Research output

Article in Journal

Location of services and the impact on healthcare quality: insights from a simulation of a musculoskeletal physiotherapy service

Citation
Bowers J, Mould G & Marshall C (2014) Location of services and the impact on healthcare quality: insights from a simulation of a musculoskeletal physiotherapy service, Journal of the Operational Research Society, 66 (7), pp. 1212-1221.

Abstract
Many healthcare systems are being redesigned to deliver local care with more services within the community. Relocation may enhance access but other aspects of healthcare quality should also be considered, notably waiting times and equity of care. This study examined a musculoskeletal physiotherapy service using a discrete-event simulation with simple heuristics to model patient behaviour. This combination provided an effective mechanism for incorporating the individuality of the patients in the flows along the patient pathways, subject to the varying availabilities of key resources. In particular, it captured the feedback that is critical in system performance, especially where waiting times are important. The model recognised the heterogeneity of patient attitudes and demonstrated how the behaviour of a relatively small proportion can affect the experience of all patients. The study suggested that, with careful operational management, more care could be delivered locally while exploiting many of the benefits of a centralised service.

Keywords
simulation; health service; behaviour; location; quality

StatusPublished
AuthorsBowers John, Mould Gillian, Marshall Carol
Publication date online15/10/2014
Date accepted by journal04/09/2014
PublisherPalgrave Macmillan
ISSN 0160-5682
LanguageEnglish

Journal
Journal of the Operational Research Society: Volume 66, Issue 7

© University of Stirling FK9 4LA Scotland UK • Telephone +44 1786 473171 • Scottish Charity No SC011159
My Portal