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dc.contributor.authorDemir, Eren
dc.contributor.authorSouthern, David
dc.contributor.authorRashid, Syed
dc.contributor.authorLebcir, Mohamed
dc.date.accessioned2019-01-03T01:16:36Z
dc.date.available2019-01-03T01:16:36Z
dc.date.issued2018-12-04
dc.identifier.citationDemir , E , Southern , D , Rashid , S & Lebcir , M 2018 , ' A Discrete Event Simulation model to evaluate the treatment pathways of patients with Cataract in the United Kingdom ' , BMC Health Services Research , vol. 18 , no. 1 , 933 . https://doi.org/10.1186/s12913-018-3741-2
dc.identifier.issn1472-6963
dc.identifier.otherPURE: 15787347
dc.identifier.otherPURE UUID: b2c9aa50-07b4-4ad0-8fee-730db85fc5f4
dc.identifier.otherScopus: 85057615817
dc.identifier.urihttp://hdl.handle.net/2299/20908
dc.description.abstractBackground The number of people affected by cataract in the United Kingdom (UK) is growing rapidly due to ageing population. As the only way to treat cataract is through surgery, there is a high demand for this type of surgery and figures indicate that it is the most performed type of surgery in the UK. The National Health Service (NHS), which provides free of charge care in the UK, is under huge financial pressure due to budget austerity in the last decade. As the number of people affected by the disease is expected to grow significantly in coming years, the aim of this study is to evaluate whether the introduction of new processes and medical technologies will enable cataract services to cope with the demand within the NHS funding constraints. Methods We developed a Discrete Event Simulation model representing the cataract services pathways at Leicester Royal Infirmary Hospital. The model was inputted with data from national and local sources as well as from a surgery demand forecasting model developed in the study. The model was verified and validated with the participation of the cataract services clinical and management teams. Results Four scenarios involving increased number of surgeries per half-day surgery theatre slot were simulated. Results indicate that the total number of surgeries per year could be increased by 40% at no extra cost. However, the rate of improvement decreases for increased number of surgeries per half-day surgery theatre slot due to a higher number of cancelled surgeries. Productivity is expected to improve as the total number of doctors and nurses hours will increase by 5 and 12% respectively. However, non-human resources such as pre-surgery rooms and post-surgery recovery chairs are under-utilized across all scenarios. Conclusions Using new processes and medical technologies for cataract surgery is a promising way to deal with the expected higher demand especially as this could be achieved with limited impact on costs. Non-human resources capacity need to be evenly levelled across the surgery pathway to improve their utilisation. The performance of cataract services could be improved by better communication with and proactive management of patients.en
dc.language.isoeng
dc.relation.ispartofBMC Health Services Research
dc.rightsOpen
dc.subjectCataract
dc.subjectDiscrete event simulation
dc.subjectHealth operations management
dc.subjectNational Health Service
dc.subjectUnited Kingdom
dc.subjectHealth Policy
dc.titleA Discrete Event Simulation model to evaluate the treatment pathways of patients with Cataract in the United Kingdomen
dc.contributor.institutionHertfordshire Business School
dc.contributor.institutionStatistical Services Consulting Unit
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85057615817&partnerID=8YFLogxK
dc.relation.schoolHertfordshire Business School
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-12-04
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/s12913-018-3741-2
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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