A non-linear discrete stochastic optimization model for Advanced Access patient appointment scheduling

Access to healthcare is a major problem in which patients are deprived of receiving timely admission to healthcare. Poor access has resulted in significant but avoidable healthcare cost, poor quality of healthcare, and deterioration in the general public health. Advanced Access is a simple and direct approach to appointment scheduling in which the majority of a clinic's appointments slots are kept open in order to provide access for immediate or same day healthcare needs and therefore, alleviate the problem of poor access the healthcare. This research formulates a non-linear discrete stochastic mathematical model of the Advanced Access appointment scheduling policy. The model objective is to maximize the expected profit of the clinic subject to constraints on minimum access to healthcare provided. Patient behavior is characterized with probabilities for no-show, balking, and related patient choices. Structural properties of the model are analyzed to determine whether Advanced Access patient scheduling is feasible. To solve the complex combinatorial optimization problem, a heuristic that combines greedy construction algorithm and neighborhood improvement search was developed. The model and the heuristic were used to evaluate the Advanced Access patient appointment policy compared to existing policies. Trade-off between profit and access to healthcare are established, and parameter analysis of input parameters was performed. The trade-off curve is a characteristic curve and was observed to be concave. This implies that there exists an access level at which at which the clinic can be operated at optimal profit that can be realized. The results also show that, in many scenarios by switching from existing scheduling policy to Advanced Access policy clinics can improve access without any decrease in profit. Further, the success of Advanced Access policy in providing improved access and/or profit depends on the expected value of demand, variation in demand, and the ratio of demand for same day and advanced appointments. The contributions of the dissertation are a model of Advanced Access patient scheduling, a heuristic to solve the model, and the use of the model to understand the scheduling policy trade-offs which healthcare clinic managers must make. ^

Resource management and optimization in wireless mesh networks

A wireless mesh network is a mesh network implemented over a wireless network system such as wireless LANs. Wireless Mesh Networks(WMNs) are promising for numerous applications such as broadband home networking, enterprise networking, transportation systems, health and medical systems, security surveillance systems, etc. Therefore, it has received considerable attention from both industrial and academic researchers. This dissertation explores schemes for resource management and optimization in WMNs by means of network routing and network coding.^ In this dissertation, we propose three optimization schemes. (1) First, a triple-tier optimization scheme is proposed for load balancing objective. The first tier mechanism achieves long-term routing optimization, and the second tier mechanism, using the optimization results obtained from the first tier mechanism, performs the short-term adaptation to deal with the impact of dynamic channel conditions. A greedy sub-channel allocation algorithm is developed as the third tier optimization scheme to further reduce the congestion level in the network. We conduct thorough theoretical analysis to show the correctness of our design and give the properties of our scheme. (2) Then, a Relay-Aided Network Coding scheme called RANC is proposed to improve the performance gain of network coding by exploiting the physical layer multi-rate capability in WMNs. We conduct rigorous analysis to find the design principles and study the tradeoff in the performance gain of RANC. Based on the analytical results, we provide a practical solution by decomposing the original design problem into two sub-problems, flow partition problem and scheduling problem. (3) Lastly, a joint optimization scheme of the routing in the network layer and network coding-aware scheduling in the MAC layer is introduced. We formulate the network optimization problem and exploit the structure of the problem via dual decomposition. We find that the original problem is composed of two problems, routing problem in the network layer and scheduling problem in the MAC layer. These two sub-problems are coupled through the link capacities. We solve the routing problem by two different adaptive routing algorithms. We then provide a distributed coding-aware scheduling algorithm. According to corresponding experiment results, the proposed schemes can significantly improve network performance.^