AI 中文总结
针对公共医疗系统中择期手术等候名单管理难题，提出集成框架，通过闭环控制策略、考虑加班取消风险模型及混合整数线性规划公式，将战略与战术决策相联，经案例研究验证可稳定名单、控风险并支持透明分配决策，计算高效。
AI 中文摘要
在公共医疗系统中，择期手术等候名单是持续的管理挑战，医院须平衡有限的手术室容量与不确定且不断变化的需求。长期规划不仅要分配手术室时间，还需考虑患者排队和手术时长的不确定性。本文提出一个不确定性下择期手术管理的集成框架，将战略队列控制决策与战术手术室调度相联系。该框架包含闭环控制策略、考虑加班取消风险的模型以及混合整数线性规划公式。通过巴西一家大型公立医院的案例研究评估，结果表明整合战略与战术决策可稳定等候名单、控制取消风险并支持更透明的手术室分配决策，且计算效率高便于实际应用。
英文摘要
In public healthcare systems, elective surgery waiting lists are a persistent management challenge, as hospitals must balance limited operating theatre capacity with uncertain and evolving demand. Long-term planning for these lists requires more than assigning operating theatre (OT) time to medical specialities, as isolated allocation decisions may fail to stabilise waiting lists over time. Such planning must account for uncertainty in patient arrivals in the queue and surgery durations, which are often neglected in OT scheduling models. In this context, we propose a novel integrated framework for elective surgery management under uncertainty, linking strategic queue-control decisions with tactical OT scheduling. The framework combines three components: (i) a closed-loop control policy that determines the number of patients to schedule in each planning cycle; (ii) a model to account for overtime-related cancellation risks; and (iii) a mixed-integer linear programming formulation, informed by the previous components, to solve an OT Scheduling Problem. The resulting tactical schedules are therefore guided by the long-term evolution of speciality-specific queues and by cancellation-risk considerations. We evaluate the proposed framework through a case study at University Hospital Unicamp, a large Brazilian public referral hospital. The results show that integrating strategic and tactical decisions stabilises waiting lists, controls cancellation risks, and supports more transparent theatre-allocation decisions, while remaining computationally efficient for practical implementation.
