Application of a computational model in simulating an endovascular clot retrieval service system within regional Australia.

Autor: Ren Y; Interventional Neuroradiology Service - Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia., Phan M; Monash Health, Melbourne, Victoria, Australia., Luong P; School of Science, Computer Science and Information Technology, RMIT University, Melbourne, Victoria, Australia., Wu J; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia., Shell D; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia., Barras CD; South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia.; Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia., Chryssidis S; Department of Medical Imaging, Flinders Medical Centre, Adelaide, South Australia, Australia., Kok HK; Interventional Radiology Service - Department of Radiology, Northern Health, Melbourne, Victoria, Australia., Burney M; Deloitte, Sydney, New South Wales, Australia., Tahayori B; Department of Biomedical Engineering, The University of Melbourne, Melbourne, Victoria, Australia., Maingard J; Interventional Neuroradiology Service - Department of Radiology, Monash Health, Melbourne, Victoria, Australia.; School of Medicine - Faculty of Health, Deakin University, Geelong, Victoria, Australia., Jhamb A; Interventional Radiology Service - Department of Radiology, St Vincent's Hospital, Melbourne, Victoria, Australia., Thijs V; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.; Department of Neurology, Austin Health, Melbourne, Victoria, Australia., Brooks DM; Interventional Neuroradiology Service - Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia.; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia., Asadi H; Interventional Neuroradiology Service - Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia.; Interventional Neuroradiology Service - Department of Radiology, Monash Health, Melbourne, Victoria, Australia.; School of Medicine - Faculty of Health, Deakin University, Geelong, Victoria, Australia.; Interventional Radiology Service - Department of Radiology, St Vincent's Hospital, Melbourne, Victoria, Australia.; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of medical imaging and radiation oncology [J Med Imaging Radiat Oncol] 2021 Dec; Vol. 65 (7), pp. 850-857. Date of Electronic Publication: 2021 Jun 08.
DOI: 10.1111/1754-9485.13255
Abstrakt: Introduction: The global demand for endovascular clot retrieval (ECR) has grown rapidly in recent years creating challenges to healthcare system planning and resource allocation. This study aims to apply our established computational model to predict and optimise the performance and resource allocation of ECR services within regional Australia, and applying data from the state of South Australia as a modelling exercise.
Method: Local geographic information obtained using the Google Maps application program interface and real-world data was input into the discrete event simulation model we previously developed. The results were obtained after the simulation was run over 5 years. We modelled and compared a single-centre and two-centre ECR service delivery system.
Results: Based on the input data, this model was able to simulate the ECR delivery system in the state of South Australia from the moment when emergency services were notified of a potential stroke patient to potential delivery of ECR treatment. In the model, ECR delivery improved using a two-centre system compared to a one-centre system, as the percentage of stroke patients requiring ECR was increased. When 15% of patients required ECR, the proportion of 'failure to receive ECR' cases for a single-centre system was 17.35%, compared to 3.71% for a two-centre system.
Conclusions: Geolocation and resource utilisation within the ECR delivery system are crucial in optimising service delivery and patient outcome. Under the model assumptions, as the number of stroke cases requiring ECR increased, a two-centre ECR system resulted in increased timely ECR delivery, compared to a single-centre system. This study demonstrated the flexibility and the potential application of our DES model in simulating the stroke service within any location worldwide.
(© 2021 The Royal Australian and New Zealand College of Radiologists.)
Databáze: MEDLINE
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