Title
A multi-phase DES modelling framework for patient-centred care.
Abstract
We provide a framework for simulating the entire patient journey across different phases (such as diagnosis, treatment, rehabilitation and long-term care) and different sectors (such as GP, hospital, social and community services), with the aim of providing better understanding of such processes and facilitating evaluation of alternative clinical and care strategies. A phase-type modelling approach is used to promote better modelling and management of the specific elements of a patient pathway, using performance measures such as clinical outcomes, patient quality of life, and cost. The approach is illustrated using stroke disease. Approximately 5% of the United Kingdom National Health Service budget is spent treating stroke disease each year. There is an urgent need to assess whether existing services are cost-effective or new interventions could increase efficiency. This assessment can be made using models across primary and secondary care; in particular we evaluate the cost-effectiveness of thrombolysis (clot busting therapy), using discrete event simulation. Using our model, patient quality of life and the costs of thrombolysis are compared under different regimes. In addition, our simulation framework is used to illustrate the impact of internal discharge queues, which can develop while patients are awaiting placement. Probabilistic Sensitivity Analysis of the value parameters is also carried out.
Year
DOI
Venue
2016
10.1057/jors.2015.114
JORS
Keywords
Field
DocType
discrete event simulation (DES), health service, cost benefit, phase-type models
Rehabilitation,Disease,Psychological intervention,Thrombolysis,Quality of life,Computer science,Stroke,Probabilistic logic,Operations management,Management science,Discrete event simulation
Journal
Volume
Issue
ISSN
67
10
0160-5682
Citations 
PageRank 
References 
0
0.34
0
Authors
6
Name
Order
Citations
PageRank
Jennifer Gillespie111.64
Sally Mcclean21029132.29
Lalit Garg3609.85
Maria Barton4122.49
Bryan W. Scotney567082.50
Ken Fullerton6122.49