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Emergency and on-demand health care: modelling a large complex system

By S.C. Brailsford, V.A. Lattimer, P. Tarnaras and J.C. Turnbull

Abstract

This paper describes how system dynamics was used as a central part of a whole-system review of emergency and on-demand health care in Nottingham, England. Based on interviews with 30 key individuals across health and social care, a 'conceptual map' of the system was developed, showing potential patient pathways through the system. This was used to construct a stock-flow model, populated with current activity data, in order to simulate patient flows and to identify system bottle-necks. Without intervention, assuming current trends continue, Nottingham hospitals are unlikely to reach elective admission targets or achieve the government target of 82% bed occupancy. Admissions from general practice had the greatest influence on occupancy rates. Preventing a small number of emergency admissions in elderly patients showed a substantial effect, reducing bed occupancy by 1% per annum over 5 years. Modelling indicated a range of undesirable outcomes associated with continued growth in demand for emergency care, but also considerable potential to intervene to alleviate these problems, in particular by increasing the care options available in the community

Topics: HD28, HV, RA, RT
Year: 2004
OAI identifier: oai:eprints.soton.ac.uk:9600
Provided by: e-Prints Soton

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Citations

  1. (2001). A comparison of discrete event simulation and system dynamics for modelling healthcare systems. In: Riley J (ed)
  2. (2001). Accident and Emergency Acute Hospital Portfolio: Review of National Findings. Audit Commission:
  3. (1996). By Accident or Design: Improving A&E Services in England and Wales.
  4. G e r a r dKet al (2004). Reviewing emergency care systems II: measuring patient preferences using a discrete choice experiment. Emerg Med J,I np r e s s . doi
  5. L a t t i m e rV Aet al (2004). Reviewing emergency care systems I: insights from system dynamics modelling. Emerg Med J, In press.

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