Percorrer por autor "Cardoso-Grilo, Teresa"
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- Enhancing optimization planning models for health human resources management with foresightPublication . Amorim-Lopes, Mário; Oliveira, Mónica; Raposo, Mariana; Cardoso-Grilo, Teresa; Alvarenga, António; Barbas, Marta; Alves, Marco; Vieira, Ana; Barbosa-Póvoa, AnaAchieving a balanced healthcare workforce requires health planners to adjust the supply of health human resources (HHR). Mathematical programming models have been widely used to assist such planning, but the way uncertainty is usually considered in these models entails methodological and practical issues and often disregards radical yet plausible changes to the future. This study proposes a new socio-technical methodology to factor in uncertainty over the future within mathematical programming modelling. The methodological approach makes use of foresight and scenario planning concepts to build tailor-made scenarios and scenario fit input parameters, which are then used within mathematical programming models. Health stakeholders and experts are engaged in the scenario building process. Causal map modelling and morphological analysis are adopted to digest stakeholders and experts’ information about the future and give origin to contrasting and meaningful scenarios describing plausible future. These scenarios are then adjusted and validated by stakeholders and experts, who then elicit their best quantitative estimates for coherent combinations of input parameters for the mathematical programming model under each scenario. These sets of parameters for each scenario are then fed to the mathematical programming model to obtain optimal solutions that can be interpreted in light of the meaning of the scenario. The proposed methodology has been applied to a case study involving HHR planning in Portugal, but its scope far extends HHR planning, being especially suited for addressing strategic and policy planning problems that are sensitive to input parameters.
- From problem structuring to optimization: a multi-methodological framework to assist the planning of medical trainingPublication . Cardoso-Grilo, Teresa; Monteiro, Marta; Oliveira, Mónica Duarte; Amorim-Lopes, Mário; Barbosa-Póvoa, AnaMedical training is an intricate and long process, which is compulsory to medical practice and often lasts up to twelve years for some specialties. Health stakeholders recognise that an adequate planning is crucial for health systems to deliver necessary care services. However, proper planning needs to account for complexity related with the setting of medical school vacancies and of residency programs, which are highly influenced by multiple stakeholders with diverse perspectives and views, as well as by the specificities of medical training. Aiming at building comprehensive models with a potential to assist health decision-makers, this article develops a multi-methodological framework to assist the planning of medical training under such a complex environment. It combines the structuring of the objectives and specificities of the medical training problem with a Soft Systems Methodology through the CATWOE (Customer, Actor, Transformation, Weltanschauung, Owner, Environment) approach, and the formulation of a Mixed Integer Linear Programming model that considers all relevant aspects. Considering the specificities of countries based on a National Health Service structure, a multi-objective planning model emerges, informing on how many vacancies should be opened/closed per year in medical schools and in each specialty. This model aims at (i) minimizing imbalances between medical demand and supply; (ii) minimizing costs; and (iii) maximizing equity across medical specialties. A case study in Portugal is explored so as to illustrate the applicability of the proposed multi-methodology, showing the relevance of proper structuring for planning models having the potential to inform health decision-makers and planners in practice.