Operations research is a methodology for analyzing problems and developing solutions in healthcare delivery. It involves 3 phases: 1) problem analysis which defines the problem, analyzes subsystems, and establishes priorities, 2) solution development which specifies objectives, decision variables, constraints, and develops analytical models, and 3) solution validation which designs and implements field tests to evaluate and integrate solutions. An example of applying this process is analyzing high default rates in a TB control program to identify factors influencing compliance and develop interventions to address them.

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
Management
-Leadership
-Decision-making
-planning
-implementation
-monitoring and
evaluation
-information
Regulation
Economic support
-Public sources of
finance
-Employers
-Organized volun-
tary agencies
-Local community
efforts
-Foreign Aid
-Private households
-Other
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 Analysis
1. 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 Analysis
2. 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 Analysis
3. 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 Development
1. 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 Development
2. 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 Development
3. 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 VALIDATION
1. Design field test
How believable are the outcome of
the field test.
Experimental
Non-experimental
Quasi-experimental

16. Phase-III SOLUTION VALIDATION
2. 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 VALIDATION
3. 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?