Operations Research By Dr. S.M. Israr Aga Khan University Karachi, Pakistan

1. Operations Research By Dr. S.M. Israr Aga Khan University Karachi, Pakistan

2. Operations Research • Session Objectives: • To describe the need and importance of Operations Research for rationale decision making in health care delivery • To discuss the basic Operations Research concepts and techniques for solving particular problem and identification of appropriate solution • To develop a research proposal using the general approach for Operations Research

3. Delivery of health care -Primary care -Secondary care -Tertiary care Economic support -Public sources of finance -Employers -Organized volun- tary agencies -Local community efforts -Foreign Aid -Private households -Other Management -Leadership -Decision-making -planning -implementation -monitoring and evaluation -information Regulation Organized arrangement of resources -National health authorities -Health insurance programmes -Other governmental agencies -Non-governmental agencies -Independent private sector Development of health resource -Manpower -Facilities -Equipment and supplies -Knowledge

4. Operations Research Operations Research is the application of analytical methods designed to help the decision makers choose between various courses of action available to accomplish specified objectives

5. Operations Research - Methodology Operations Research Problem Analysis Solution Development Solution Validation Evaluation Implementation

6. Operations Research Approach • Phase -I PROBLEM ANALYSIS • Define the Operations Research • Analyze the problem and divide into smaller units • Establish research priorities

7. Operations Research Approach • Phase-II SOLUTION DEVELOPMENT • Specify solution objectives • Specify decision variables and stipulate constraints on the solution • Identify or construct an appropriate model for solution development • Determine and obtain required data • Develop solutions using analytical model

8. Operations Research Approach • Phase-III SOLUTION VALIDATION • Design field test • Implement field test • Evaluate the propose solution • modify if necessary • Integrate the solution with the larger system

9. Phase -I, Problem Analysis1. Define the operational problem • Discussion of problem with all stake- holders • Identifying subsystems • Develop objectives for subsystems • obtaining consensus on objectives of the subsystem

10. Phase -I, Problem Analysis2. Analyze the problem and divide into smaller units • Operational problem is analyzed in detail. • The problem is broken into smaller units. • This is presented graphically. • The graph shows inputs, outputs and the outside factors.

11. Phase -I, Problem Analysis3. Establishing Research Priorities • First look at the system as a whole and then as a cluster of major subsystems. • Then ask where one should expect modifications to produce the greatest positive impact on outputs.

12. Phase -II, Solution Development1. Specify solution objectives • Solution objectives are statements of the desired solutions to the operational problem. • These are usually stated in terms of system efficiency that is conservation of inputs and maximization of outputs. • Fixed inputs with maximum outputs. • Minimum inputs with maximum outputs.

13. Phase -II, Solution Development2. Specify decision variables and stipulate constraints on the solution • Decision variables are factors that both play a role in determining how a system functions and are also within the control of the system manager. • Amount of ORS packets • Training methods • Factors that limit the the practical range of one or more decision variables are called constraints. • Socio-economic, ethnicity, occupation, educational level, weather, terrain

14. Phase -II, Solution Development3. Identify or construct an appropriate model for solution development • Model building is the essence of the operations research • A model is the simplified representation of the real world • Resource allocation • Networking • Cost-analysis

15. Phase-III SOLUTION VALIDATION1. Design field test • How believable are the outcome of the field test. • Experimental • Non-experimental • Quasi-experimental

16. Phase-III SOLUTION VALIDATION2. Implementing the field test • Determination of requisite resources • Development of management scheme • Development of training material • Arrangements of obtaining human and other resources needed • Design of an information system

17. Phase-III SOLUTION VALIDATION3. Evaluating,modifying and integrating the solutions • Continuous assessment to ensure refinements of inputs • Integrating the solution within the system

18. An Example………………... • TB control Program. • High defaulter rate among TB patients. • How to assess the situation?