Papers by Michele Sonnessa
Lecture Notes in Computer Science, 2017
The Emergency Department (ED) is responsible to provide medical and surgical care to patients arr... more The Emergency Department (ED) is responsible to provide medical and surgical care to patients arriving at the hospital in need of immediate care. At the regional level, the EDs system can be seen as a network of EDs cooperating to maximise the outputs (number of patients served, average waiting time, ...) and outcomes in terms of the provided care quality. In this paper we discuss how quantitative analysis based on health care big data can provide a tool to evaluate the dispatching policies for the network of emergency departments operating in Piedmont, Italy: the basic idea is to exploit clusters of EDs in such a way to fairly distribute the workload. Further, we discuss how big data can enable a novel methodological approach to the health system analysis.
This paper shows how agent-based modelling technique is a suitable approach for social scientists... more This paper shows how agent-based modelling technique is a suitable approach for social scientists to model complex adaptive systems, using computer as experimental environment. Unfortunately advanced tools are lacking as well as an unified language supporting its development. We present JAS, a new agent-based simulation tool, developed with the aim to improve AB models designing. We give a brief methodological introduction to its use and a short description of its architecture.
Proceedings of the 2nd International Conference on Simulation and Modeling Methodologies, Technologies and Applications, 2012
Some forms of co-payment are required in insurance markets to avoid moral hazard that in health s... more Some forms of co-payment are required in insurance markets to avoid moral hazard that in health sector entails excessive consumption and costs. Literature and empirical findings, however, do not agree about the effectiveness of co-payment in practical situations. Moreover, in health systems co-payment seems to be more aimed to help in financing than to reduce moral hazard. The final impact of co-payment is rather difficult to predict due to these conflicting aims. Assessing the impact of a co-payment policy is, however, very important, because it affects also the principles of universalistic health systems threatening equity attainment. The specific aim of this paper is to propose an Agent-based simulation model that allows both i) to take into account all these contradictory effects at the same time, ii) to compare different co-payment models. The model development is presented mixing empirical data with some stochastic assumptions the authors intend to test.
Springer Proceedings in Mathematics & Statistics, 2017
This paper deals with the problem of patient boarding in Emergency Department (ED) due to the lac... more This paper deals with the problem of patient boarding in Emergency Department (ED) due to the lack of availability of stay beds in inpatient hospital wards. The boarding of emergent patients is a major reason of ED overcrowding, which in turn creates long waiting times in ED, as well as patient and staff dissatisfaction. In this paper a hybrid simulation framework is proposed to describe how emergent and elective patients flows interact each other inside the hospital. The framework combines System Dynamics (SD) and Discrete Event Simulation (DES). Flows are generated at macro level by the SD model, while in DES model they are disentangled into single entities following a detailed process-oriented pathway. The hybrid model has been then applied and validated to data from a medium-size public hospital located in Genova (Italy). Furthermore, some metrics (such as waiting times to be admitted in hospital, number of trolleys in ED, inpatient bed occupancy rates and elective patients delayed) are proposed as key indicators to assess the system performance.
Proceedings of the 4th International Conference on Simulation and Modeling Methodologies, Technologies and Applications, 2014
In recent years, due to the overcrowding of Emergency Department (ED) and the growing concern in ... more In recent years, due to the overcrowding of Emergency Department (ED) and the growing concern in reducing the number of inpatient ward beds, it has become crucial to improve the capacity planning and control activities, which manage the patient flows from EDs to hospital wards. Bed Management has a key role in this context. This study starts by a collaboration with the Local Health Government (LHG) of the Liguria region aimed at studying the impact of supporting bed management with some operational strategies without increasing the bed capacity. A large amount of data was collected over a one-year period at public hospital in Genova and a preliminary observational analysis was conducted to get the main information about the flow of emergency and elective patients from ED to inpatient wards. A Discrete Event Simulation (DES) model has been then developed in order to represent the real system. A scenarios analysis is proposed to assess the best strategy to improve the system performance without increasing bed capacity, by simply synchronizing bed supply and demand. The model can be used as a decision support tool to optimise the use of the available resources as well as to improve the quality of the patient pathway inside the hospital.
ERN: Simulation Methods (Topic), 2006
Traditional (i.e. analytical) modelling practices in the social sciences rely on a very well esta... more Traditional (i.e. analytical) modelling practices in the social sciences rely on a very well established, although implicit, methodological protocol, both with respect to the way models are presented and to the kinds of analysis that are performed. Unfortunately, computer-simulated models often lack such a reference to an accepted methodological standard. This is one of the main reasons for the scepticism among mainstream social scientists that results in low acceptance of papers with agent-based methodology in the top journals. We identify some methodological pitfalls that, according to us, are common in papers employing agent-based simulations, and propose appropriate solutions. We discuss each issue with reference to a general characterization of dynamic micro models, which encompasses both analytical and simulation models. In the way, we also clarify some confusing terminology. We then propose a three-stage process that could lead to the establishment of methodological standards...
Dottorato in " Cultura e Impresa " Modelli matematici/informatici per l'impresa – S... more Dottorato in " Cultura e Impresa " Modelli matematici/informatici per l'impresa – Simulazione, rappresentazione della conoscenza e impresa Supervisori:
We present JAS 2, a new Java platform which aims at providing a unique simulation tool for discre... more We present JAS 2, a new Java platform which aims at providing a unique simulation tool for discrete-event simulations, including agent-based and dynamic microsimulation models. JAS 2 is not released as a self-contained stand-alone application for model development. With the aim to develop large-scale, computationally resource-intensive models, the main architectural choice of JAS 2 is to use whenever possible standard, open-source tools aready available in the software development community. This decision entails a longer learning curve for the user than a dedicated, language-specific software package, but it allows for a more professional approach to simulation modeling compared to specific proprietary environments. There are two main advantages of using an open architecture where external libraries can be added and utilized: one is the possibility to easily integrate external functions that can be added as plug-ins; the other is the possibility to freely extend and modify the func...
Operations Research for Health Care
Journal of the Operational Research Society, 2016
International Transactions in Operational Research, 2016
Springer Proceedings in Mathematics & Statistics, 2016
Advances in Intelligent Systems and Computing, 2015
Agent-based Models of the Economy, 2015
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Papers by Michele Sonnessa