Bed capacity and surgical waiting lists: a simulation analysis

Manel Antelo,Adela Martinez Calvo,Francisco Reyes Santias

doi:10.17979/ejge.2015.4.2.4310

Manel Antelo, Adela Martinez Calvo + Show 1 more

Open Access

https://doi.org/10.17979/ejge.2015.4.2.4310

Copy DOI

Abstract

Waiting time for elective surgery is a key problem in the current medical world. This paper aims to reproduce, by a Monte Carlo simulation model, the relationship between hospital capacity, inpatient activity, and surgery waiting list size in teaching hospitals. Inpatient activity is simulated by fitting a Normal distribution to real inpatient activity data, and the effect of the number of beds on inpatient activity is modelled with a linear regression model. Analysis is performed with data of the University Multi-Hospital Complex of Santiago de Compostela (Santiago de Compostela, Spain), by considering two scenarios regarding the elastiticity of demand with bed increase. If demand does not grow with an increase on bed capacity, small changes lead to drastic reductions in the waiting lists. However, if demand grows as bed capacity does, adding additional capacity merely makes waiting lists worse.

Highlights

A waiting list for healthcare is a queue of patients who have been given a care procedure but, due to reasons beyond their control, must wait to be served within a variable time period (Sampietro and Espallargues, 2001)
This paper is focused on analysing the situation in one of these hospitals, namely the University Multi-Hospital Complex of Santiago de Compostela2 (Santiago de Compostela, Spain) we examine the impact of bed capacity—a scarce and expensive input in healthcare—on daily inpatient activity, patients’ length of stay and, waiting lists in a teaching hospital like the above mentioned
Waiting time for elective surgery is a significant problem in the current medical world

Summary

Introduction

A waiting list for healthcare is a queue of patients who have been given a care procedure but, due to reasons beyond their control, must wait to be served within a variable time period (Sampietro and Espallargues, 2001). Though waiting lists are common in different healthcare fields (both primary and specialty care), healthcare levels (outpatient and hospital care), and therapeutic procedures (surgical and nonsurgical), diagnostic and rehabilitative (Churruca, 2000), surgical waiting lists are those commonly discussed. These are often studied due to their major problems of morbidity and mortality, as well as their greater economic impact (Richards, 1999; Silber et al, 1996). Productive capacity usually refers to resources such as staff, beds, operating theatres, and community-based health centers, just to name a few, the two main resources in hospital production function are personnel and number of beds (often considered a rough proxy for capital endowment).

Objectives

Findings

Discussion

Conclusion