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        Patient Pathway Modelling Using Discrete Event Simulation to Improve the Management of COPD

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        Demir_et_al.pdf (PDF, 1Mb)
        Author
        Yakutcan, Usame
        Demir, Eren
        Hurst, John
        Taylor, Paul
        Attention
        2299/23758
        Abstract
        The number of people affected by chronic obstructive pulmonary disease (COPD) is increasing and the hospital readmission rate is remarkably high. Therefore, healthcare professionals and managers have financial and workforce-related pressures. A decision support toolkit (DST) for improving the management and efficiency of COPD care is needed to respond to the needs of patients now and in the future. In collaboration with the COPD team of a hospital and community service in London, we conceptualised the pathway for COPD patients and developed a discrete event simulation model (DES) incorporating the dynamics of patient readmissions. A DES model or operational model at this scale has never been previously developed, despite many studies using other modelling and simulation techniques in COPD. Our model is the first of its kind to include COPD readmissions as well as assessing the quantifiable impact of re-designing COPD services. We demonstrate the impact of post-exacerbation pulmonary rehabilitation (PEPR) policy and observe that PEPR would be cost-effective with improvements in quality-adjusted life years (QALYs), reduction in emergency readmissions and occupied bed days. The DST improves the understanding of the impact of scenarios (activities, resources, financial implications etc.) for key decision makers and supports commissioners in implementing the interventions.
        Publication date
        2020-12-30
        Published in
        Journal of the Operational Research Society
        Published version
        https://doi.org/10.1080/01605682.2020.1854626
        Other links
        http://hdl.handle.net/2299/23758
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