Simulation Modeling of Healthcare Delivery

2011 ◽  
pp. 69-89
Author(s):  
Ian W. Gibson
Keyword(s):  
Simulation Modeling ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Healthcare Delivery System ◽  
Scarce Resources ◽  
Power Simulation ◽  
Modeling Analysis ◽  
Management Techniques ◽  
The Cost ◽  
Delivery Models

Healthcare has delivered incredible improvements in diagnosis and treatment of diseases but faces challenges to improve the delivery of services. Healthcare is a complex system using expensive and scarce resources. Benchmarking, experience, and lean management techniques currently provide the basis for developing service delivery models and facility planning. Simulation modeling can supplement these methods to enable a better understanding of the complex systems involved. This provides the basis for developing and evaluating options to provide improved healthcare delivery. Simulation modeling enables a better understanding of the processes and the resources used in delivering healthcare services and improving healthcare delivery systems. Options to improve the cost effectiveness can be evaluated without experimenting with patients. This chapter reviews the current challenges and methods including the use of simulation modeling. Analysis of emergency patient flows through a major hospital shows the capability of simulation modeling to enable improvement of the healthcare delivery system. This chapter enables healthcare managers to understand the power simulation modeling brings to the improvement of healthcare delivery.

Active and Healthy Aging

2017 ◽  
pp. 369-391
Author(s):  
Emine Özmete
Keyword(s):  
Qualitative Research ◽  
Delivery System ◽  
Healthy Aging ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Capital City ◽  
Elderly Persons ◽  
Healthcare Delivery System ◽  
Care And Support ◽  
Depth Interviews

This study aims to investigate the difficulties experienced by elderly persons in accessing healthcare services and their satisfaction with issues as regards the healthcare system. In this study, qualitative research was carried out to assess the difficulties regarding the healthcare delivery system and satisfaction with the healthcare services. This qualitative research was performed through in-depth interviews with 6 men and 4 women aged 65+ years, in Ankara, the capital city of Turkey. It was discovered that elderly persons required the support of others to access a doctor, a health institution or hospital and the care and support of others for the regular intake of their drugs with increasing age. They were satisfied with the current family physician program. The most significant challenges experienced by elderly persons regarding the healthcare delivery system included crowded hospitals, difficulty walking, the unavailability of wheel chairs, and inadequate assistance from support staff.

scholarly journals Towards a Shariah Compliance Model for Healthcare Centres with reference to Spiritual Healers: Issues and Challenges

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Ramizah Wan Muhammad
Keyword(s):  
Public Health ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Healthcare Delivery System ◽  
Factors Affecting ◽  
Healthcare Centre ◽  
The Public ◽  
The People ◽  
Spiritual Healers

Generally, a good healthcare centre comprises of qualified manpower, right policies and right procedures in providing primary care, secondary care and tertiary care for the patients as well as in public health. Other than manpower, healthcare centres must also look at social, religious and cultural factors affecting the recipients of the healthcare services given by the healthcare centres. In this paper, the author will look at some pertinent issues such as the need to have spiritual healers in any healthcare centre to help the patients in dealing with fatal illness. The spiritual healer is to help the patient and give him motivation so that he could have a positive mind throughout his journey in battling with his illness. Sometimes we have patients who refused to listen to the doctor's advice. Thus, the role of the spiritual healer would be important in assisting the healthcare centres and its management to convince him. Another issue is the privacy, respect and trust between patients and doctors as well as with the management of the healthcare centres. One of the duties of the healthcare centres’ management and doctors is, to respect the patient's religion and his faith. These three issues are amongst the important issues which every healthcare centre must look upon. Definitely there are a lot of challenges in addressing the above mentioned issues such as the procedures, methods on how to execute these issues and most importantly the perception of the public. In Islam, health care is one of the five important elements in which the Prophet SAW has mentioned in one hadith to be taken care of. A study has shown that a nation-building efforts has no meaningwithout the best public health and healthcare delivery system to the people.

scholarly journals Investigating Perceptions of Patients on Healthcare Pricing Within The Private Healthcare Sector In Sri Lanka

2021 ◽  
Vol 16 (3) ◽  
pp. 235-242
Author(s):  
Kanchana Sajeeva Narangoda ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Sri Lanka ◽  
Private Sector ◽  
Healthcare Delivery ◽  
Target Population ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Sufficient Evidence ◽  
Healthcare Delivery System ◽  
Private Hospitals ◽  
Private Healthcare

Demand for private sector healthcare services in Sri Lanka is on the rise. This is very evident from the increase in the number of registered private healthcare institutions from 1990 to 2017. [1,2] With the increasing utilization of private sector healthcare services, various qualitative factors,  and service-related issues associated with the healthcare delivery system have become common debates. A major concern, patients have expressed, is about the fees charged by doctors and hospitals. Principle aim of this study was to investigate the perceptions of patients on healthcare pricing within the private healthcare sector in Sri Lanka. The target population of the study was defined as Sri Lankans who have been inpatients in private hospitals within the past year. The focus districts were Colombo, Kandy, and Galle. These 3 districts represented nearly 60% of the total private sector bed capacity. From each district, three main private hospitals were selected. Over 700 patients were invited to participate, 246 surveys were completed, and 215 were retained as 31 had excessive missing and/or unclear data. In all 3 districts the majority of patients were either dissatisfied with or remained neutral (69%) on the hospital fees,(66%) on doctor’s fees,(74%) on the overall price they ended up paying,(76%)  on whether they think the healthcare services they received are value for money. This study did not investigate the reasons or the factors that may affect the satisfaction or dissatisfaction of patients towards the fees they paid Multiple factors can affect patient’s perception on the fees they paid. With negative perception on the above it can be concluded that there is sufficient evidence to challenge private sector healthcare satisfaction level vs price/fees equilibrium in Sri Lanka.

scholarly journals 1107. The MAAGE Study: Health Care Utilization for the Treatment of Medically Attended Acute Gastroenteritis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S331-S332
Author(s):  
Claire P Mattison ◽  
Holly Groom ◽  
Judy Donald ◽  
S Bianca Salas ◽  
Zachary Marsh ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Acute Gastroenteritis ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Care Utilization ◽  
Comorbid Condition ◽  
Inpatient Setting ◽  
Healthcare Delivery System ◽  
Kaiser Permanente ◽  
Demographic Patterns

Abstract Background Acute gastroenteritis (AGE) exacts a substantial disease burden across the age spectrum, although healthcare utilization for AGE is not well characterized. Through active surveillance of medically attended acute gastroenteritis (MAAGE) encounters within a large, integrated healthcare delivery system, we analyzed demographic patterns of healthcare utilization among AGE patients. Methods From April 1, 2014 to September 30, 2016, we collected information on all MAAGE encounters in Kaiser Permanente Northwest (KPNW) patients through daily abstraction from electronic health records using ICD-9/-10 codes. For each patient, a MAAGE episode was defined as all MAAGE encounters <30 days apart. Results There were 109,493 MAAGE encounters among 39,451 patients. Patients were 60.4% female and 39.6% male; 10.3% were <5 years old, 9.7% were 5–17, 31.1% were 18–44, 25.4% were 45–64, and 23.5% were ≥65. Among those with known race, 87.2% were white; 4.1% were Asian, 3.6% were black, and 5.1% were other or multiple races. Prevalence of any chronic comorbid condition was 52.9%. Of 52,107 MAAGE episodes, 81.0% first presented as outpatients; this was most common in those aged <5 (92.1%) and decreased with age to 75.0% in those ≥65. First presenting remotely (email or telephone) ranged from 4.0% in those aged <5 to 19.3% in those ≥65; 52.7% of episodes first presenting remotely had no subsequent visits. Few episodes first presented to an emergency department (3.8% in <5 year olds to 6.6% in 18–44 year olds) or inpatient setting (0.1% in <5 year olds to 1.7% in ≥65 year olds). Most MAAGE episodes comprised of one encounter (median: 1.0, mean: 2.1). The number of encounters per episode was lowest in those <5 years old (median: 1.0, mean: 1.5) and highest in those ≥65 (median: 2.0, mean: 2.5). Most deaths within 30 days from the start of an episode (131/161) were in those ≥65; there were none in those <5, 1 in those 5–17, 5 in those 18–44, and 24 in those 45–64. Conclusion We found that the number of encounters per MAAGE episode increased with age and that outpatient and remote encounters are important settings for the initial clinical management of MAAGE in all ages. These data can help to better quantify the economic burden of AGE and guide appropriate delivery of healthcare services. Disclosures All authors: No reported disclosures.

Application of Fuzzy Soft Set in Patients' Prioritization

2017 ◽  
pp. 221-244 ◽  
Author(s):  
Samira Abbagholizadeh Rahimi
Keyword(s):  
Healthcare Delivery ◽  
Healthcare Services ◽  
Medical Community ◽  
Healthcare Organizations ◽  
Soft Sets ◽  
Scarce Resources ◽  
Fuzzy Soft Sets ◽  
Treat All ◽  
United States Healthcare

Based on studies, access to healthcare services and long waiting time is one of the main issues in many countries including Canada and United States. Healthcare organizations can't increase their limited resources nor treat all patients simultaneously. Then, patients' access to these services should be prioritized in a way that best uses the scarce resources and insures patients' safety. Prioritization is essential and inevitable not only because of resource shortage, which have not been improved during years, but also because it is a crucial issue that could contribute to the capability and stability of the healthcare systems, and most importantly to patients' safety. On the other hand, inappropriate prioritization of patients waiting for treatment, could affect directly on inefficiencies in healthcare delivery, quality of care, and most importantly on patients' safety and their quality of life and satisfaction. Inspired by these facts, in this chapter the importance of patients' prioritization and using fuzzy logic in this area will be discussed, and a novel hybrid framework using fuzzy soft sets for patients' prioritization will be proposed. The proposed framework may have a significant impact on patients' safety, and on both medical community and the public's faith in justice and equity.

Active and Healthy Aging

2017 ◽  
pp. 384-406
Author(s):  
Emine Özmete
Keyword(s):  
Qualitative Research ◽  
Delivery System ◽  
Healthy Aging ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Capital City ◽  
Elderly Persons ◽  
Healthcare Delivery System ◽  
Care And Support ◽  
Depth Interviews

This study aims to investigate the difficulties experienced by elderly persons in accessing healthcare services and their satisfaction with issues as regards the healthcare system. In this study, qualitative research was carried out to assess the difficulties regarding the healthcare delivery system and satisfaction with the healthcare services. This qualitative research was performed through in-depth interviews with 6 men and 4 women aged 65+ years, in Ankara, the capital city of Turkey. It was discovered that elderly persons required the support of others to access a doctor, a health institution or hospital and the care and support of others for the regular intake of their drugs with increasing age. They were satisfied with the current family physician program. The most significant challenges experienced by elderly persons regarding the healthcare delivery system included crowded hospitals, difficulty walking, the unavailability of wheel chairs, and inadequate assistance from support staff.

A Review of Ergonomics and Simulation Modeling in Healthcare Delivery System

2013 ◽  
Vol 845 ◽  
pp. 604-608 ◽  
Author(s):  
Ali Anjomshoae ◽  
Adnan Hassan ◽  
Mat Rebi Abdul Rani
Keyword(s):  
Patient Safety ◽  
Delivery System ◽  
Simulation Modeling ◽  
Clinical Performance ◽  
Healthcare Delivery ◽  
Medication Administration ◽  
High Rate ◽  
Healthcare Delivery System ◽  
Medication Administration Error ◽  
Administration Error

This paper is an overview of recent issues in determining healthcare delivery systems and aims to explain how Human Factor and Ergonomics (HFE) and simulation modeling can contribute to the quality of patient safety and healthcare delivery. It has been found that the layout of the patient unit and resources are significant factors that influence the amount of medication errors and therefore should be included in any description of the research context. Therefore current trends and applications of HFE as well as simulation modeling and how they can contribute to provide safe, efficient, and effective service to the patients are discussed. This review provides previous work of researchers to identify relationships between these two areas of research, particularly in patient safety. The review suggests that, high rate of medication administration error is due to inefficient healthcare delivery system and highlights the efficiency of simulation modeling versus ergonomics in analyzing the root cause of problems in clinical performance.

scholarly journals India’s RMNCH+A Strategy: approach, learnings and limitations

2019 ◽  
Vol 4 (3) ◽  
pp. e001162 ◽  
Author(s):  
Gunjan Taneja ◽  
Vegamadagu Suryanarayana-Rao Sridhar ◽  
Jaya Swarup Mohanty ◽  
Anurag Joshi ◽  
Pranav Bhushan ◽  
...  
Keyword(s):  
Health Planning ◽  
Healthcare Delivery ◽  
Monitoring And Evaluation ◽  
Healthcare Services ◽  
Evaluation Framework ◽  
Public Healthcare ◽  
Healthcare Delivery System ◽  
District Health ◽  
Public Health Challenges ◽  
The Government

Building on the gains of the National Health Mission, India’s Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) Strategy, launched in 2013, was a milestone in the country’s health planning. The strategy recognised the interdependence of RMNCH+A Interventions across the life stages and adopted a comprehensive approach to address inequitable distribution of healthcare services for the vulnerable population groups and in poor-performing geographies of the country. Based on innovative approaches and management reforms, like selection of poor-performing districts, prioritisation of high-impact RMNCH+A healthcare interventions, engagement of development partners and institutionalising a concurrent monitoring system the strategy strived to improve efficiency and effectiveness within the public healthcare delivery system of the country. 184 High Priority Districts were identified across the country on a defined set of indicators for implementation of critical RMNCH+A Interventions and a dedicated institutional framework comprising National and State RMNCH+A Units and District Level Monitors supported by the development partners was established to provide technical support to the state and district health departments. Health facilities based on case load and available services across the High Priority Districts were prioritised for strengthening and were monitored by an RMNCH+A Supportive Supervision mechanism to track progress and generate evidence to facilitate actions for strengthening ongoing interventions. The strategy helped develop an integrated systems-based approach to address public health challenges through a comprehensive framework, defined priorities and robust partnerships with the partner agencies. However, lack of a robust monitoring and evaluation framework and sub-optimal focus on social determinants of health possibly limited its overall impact and ability to sustain improvements. Guided by the learnings and limitations, the Government of India has now designed the ‘Aspirational Districts Program’ to holistically address health challenges in poor-performing districts within the overall sociocultural domain to ensure inclusive and sustained improvements.

scholarly journals Health Status and Health Determinants of Older Immigrant Women in Canada: A Scoping Review

2021 ◽  
Author(s):  
Sepali Guruge ◽  
Birpreet Birpreet ◽  
Joan A. Samuels-Dennis
Keyword(s):  
Health Status ◽  
Health Beliefs ◽  
Scoping Review ◽  
Immigrant Women ◽  
Healthcare Access ◽  
Cultural Beliefs ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Health Determinants ◽  
Healthcare Delivery System

Increasing international migration in the context of aging populations makes a comprehensive understanding of older immigrant women’s health status and determinants of their health particularly urgent. Using Arksey and O’Malley’s framework, we conducted a scoping review to examine the available literature on the health of older immigrant women in Canada. We searched CINAHL, PsycINFO, Embase,Medline, and Cochrane databases for the period of 1990 to 2014 for Canadian-based, peer-reviewed studies on the topic. A total of 20 articles met the inclusion criteria.These articles were divided into six areas of focus: physical health; mental health; abuse; health promotion and chronic disease prevention; barriers to healthcare access and utilization; and health beliefs, behaviours, and practices. Our results show that the health of older immigrant women is affected by the interplay of various social determinants of health including the physical and social environment; economic conditions; cultural beliefs; gendered norms; and the healthcare delivery system. Our results also revealed that older immigrant women tend to have more health problems, underutilize preventive services, such as cancer screening, and experience more difficulties in accessing healthcare services.

Postcrisis redevelopment of sustainable healthcare systems

2014 ◽  
Vol 9 (4) ◽  
pp. 247-258 ◽  
Author(s):  
Koren V. Kanadanian, MS ◽  
Constance K. Haan, MD, MS, MA
Keyword(s):  
Healthcare Delivery ◽  
Systems Design ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Delivery Of Healthcare ◽  
Healthcare Delivery System ◽  
Community Stakeholders ◽  
Proposed Model ◽  
Successful Recovery ◽  
Primary Focus

Objective: Research and field experience have identified a global gap in postdisaster rebuilding of healthcare systems due to the current primary focus on returning devastated community infrastructures to predisaster conditions. Disasters, natural or man-made, present an opportunity for communities to rebuild, restructure, and redefine their predisaster states, creating more resilient and sustainable healthcare systems. Design: A model for sustainable postdisaster healthcare rebuilding was developed by bridging identified gaps in the literature on the processes of developing healthcare systems postdisaster and utilizing evidence from the literature on postdisaster community reconstruction.Results: The proposed model—the Sustainable Healthcare Redevelopment Model—is designed to guide communities through the process of recovery, and identifies four stages for rebuilding healthcare systems: (1) response, (2) recovery, (3) redevelopment, and (4) sustainable development. Implementing sustainable healthcare redevelopment involves a bottom-up approach, where community stakeholders have the ability to influence policy decisions. Relationships within internal government agencies and with public-private partnerships are necessary for successful recovery. Conclusion: The Sustainable Healthcare Redevelopment Model can serve as a guideline for delivery of healthcare services following disaster or conflict and use of crisis as a window of opportunity to improve the healthcare delivery system and incorporate resilience into the healthcare infrastructure.

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