RESUMO
INTRODUCTION: Many patients used telehealth services during the COVID-19 pandemic. In this study, we evaluate how different factors have affected telehealth utilization in recent years. Decision makers at the federal and state levels can use the results of this study to inform their healthcare-related policy decisions. METHODS: We implemented data analytics techniques to determine the factors that explain the use of telehealth by developing a case study using data from Arkansas. Specifically, we built a random forest regression model which helps us identify the important factors in telehealth utilization. We evaluated how each factor impacts the number of telehealth patients in Arkansas counties. RESULTS: Of the 11 factors evaluated, five are demographic, and six are socioeconomic factors. Socioeconomic factors are relatively easier to influence in the short term. Based on our results, broadband subscription is the most important socioeconomic factor and population density is the most important demographic factor. These two factors were followed by education level, computer use, and disability in terms of their importance as it relates to telehealth use. DISCUSSION: Based on studies in the literature, telehealth has the potential to improve healthcare services by improving doctor utilization, reducing direct and indirect waiting times, and reducing costs. Thus, federal and state decision makers can influence the utilization of telehealth in specific locations by focusing on important factors. For example, investments can be made to increase broadband subscriptions, education levels, and computer use in targeted locations.
RESUMO
A multistage, mixed integer programing model was developed that fully integrates multimodal transport into the cellulosic biofuel supply chain design under feedstock seasonality. Three transport modes are considered: truck, single railcar, and unit train. The goal is to minimize the total cost for infrastructure, feedstock harvesting, biofuel production, and transportation. Strategic decisions including the locations and capacities of transshipment hubs, biorefineries, and terminals and tactical decisions on system operations are optimized in an integrated manner. When the model was implemented to a case study of cellulosic ethanol production in California, it was found that trucks are convenient for short-haul deliveries while rails are more effective for long-haul transportation. Taking the advantage of these benefits, the multimodal transport provides more cost effective solutions than the single-mode transport (truck).