Mount Sinai Hospital Uses Integer Programming to Allocate Operating Room Time

I n most developed countries, except the United States, strategies for providing universal access to health care while containing costs involve formal or informal caps on health-care spending (Pierskalla and Brailer 1994, p. 470). As a result of centrally constrained funds, resource-allocation problems in which a central authority must plan for and allocate limited resources to competing groups or services are common issues in health-care planning at the national, regional, and institutional levels. Canadian experience suggests that a centrally imposed limit on expenditures is an effective method for controlling the size of a national health-care system. While the percentage of gross domestic product (GDP) spent on health care in Canada in 1997was 9.0 per cent, the proportion of GDP spent on health care in the United States was 13.6 per cent (Canadian Institute for Health Information 1999, p. 26). Centrally limited budgets do, however, create a problem of scarcity. Under such systems, demand for resources outstrips supply, necessitating a complex and often contentious process for determining how to best allocate resources between competing demands. In a resource-allocation problem at Mount Sinai