated whether following these treatments the patients should stay at the hospital for an observation period or be sent home instead. Patients with hematological malignancies are susceptible to life-threatening infections after chemotherapy. Hence, LOS optimization for hematology patients must balance the risks of patient infection and mortality. The former is reduced by minimizing hospital stay, while the latter is reduced by maximizing hospital stay, whereby infections can be identified and treated earlier. We develop a Markov decision process formulation to explore the impact of the infection and mortality risks on the optimal LOS from a single-patient perspective. We further consider the social optimization problem in which capacity constraints limit the ability of hospitals to keep patients for the entirety of their optimal LOS. We find that the optimal policy under this constraint takes the form of a two-threshold policy. This policy may block some patients and immediately route them to home care, or speed up some patients’ LOS and send them to home care early after an observation period in the hospital. Joint work with Prof. Galit Yom-Tov from the Technion.