Optimal timing of joint replacement using mathematical programming and stochastic programming models

Baruch Keren, Joseph S. Pliskin

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The optimal timing for performing radical medical procedures as joint (e. g., hip) replacement must be seriously considered. In this paper we show that under deterministic assumptions the optimal timing for joint replacement is a solution of a mathematical programming problem, and under stochastic assumptions the optimal timing can be formulated as a stochastic programming problem. We formulate deterministic and stochastic models that can serve as decision support tools. The results show that the benefit from joint replacement surgery is heavily dependent on timing. Moreover, for a special case where the patient's remaining life is normally distributed along with a normally distributed survival of the new joint, the expected benefit function from surgery is completely solved. This enables practitioners to draw the expected benefit graph, to find the optimal timing, to evaluate the benefit for each patient, to set priorities among patients and to decide if joint replacement should be performed and when.

Original languageEnglish
Pages (from-to)361-369
Number of pages9
JournalHealth Care Management Science
Volume14
Issue number4
DOIs
StatePublished - 1 Nov 2011

Keywords

  • Joint replacement
  • Mathematical programming
  • Optimal timing
  • QALY
  • Stochastic programming

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