Show simple item record

dc.contributor.authorDemir, Eren
dc.contributor.authorSouthern, David
dc.contributor.authorVerner, Aimee
dc.contributor.authorAmoaku, Winfried
dc.date.accessioned2018-11-21T12:39:14Z
dc.date.available2018-11-21T12:39:14Z
dc.date.issued2018-10-04
dc.identifier.citationDemir , E , Southern , D , Verner , A & Amoaku , W 2018 , ' A simulation tool for better management of retinal services ' , BMC Health Services Research , vol. 18 , no. 1 , 759 , pp. 759 . https://doi.org/10.1186/s12913-018-3560-5
dc.identifier.issn1472-6963
dc.identifier.otherPURE: 15692842
dc.identifier.otherPURE UUID: 9263d8d1-90e2-4636-a934-f18babefe5ad
dc.identifier.otherScopus: 85054425233
dc.identifier.otherPubMed: 30286750
dc.identifier.urihttp://hdl.handle.net/2299/20814
dc.description.abstractBackground: Advances in the management of retinal diseases have been fast-paced as new treatments become available, resulting in increasing numbers of patients receiving treatment in hospital retinal services. These patients require frequent and long-term follow-up and repeated treatments, resulting in increased pressure on clinical workloads. Due to limited clinic capacity, many National Health Service (NHS) clinics are failing to maintain recommended follow-up intervals for patients receiving care. As such, clear and robust, long term retinal service models are required to assess and respond to the needs of local populations, both currently and in the future. Methods: A discrete event simulation (DES) tool was developed to facilitate the improvement of retinal services by identifying efficiencies and cost savings within the pathway of care. For a mid-size hospital in England serving a population of over 500,000, we used 36 months of patient level data in conjunction with statistical forecasting and simulation to predict the impact of making changes within the service. Results: A simulation of increased demand and a potential solution of the 'Treat and Extend' (T&E) regimen which is reported to result in better outcomes, in combination with virtual clinics which improve quality, effectiveness and productivity and thus increase capacity is presented. Without the virtual clinic, where T&E is implemented along with the current service, we notice a sharp increase in the number of follow-ups, number of Anti-VEGF injections, and utilisation of resources. In the case of combining T&E with virtual clinics, there is a negligible (almost 0%) impact on utilisation of resources. Conclusions: Expansion of services to accommodate increasing number of patients seen and treated in retinal services is feasible with service re-organisation. It is inevitable that some form of initial investment is required to implement service expansion through T&E and virtual clinics. However, modelling with DES indicates that such investment is outweighed by cost reductions in the long term as more patients receive optimal treatment and retain vision with better outcomes. The model also shows that the service will experience an average of 10% increase in surplus capacity.en
dc.language.isoeng
dc.relation.ispartofBMC Health Services Research
dc.rightsOpen
dc.subjectAmbulatory Care Facilities/standards
dc.subjectBevacizumab
dc.subjectComputer Simulation
dc.subjectComputer Systems
dc.subjectCost Savings
dc.subjectData Accuracy
dc.subjectDelivery of Health Care/standards
dc.subjectEngland
dc.subjectHealth Facility Size/statistics & numerical data
dc.subjectHealth Resources
dc.subjectHumans
dc.subjectInvestments
dc.subjectNational Health Programs
dc.subjectQuality of Health Care
dc.subjectRetinal Diseases/therapy
dc.subjectWorkload/statistics & numerical data
dc.titleA simulation tool for better management of retinal servicesen
dc.contributor.institutionHertfordshire Business School
dc.contributor.institutionUniversity of Hertfordshire
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85054425233&partnerID=8YFLogxK
dc.relation.schoolHertfordshire Business School
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-10-04
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/s12913-018-3560-5
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record