Discrete-event simulation applied to analysis of waiting lists. Evaluation of a prioritization system for cataract surgery
Mostra el registre complet Registre parcial de l'ítem
- dc.contributor.author Comas Serrano, Mercè
- dc.contributor.author Castells, Xavier
- dc.contributor.author Hoffmeister Arce, Lorena
- dc.contributor.author Román, Rubén
- dc.contributor.author Cots, Francesc
- dc.contributor.author Mar, Javier
- dc.contributor.author Gutiérrez-Moreno, Santiago
- dc.contributor.author Espallargues, Mireia
- dc.date.accessioned 2025-01-13T08:53:00Z
- dc.date.available 2025-01-13T08:53:00Z
- dc.date.issued 2008
- dc.description.abstract Objectives: To outline the methods used to build a discrete-event simulation model for use in decision-making in the context of waiting list management strategies for cataract surgery by comparing a waiting list prioritization system with the routinely used first-in, first-out (FIFO) discipline. Methods: The setting was the Spanish health system. The model reproduced the process of cataract, from incidence of need of surgery (meeting indication criteria), through demand, inclusion on a waiting list, and surgery. "Nonexpressed Need" represented the population that, even with need, would not be included on a waiting list. Parameters were estimated from administrative data and research databases. The impact of introducing a prioritization system on the waiting list compared with the FIFO system was assessed. For all patients entering the waiting list, the main outcome variable was waiting time weighted by priority score. A sensitivity analysis with different scenarios of mean waiting time was used to compare the two alternatives. Results: The prioritization system shortened waiting time (weighted by priority score) by 1.55 months (95% CI: 1.47 to 1.62) compared with the FIFO system. This difference was statistically significant for all scenarios (which were defined from a waiting time of 4 months to 24 months under the FIFO system). A tendency to greater time savings in scenarios with longer waiting times was observed. Conclusions: Discrete-event simulation is useful in decision-making when assessing health services. Introducing a waiting list prioritization system produced greater benefit than allocating surgery by waiting time only. Use of the simulation model would allow the impact of proposed policies to reduce waiting lists or assign resources more efficiently to be tested.
- dc.format.mimetype application/pdf
- dc.identifier.citation Comas M, Castells X, Hoffmeister L, Román R, Cots F, Mar J, et al. Discrete-event simulation applied to analysis of waiting lists. Evaluation of a prioritization system for cataract surgery. Value Health. 2008 Dec;11(7):1203-13. DOI: 10.1111/j.1524-4733.2008.00322.x
- dc.identifier.doi http://dx.doi.org/10.1111/j.1524-4733.2008.00322.x
- dc.identifier.issn 1098-3015
- dc.identifier.uri http://hdl.handle.net/10230/69086
- dc.language.iso eng
- dc.publisher Elsevier
- dc.relation.ispartof Value Health. 2008 Dec;11(7):1203-13
- dc.rights © Elsevier This is the published version of an article http://dx.doi.org/10.1111/j.1524-4733.2008.00322.x that appeared in the journal [nom-revista]. It is published in an Open Archive under an Elsevier user license. Details of this licence are available here: https://www.elsevier.com/about/our-business/policies/open-access-licenses/elsevier-user-license
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://www.elsevier.com/open-access/userlicense/1.0/
- dc.subject.keyword Cataract extraction
- dc.subject.keyword Computer simulation
- dc.subject.keyword Elective surgical procedures
- dc.subject.keyword Methods
- dc.subject.keyword Prioritization
- dc.subject.keyword Waiting lists
- dc.title Discrete-event simulation applied to analysis of waiting lists. Evaluation of a prioritization system for cataract surgery
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion