Improving emergency departments during COVID-19 pandemic: a simulation and MCDM approach with MARCOS methodology in an uncertain environment

The Application of Data Envelopment Analysis to Emergency Departments and Management of Emergency Conditions: A Narrative Review

The healthcare industry is one application for data envelopment analysis (DEA) that can have significant benefits for standardizing health service delivery. This narrative review focuses on the application of DEA in emergency departments (EDs) and the management of emergency conditions such as acute ischemic stroke and acute myocardial infarction (AMI). This includes benchmarking the proportion of patients that receive treatment for these emergency conditions. The most frequent primary areas of study motivating work in DEA, EDs and management of emergency conditions including acute management of stroke are sorted into five distinct clusters in this study: (1) using basic DEA models for efficiency analysis in EDs, i.e., applying variable return to scale (VRS), or constant return to scale (CRS) to ED operations; (2) combining advanced and basic DEA approaches in EDs, i.e., applying super-efficiency with basic DEA or advanced DEA approaches such as additive model (ADD) and slack-based measurement (SBM) to clarify the dynamic aspects of ED efficiency throughout the duration of a first-aid program for AMI or heart attack; (3) applying DEA time series models in EDs like the early use of thrombolysis and percutaneous coronary intervention (PCI) in AMI treatment, and endovascular thrombectomy (EVT) in acute ischemic stroke treatment, i.e., using window analysis and Malmquist productivity index (MPI) to benchmark the performance of EDs over time; (4) integrating other approaches with DEA in EDs, i.e., combining simulations, machine learning (ML), multi-criteria decision analysis (MCDM) by DEA to reduce patient waiting times, and futile transfers; and (5) applying various DEA models for the management of acute ischemic stroke, i.e., using DEA to increase the number of eligible acute ischemic stroke patients receiving EVT and other medical ischemic stroke treatment in the form of thrombolysis (alteplase and now Tenecteplase). We thoroughly assess the methodological basis of the papers, offering detailed explanations regarding the applied models, selected inputs and outputs, and all relevant methodologies. In conclusion, we explore several ways to enhance DEA's status, transforming it from a mere technical application into a strong methodology that can be utilized by healthcare managers and decision-makers.

A decision-making framework for COVID-19 infodemic management strategies evaluation in spherical fuzzy environment

100 years after the Spanish flu, the COVID-19 crisis showed that large-scale epidemics and pandemics do not belong to the past. On the report of the World Health Organization, COVID-19 is the most significant public health problem of the twenty-first century. Like previous epidemics, the current crisis is accompanied by uncertainty, mistrust, doubt and fear, and this has led to an infodemic connection to the epidemic. So not only are we fighting an epidemic, but also, we are brawling an infodemic. To reduce the social and economic consequences and harmful effects of infodemic health, and to overcome it, we need to implement strategies against infodemic. Evaluating strategies based on multiple characteristics can be considered multi-criteria decision-making (MCDM) problem. According to the literature, there is no study that aims on proposing an integrated approach to evaluate infodemic management strategies under uncertain environment. Therefore, in this paper, an integrated framework based on the extended version of best-worst method (BWM) and Combined Compromise Solution (CoCoSo) methods under a spherical fuzzy set (SFS) is developed for the first time to address the COVID-19 infodemic management strategies selection. Initially, the criteria are weighted using the developed SFS BWM which reduces uncertainty in pairwise comparisons. In the next step, the 15 selected strategies are analyzed and ranked using SFS CoCoSo. The outputs of this paper illustrate that online tools for fact checking COVID-19 information and engage and empower communities are placed in the first and second priorities, respectively. The comparison of ranking results SFS-CoCoSo with other MCDM methods demonstrates the performance of the proposed approach and its ranking stability.