An approximate dynamic programming approach to network-based scheduling of chemotherapy treatment sessions
提出一种网络化化疗排程方法，通过近似动态规划求解马尔可夫决策过程模型，在保证首末次治疗在同一中心的前提下灵活调度中间疗程，模拟显示可降低20%运营成本并缩短一半首次等待时间。
A solution approach is proposed for the interday problem of assigning chemotherapy sessions at a network of treatment centres with the goal of increasing the cost-efficiency of system-wide capacity use. This network-based scheduling procedure is subject to the condition that both the first and last sessions of a patient's treatment protocol are administered at the same centre the patient is referred to by their oncologist. All intermediate sessions may be administered at other centres. It provides a systematic way of identifying effective multi-appointment scheduling policies that exploit the total capacity of a networked system, allowing patients to be treated at centres other than their home centre. The problem is modelled as a Markov decision process which is then solved approximately using techniques of approximate dynamic programming. The benefits of the approach are evaluated and compared through simulation with the existing manual scheduling procedures at two treatment centres in Santiago, Chile. The results suggest that the approach would obtain a 20% reduction in operating costs for the whole system and cut existing first-session waiting times by half. A key conclusion, however, is that a network-based scheduling procedure brings no real benefits if it is not implemented in conjunction with a proactive assignment policy like the one proposed in this paper.