Researcher: Güneş, Evrim Didem
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Güneş, Evrim Didem
Güneş Erçetin, Evrim Didem
Güneş Erçetin, Evrim Didem
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Publication Metadata only The 39th international conference of the EURO working group on operational research applied to health services: ORAHS 2013 special issue(Springer, 2015) Çayırlı, Tuğba; Günal, Murat M.; Department of Business Administration; Department of Industrial Engineering; Güneş, Evrim Didem; Örmeci, Lerzan; Faculty Member; Faculty Member; Department of Business Administration; Department of Industrial Engineering; College of Administrative Sciences and Economics; College of Engineering; 51391; 32863N/APublication Metadata only Transition to family practice in Turkey(Wiley, 2008) Yaman, Hakan; Department of Business Administration; Güneş, Evrim Didem; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 51391Introduction: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary health care and the family medicine model that is in the process of implementation and discusses implications of the transition for family physicians and the challenges faced in meeting the needs for health care staff. In Turkey a trend toward urbanization is evident and more staff positions in rural PHC centers are vacant. Shortages of physicians and an ineffective distribution of doctors are seen as a major problem. Family medicine gained popularity at the beginning of the 1990s, as a specialty with a 3-year postgraduate training program. Medical practitioners who are graduates of a 6-year medical training program and are already working in the PHC system are offered retraining courses. Better working conditions and higher salaries may be important incentives for medical practitioners to sign a contract with the social security institution of Turkey. Discussion: The lack of well-trained primary care staff is an ongoing challenge. Attempts to retrain medical practitioners to act as family physicians show promising results. Shortness of physician and health professionals and lack of time and resources in primary health care are problems to overcome during this process.Publication Metadata only Optimal timing of insulin initiation using a mathematical model(IEEE, 2019) Minsin, F. Erkam; Dursun, Mehtap; Department of Business Administration; Güneş, Evrim Didem; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 51391Diabetes is a chronic disease that is rapidly spreading worldwide. In the treatment of patients with type 2 diabetes, the most common type of the disease, doctors have many intervention methods. Therefore, taking the right action at the most appropriate time among these many types of interventions will make a great contribution to the patient's health as well as the costs of treatment. In this study, we developed a finite-horizon Markov decision process (MDP) model in which the state of the process will cover the patient's metabolic health status and history of drug used to solve this problem. The model is operated by using existing data in the literature and the results are discussed.Publication Metadata only Modeling change in a health system: implications on patient flows and resource allocations(Canadian Soc Clinical Investigation, 2005) Yaman, Hande; Department of Business Administration; Güneş, Evrim Didem; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 51391This work is motivated by the recent changes in the health system in Turkey, which is a consolidation of health insurance funds, and its implications on the resource allocations and the flow of patients in the system. Our aim is to provide a model to find the best reallocation of resources between the hospitals and the best patient-hospital match to minimize the costs.Publication Metadata only Health network mergers and hospital re-planning(Taylor & Francis, 2010) Yaman, H.; Department of Business Administration; Güneş, Evrim Didem; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 51391This paper presents an integer programming formulation for the hospital re-planning problem which arises after hospital network mergers. The model finds the best re-allocation of resources among hospitals, the assignment of patients to hospitals and the service portfolio to minimize the system costs subject to quality and capacity constraints. An application in the Turkish hospital networks case is illustrated to show the implications of consolidation of health insurance funds on resource allocations and flow of patients in the system. Journal of the Operational Research Society (2010) 61, 275-283. doi: 10.1057/jors.2008.165 Published online 11 February 2009Publication Metadata only A modeling framework for control of preventive services(Informs, 2016) Kunduzcu, Derya; Department of Industrial Engineering; Department of Business Administration; Örmeci, Lerzan; Güneş, Evrim Didem; Faculty Member; Faculty Member; Department of Industrial Engineering; Department of Business Administration; College of Engineering; College of Administrative Sciences and Economics; 32863; 51391We present a modeling framework for facilities that provide both screening (preventive) and diagnostic (repair) services. The facility operates in a random environment that represents the condition of the population that needs screening and diagnostic services, such as the disease prevalence level. We model the environment as a partially endogenous process: the population's health can be improved by providing screening services, which reduces future demand for diagnostic services. We use event-based dynamic programming to build a framework for modeling different kinds of these facilities. This framework contains a number of service priority policies that are concerned with prioritizing screening versus diagnostic services. The main trade-off is between serving urgent diagnostic needs and providing screening services that may decrease future diagnostic needs. Under certain conditions, this trade-off reverses the famous c,u, rule; i.e., the patients with lower waiting cost are given priority over the others. We define appropriate event operators and specify the properties preserved by these operators. These characterize the structure of optimal policies for all models that can be built within this framework. A numerical study on colonoscopy services illustrates how the framework can be used to gain insights on developing good screening policies.Publication Metadata only Modeling time allocation for prevention in primary care(Springer, 2009) Department of Business Administration; Güneş, Evrim Didem; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 51391This paper discusses the problem of allocating time for prevention at the primary care level, focusing on a general practitioner (GP) practice. The basic trade-off is between improved state of the health of the population, which translates into less demand for the GP services, and a decreased capacity for curative services, which translates into increased congestion. The problem of how much time to devote to prevention is modeled as a non-linear optimization problem. As an extension of the problem, selection of preventive activities to perform among recommended alternatives is modeled using a knapsack formulation, and its application is illustrated with a numerical example.Publication Metadata only Matching patient and physician preferences in designing a primary care facility network(Taylor and Francis Ltd, 2014) Yaman, H.; Cekyay, B.; Verter, V.; N/A; Güneş, Evrim Didem; Faculty Member; N/A; 51391This paper introduces an integer programming model for planning primary care facility networks, which accounts for the interests of different stakeholders while maximizing access to health care. Physician allocation to health-care facilities is explicitly modelled, which allows consideration of physician incentives in the planning phase. An illustrative case study in the Turkish primary care system is presented to show the implications of focusing on patient or physician preferences in the planning phase. A discussion of trade-offs between the different stakeholder preferences and some recommendations for modelling choices to match these preferences are provided. In the context of this case, we found that using an access measure that decays with distance, and incorporating nearest allocation constraints improves performance for all stakeholders. We also show that increasing the number of physicians may have adverse affects on access measures when physician preferences are addressed.Publication Metadata only Or applications in disease screening(Springer, 2018) Department of Business Administration; Department of Industrial Engineering; Güneş, Evrim Didem; Örmeci, Lerzan; Faculty Member; Faculty Member; Department of Business Administration; Department of Industrial Engineering; College of Administrative Sciences and Economics; College of Engineering; 51391; 32863This chapter presents an overview of disease screening problems and operations research applications on different aspects of the problem. We first discuss operations research applications in evaluation and optimization of screening policies. Cost-effectiveness analysis and personalized medical decision making approaches for screening problems are be discussed here. The methodologies discussed include microsimulation models, compartmental models, general stochastic models and Partially Observed Markov Decision Processes. Then, organization of screening services for reaching out to the population and improving the effectiveness of screening, is discussed. Main topics included are location and resource allocation problems. We conclude with a brief discussion of future research directions.Publication Metadata only How does workload affect test ordering behavior of physicians? An empirical investigation(Wiley, 2022) Kocabıyıkoğlu, Ayşe; Keskin, Ahmet; N/A; Department of Business Administration; Şahin, Büşra Ergün; Güneş, Evrim Didem; PhD Student; Faculty Member; Department of Business Administration; Graduate School of Business; College of Administrative Sciences and Economics; N/A; 51391We study the relationship between workload and the test ordering behavior of physicians in an operational context where examination can be finished with a test order. We define workload in two forms: the unfinished workload, that is, the work waiting to be completed, and the finished workload, that is, the already completed work since the beginning of the work day. We investigate their effect on the probability of a test order and the number of tests ordered for a patient who receives a test order. Empirical analysis of data from a public research and training hospital shows that these workload measures have different effects: A higher unfinished workload increases the probability of giving a test order, while a higher finished load decreases the number of tests ordered for those patients who receive a test order. The observed effects of the operational factors workload and finished load, which have no relation to the patients' complaints and hence, should have no bearing on the eventual diagnosis, and have significant implications for the quality and cost of health care. We also observe that the control variable, examination time, has a significant negative effect on the likelihood of ordering and the number of tests. We report the results of several robustness tests, which confirm our results.