scholarly journals Data Analysis of Ambient Intelligence in a Healthcare Simulation System: A Pilot Study in High-end Health Screening Process Improvement

2020 ◽  
Author(s):  
Ming-Shu Chen ◽  
Kun-Chih Wu ◽  
Yu-Ling Tsai ◽  
Bernard C. Jiang
Keyword(s):  
Waiting Time ◽  
Wait Time ◽  
Tertiary Hospital ◽  
Health Screening ◽  
Health Examination ◽  
Screening Process ◽  
Arrival Times ◽  
System A ◽  
The Cost ◽  
Bottleneck Resources

Abstract This study aimed to reduce the total waiting time for high-end health screening processes. The subjects of this study were recruited from a health screening center in a tertiary hospital in northern Taiwan from September 2016 to February 2017 and a total of 2,342 high-end customers were collected. Arena software was used to simulate the examination process. We presented the simulation results of three different policies and compared those results to the current state. The first policy presented a predetermined proportion of customer types, in which the total waiting time was increased from 72.29 to 83.04 mins. The second policy was based on increased bottleneck resources and provided significant improvement, with the total waiting time was decreased from 72.29 to 28.39 mins. However, this policy also caused the cost to increase dramatically, while lowering the utilization of this exam station. The third policy was adjusting customer arrival times, which reduced the waiting time significantly, as the total waiting time was reduced from 72.29 to 55.02 mins. Although the wait time of this policy was slightly longer than that of the second policy, the additional cost was much lower than the second plan. Scheduled arrival intervals could help to reduce customer waiting time in the health screening department base on FIFO rule. The simulation model of this study could be utilized and the parameters could be modified to comply with different health examination centers to improve process and service quality.

scholarly journals Data analysis of ambient intelligence in a healthcare simulation system: a pilot study in high-end health screening process improvement

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ming-Shu Chen ◽  
Kun-Chih Wu ◽  
Yu-Ling Tsai ◽  
Bernard C. Jiang
Keyword(s):  
Waiting Time ◽  
Tertiary Hospital ◽  
Health Screening ◽  
Screening Process ◽  
Arrival Times ◽  
System A ◽  
The Cost ◽  
Bottleneck Resources ◽  
First In First Out ◽  
Northern Taiwan

Abstract Background This study aimed to reduce the total waiting time for high-end health screening processes. Method The subjects of this study were recruited from a health screening center in a tertiary hospital in northern Taiwan from September 2016 to February 2017, where a total of 2342 high-end customers participated. Three policies were adopted for the simulation. Results The first policy presented a predetermined proportion of customer types, in which the total waiting time was increased from 72.29 to 83.04 mins. The second policy was based on increased bottleneck resources, which provided significant improvement, decreasing the total waiting time from 72.29 to 28.39 mins. However, this policy also dramatically increased the cost while lowering the utilization of this health screening center. The third policy was adjusting customer arrival times, which significantly reduced the waiting time—with the total waiting time reduced from 72.29 to 55.02 mins. Although the waiting time of this policy was slightly longer than that of the second policy, the additional cost was much lower. Conclusions Scheduled arrival intervals could help reduce customer waiting time in the health screening department based on the “first in, first out” rule. The simulation model of this study could be utilized, and the parameters could be modified to comply with different health screening centers to improve processes and service quality.

scholarly journals Assessment of patients waiting and service times in the ophthalmology clinic of a public tertiary hospital in Nigeria

2020 ◽  
Vol 54 (4) ◽  
pp. 231-237
Author(s):  
Lateefat B. Olokoba ◽  
Kabir A. Durowade ◽  
Feyi G. Adepoju ◽  
Abdulfatai B. Olokoba
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Sampling Technique ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Ethical Review ◽  
Cross Sectional ◽  
Arrival Times ◽  
The Mean ◽  
Service Times

Introduction: Long waiting time in the out-patient clinic is a major cause of dissatisfaction in Eye care services. This study aimed to assess patients’ waiting and service times in the out-patient Ophthalmology clinic of UITH. Methods: This was a descriptive cross-sectional study conducted in March and April 2019. A multi-staged sampling technique was used. A timing chart was used to record the time in and out of each service station. An experience based exit survey form was used to assess patients’ experience at the clinic. The frequency and mean of variables were generated. Student t-test and Pearson’s correlation were used to establish the association and relationship between the total clinic, service, waiting, and clinic arrival times. Ethical approval was granted by the Ethical Review Board of the UITH. Result: Two hundred and twenty-six patients were sampled. The mean total waiting time was 180.3± 84.3 minutes, while the mean total service time was 63.3±52.0 minutes. Patient’s average total clinic time was 243.7±93.6 minutes. Patients’ total clinic time was determined by the patients’ clinic status and clinic arrival time. Majority of the patients (46.5%) described the time spent in the clinic as long but more than half (53.0%) expressed satisfaction at the total time spent at the clinic. Conclusion: Patients’ clinic and waiting times were long, however, patients expressed satisfaction with the clinic times.

scholarly journals Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model

2021 ◽  
Vol 8 ◽  
Author(s):  
Haishuang Lin ◽  
Jing Sun ◽  
Nathan Congdon ◽  
Meiping Xu ◽  
Shanshan Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Single Case ◽  
Cost Model ◽  
Low Cost ◽  
Tertiary Hospital ◽  
Fundus Photography ◽  
Health Examination ◽  
The Cost ◽  
Uncorrected Refractive Error

Purpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual acuity, noncycloplegic autorefraction, noncontact tonometry, fundus photography, and slit-lamp examination were performed. Refractive error was defined as having spherical equivalent ≤ -0.75 D or ≥ +1 D and uncorrected refractive error was considered as refractive error combined with presenting visual acuity < 6/12 in the better eye. Costs for the screening were assessed.Results: A total of 5,284 participants (61 ± 14 years) were included. The overall prevalence of myopia and hyperopia was 38.7% (95% CI, 37.4–40.0%) and 23.5% (95% CI, 22.3–24.6%), respectively. The prevalence of uncorrected refractive error was 7.85% (95% CI, 7.13–8.58%). Women (p < 0.001 and p = 0.003), those with age ≥ 70 years (p < 0.001 and p = 0.003), and myopia (p < 0.001 and p < 0.001) were at higher risk of uncorrected refractive error and uncorrected refractive error-related visual impairment. Spectacle coverage rate was 70.6% (95% CI, 68.2–73.0%). The cost to identify a single case of refractive error and uncorrected refractive error was US$3.2 and US$25.2, respectively.Conclusion: The prevalence of uncorrected refractive error is high in the urban Chinese adults. Health examination center-based refractive error screening is able to provide an efficient and low-cost model to improve the refractive services in China.

scholarly journals Reducing overcrowding in an emergency department: a pilot study

2019 ◽  
Vol 65 (12) ◽  
pp. 1476-1481
Author(s):  
Fábio Ferreira Amorim ◽  
Karlo Jozefo Quadros de Almeida ◽  
Sanderson Cesar Macedo Barbalho ◽  
Vanessa de Amorim Teixeira Balieiro ◽  
Arnaldo Machado Neto ◽  
...  
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Wait Time ◽  
Federal District ◽  
Arrival Times ◽  
Process Maps ◽  
Manchester Triage System ◽  
Simulation Scenario ◽  
Reduce Wait Time ◽  
Capacity Data

SUMMARY OBJECTIVE Exploring the use of forecasting models and simulation tools to estimate demand and reduce the waiting time of patients in Emergency Departments (EDs). METHODS The analysis was based on data collected in May 2013 in the ED of Recanto das Emas, Federal District, Brasil, which uses a Manchester Triage System. A total of 100 consecutive patients were included: 70 yellow (70%) and 30 green (30%). Flow patterns, observed waiting time, and inter-arrival times of patients were collected. Process maps, demand, and capacity data were used to build a simulation, which was calibrated against the observed flow times. What-if analysis was conducted to reduce waiting times. RESULTS Green and yellow patient arrival-time patterns were similar, but inter-arrival times were 5 and 38 minutes, respectively. Wait-time was 14 minutes for yellow patients, and 4 hours for green patients. The physician staff comprised four doctors per shift. A simulation predicted that allocating one more doctor per shift would reduce wait-time to 2.5 hours for green patients, with a small impact in yellow patients’ wait-time. Maintaining four doctors and allocating one doctor exclusively for green patients would reduce the waiting time to 1.5 hours for green patients and increase it in 15 minutes for yellow patients. The best simulation scenario employed five doctors per shift, with two doctors exclusively for green patients. CONCLUSION Waiting times can be reduced by balancing the allocation of doctors to green and yellow patients and matching the availability of doctors to forecasted demand patterns. Simulations of EDs’ can be used to generate and test solutions to decrease overcrowding.

scholarly journals Age- and sex-specific profiles of temporal fasting plasma glucose variability in a population undergoing routine health screening

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Agyei Helena Lartey ◽  
Xiaona Li ◽  
Zhongqi Li ◽  
Qun Zhang ◽  
Jianming Wang
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Chinese Population ◽  
Age Groups ◽  
Health Screening ◽  
Health Examination ◽  
Cross Sectional ◽  
Fasting Plasma ◽  
Percentage Difference ◽  
Age And Sex

Abstract Background Fasting plasma glucose (FPG) variability is a significant predictor of mortality, especially in patients with poor glycemic control. This study aimed to explore the temporal age- and sex-specific profiles of temporal FPG variability in a Chinese population undergoing routine health screening and to guide the development of targeted public health interventions for the prevention and control of diabetes. Methods In this cross-sectional study, we used a general linear model to compare differences in temporal FPG values between sexes and across age groups in 101,886 Nanjing residents who underwent a routine physical health examination at the Health Management Center, the First Affiliated Hospital of Nanjing Medical University, in 2018. The variability of FPG as a function of time, age, and sex, independently and in combination, was analyzed. Results The participants included 57,455 (56.4%) males and 44,431 (43.6%) females, with a mean ± SD age of 42.8 ± 15.0 years. The average ± SD FPG level was 5.5 ± 1.1 mmol/L. The monthly variation contributed to 22% of the overall FPG variability. A significant main effect for the age group was observed (F = 7.39, P < 0.05), with an excellent fitting effect (Eta-squared =0.15). The variability of FPG showed sex differences in the percentage difference of the coefficient of variation, which was 34.1% higher in males than females. There were significant interaction effects for month*age*sex and day*age*sex. Conclusions Temporal variability in FPG is evident in the general Chinese population and is affected by both age and sex. To avoid complications associated with FPG variability, interventions should be directed at females and males at specific ages for optimal control of FPG variability and to reduce the risk of diabetes and cardiovascular events.

scholarly journals Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar

2021 ◽  
Vol 6 (1) ◽  
pp. e000561
Author(s):  
Ving Fai Chan ◽  
Fatma Omar ◽  
Elodie Yard ◽  
Eden Mashayo ◽  
Damaris Mulewa ◽  
...  
Keyword(s):  
Implementation Research ◽  
Cost Savings ◽  
Cost Effective ◽  
Integrated Model ◽  
Health Screening ◽  
High Coverage ◽  
Health Delivery ◽  
Screening Cost ◽  
Eye Health ◽  
The Cost

ObjectiveTo review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar.Methods and analysisThis 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the IM and VM, respectively. In the VM, teachers conducted eye health screening and education only while these eye health components were added to the existing school feeding programme (IM). The number of children aged 6–13 years old screened and identified was collected monthly. A review of project account records was conducted with 19 key informants. The actual costs were calculated for each cost categories, and costs per child screened and cost per child identified were compared between the two models.ResultsScreening coverage was 96% and 90% in the IM and VM with 297 children (69.5%) from the IM and 130 children (30.5%) from VM failed eye health screening. The 6-month eye health screening cost for VM and IM was US$6 728 and US$7 355. The cost per child screened for IM and VM was US$1.23 and US$1.31, and the cost per child identified was US$24.76 and US$51.75, respectively.ConclusionBoth models achieved high coverage of eye health screening with the IM being a more cost-effective school eye health delivery screening compared with VM with great opportunities for cost savings.

Cost-Effectiveness of Paving Fabrics Used to Control Reflective Cracking

2000 ◽  
Vol 1730 (1) ◽  
pp. 139-149 ◽  
Author(s):  
William G. Buttlar ◽  
Diyar Bozkurt ◽  
Barry J. Dempsey
Keyword(s):  
Life Cycle ◽  
Cost Effectiveness ◽  
Department Of Transportation ◽  
Reflective Cracking ◽  
Crack Control ◽  
Condition Rating ◽  
System A ◽  
Rigid Pavements ◽  
The Cost ◽  
And Control

The Illinois Department of Transportation (IDOT) spends $2 million annually on reflective crack control treatments; however, the cost-effectiveness of these treatments had not been reliably determined. A recent study evaluated the cost-effectiveness of IDOT reflective crack control System A, which consists of a nonwoven polypropylene paving fabric, placed either in strips longitudinally over lane-widening joints or over the entire pavement (area treatment). The study was limited to projects constructed originally as rigid pavements and subsequently rehabilitated with one or more bituminous overlays. Performance of 52 projects across Illinois was assessed through crack mapping and from distress and serviceability data in IDOT’s condition rating survey database. Comparisons of measured reflective cracking in treated and control sections revealed that System A retarded longitudinal reflective widening crack development, but it did not significantly retard transverse reflective cracking, which agrees with earlier studies. However, both strip and area applications of these fabric treatments appeared to improve overall pavement serviceability, and they were estimated to increase rehabilitation life spans by 1.1 and 3.6 years, respectively. Reduction in life-cycle costs was estimated to be 4.4 and 6.2 percent when placed in medium and large quantities, respectively, and to be at a break-even level for small quantities. However, life-cycle benefits were found to be statistically insignificant. Limited permeability testing of field cores taken on severely distressed transverse joints suggested that waterproofing benefits could exist even after crack reflection. This was consistent with the observation that, although serviceability was generally improved with area treatment, crack reflection was not retarded relative to untreated areas.

scholarly journals Physical health examination in outpatients with schizophrenia: the cost effectiveness of laboratory screening tests

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Saana Eskelinen ◽  
Janne V. J. Suvisaari ◽  
Jaana M. Suvisaari
Keyword(s):  
Cost Effectiveness ◽  
Laboratory Test ◽  
Reference Range ◽  
Health Examination ◽  
Abnormal Result ◽  
Gamma Glutamyltransferase ◽  
Hydroxyvitamin D ◽  
Laboratory Screening ◽  
25 Hydroxyvitamin D ◽  
The Cost

Abstract Background Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied. Methods The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results. Results A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5€ for glucose, all lipids and sodium, and below 10€ for creatinine and gamma glutamyltransferase. Potassium (130€), pH-adjusted ionized calcium (33 €) and thyroid stimulating hormone (33€) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients. Conclusions An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.

scholarly journals Thyroidectomy under Local Anaesthesia; Experience from a Tertiary Hospital in Kumasi, Ghana

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Anna Konney ◽  
Mawutor Dzogbefia ◽  
Philip Oppong Peprah ◽  
Derrick Gyimah ◽  
Isaac Barnor
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Tertiary Referral Hospital ◽  
Thyroid Lobectomy ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
The Cost

Objectives: Improvement in anaesthesia has allowed thyroidectomies to be performed mainly under general anaesthesia. There is however a growing interest in performing thyroid surgery under local or regional anaesthesia. The objective of this study was to analyse and share our experience with safety of thyroidectomy under regional cervical plexus block/ local anaesthesia in a tertiary referral hospital in Ghana. Materials and Methods: A retrospective study was conducted on all patients who had thyroidectomy under local anaesthesia from 1st January 2017 to 31st May 2018 in KATH. Data collected were demography, grade of goitre, operating time, and duration of hospital stay, complications and cost effectiveness of the procedure. Data was analysed using Stata version 16.0software. Results: A total of 105 thyroidectomies were done in the study period out of which 16 were done under local anaesthesia. All 16 patients (16 females, 100%) and majority 11 (68.75%) were aged between 30 and 50 years. 11 (68.75) had grade IB goitres. The most frequently performed surgery was thyroid lobectomy 12 (75%) and in 75% of cases the surgery was completed between 60 and 90 minutes. Most patients, 9 (56.25%) were discharged home within 48 hours following surgery. The cost of treatment was averagely 30% less compared to same surgery under general anaesthesia. No complications were recorded in the post-operative period. Conclusions: Comprehensive clinical assessment and careful patient selection for thyroidectomy under local anaesthesia result in good surgical outcomes. The procedure is safe and cost-effective and should be performed by experienced surgeons for the best outcomes.

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