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Case mix planning in hospitals: a review and future agenda

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Listed:
  • Sebastian Hof

    (Universität Augsburg)

  • Andreas Fügener

    (Universität Augsburg)

  • Jan Schoenfelder

    (Universität Augsburg)

  • Jens O. Brunner

    (Universität Augsburg)

Abstract

The case mix planning problem deals with choosing the ideal composition and volume of patients in a hospital. With many countries having recently changed to systems where hospitals are reimbursed for patients according to their diagnosis, case mix planning has become an important tool in strategic and tactical hospital planning. Selecting patients in such a payment system can have a significant impact on a hospital’s revenue. The contribution of this article is to provide the first literature review focusing on the case mix planning problem. We describe the problem, distinguish it from similar planning problems, and evaluate the existing literature with regard to problem structure and managerial impact. Further, we identify gaps in the literature. We hope to foster research in the field of case mix planning, which only lately has received growing attention despite its fundamental economic impact on hospitals.

Suggested Citation

  • Sebastian Hof & Andreas Fügener & Jan Schoenfelder & Jens O. Brunner, 2017. "Case mix planning in hospitals: a review and future agenda," Health Care Management Science, Springer, vol. 20(2), pages 207-220, June.
    • Handle: RePEc:kap:hcarem:v:20:y:2017:i:2:d:10.1007_s10729-015-9342-2
    DOI: 10.1007/s10729-015-9342-2
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    2. Shehadeh, Karmel S. & Padman, Rema, 2021. "A distributionally robust optimization approach for stochastic elective surgery scheduling with limited intensive care unit capacity," European Journal of Operational Research, Elsevier, vol. 290(3), pages 901-913.
    3. Veneklaas, W. & Leeftink, A.G. & van Boekel, P.H.C.M. & Hans, E.W., 2021. "On the design, implementation, and feasibility of hospital admission services: The admission lounge case," Omega, Elsevier, vol. 100(C).
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    5. Fernanda Bravo & Marcus Braun & Vivek Farias & Retsef Levi & Christine Lynch & John Tumolo & Richard Whyte, 2021. "Optimization-driven framework to understand health care network costs and resource allocation," Health Care Management Science, Springer, vol. 24(3), pages 640-660, September.
    6. Omolbanin Mashkani & Andreas T. Ernst & Dhananjay Thiruvady & Hanyu Gu, 2023. "Minimizing patients total clinical condition deterioration in operating theatre departments," Annals of Operations Research, Springer, vol. 328(1), pages 821-857, September.
    7. McRae, Sebastian & Brunner, Jens O., 2020. "Assessing the impact of uncertainty and the level of aggregation in case mix planning," Omega, Elsevier, vol. 97(C).
    8. Aringhieri, Roberto & Duma, Davide & Landa, Paolo & Mancini, Simona, 2022. "Combining workload balance and patient priority maximisation in operating room planning through hierarchical multi-objective optimisation," European Journal of Operational Research, Elsevier, vol. 298(2), pages 627-643.
    9. Lien Wang & Erik Demeulemeester & Nancy Vansteenkiste & Frank E. Rademakers, 2022. "On the use of partitioning for scheduling of surgeries in the inpatient surgical department," Health Care Management Science, Springer, vol. 25(4), pages 526-550, December.
    10. Camilleri, Carl & Jofre-Bonet, Mireia & Serra-Sastre, Victoria, 2018. "The suitability of a DRG casemix system in the Maltese hospital setting," Health Policy, Elsevier, vol. 122(11), pages 1183-1189.
    11. Burdett, Robert L & Corry, Paul & Yarlagadda, Prasad & Cook, David & Birgan, Sean & McPhail, Steven M, 2023. "A mathematical framework for regional hospital case mix planning and capacity appraisal," Operations Research Perspectives, Elsevier, vol. 10(C).
    12. Stephanie Carew & Mahesh Nagarajan & Steven Shechter & Jugpal Arneja & Erik Skarsgard, 2021. "Dynamic Capacity Allocation for Elective Surgeries: Reducing Urgency-Weighted Wait Times," Manufacturing & Service Operations Management, INFORMS, vol. 23(2), pages 407-424, March.

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