The use of modelling studies to inform planning of health services: case study of rapidly increasing endoscopy services in Australia
| Autor: | Nicholas Graves, Michael Zanco, Dylan Knowles, Nick Steele, Mark Appleyard, Timothy J. Moroney, Tony Rahman, Hannah E. Carter, Gerald Holtmann |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Population ageing Waiting Lists Cost effectiveness Cost-Benefit Analysis Waiting list Decision Making Discrete event simulation Health informatics Service planning Endoscopy Gastrointestinal Health administration 03 medical and health sciences 0302 clinical medicine Intestinal Neoplasms medicine Humans Operations management 030212 general & internal medicine Early Detection of Cancer Service (business) Models Statistical Cost–benefit analysis business.industry Hospitals Public lcsh:Public aspects of medicine 030503 health policy & services Health Policy Public health Australia lcsh:RA1-1270 Endoscopy Quality-adjusted life year Health Planning Cost-effectiveness Quality-Adjusted Life Years 0305 other medical science business Research Article Model |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 19, Iss 1, Pp 1-8 (2019) |
| ISSN: | 1472-6963 |
| Popis: | Background Demand for gastrointestinal endoscopy in Australia is increasing as a result of the expanding national bowel cancer screening program and a growing, ageing population. More services are required to meet demand and ensure patients are seen within clinically recommended timeframes. Methods A discrete event simulation model was developed to project endoscopy waiting list outcomes for two large metropolitan health services encompassing 8 public hospitals in Australia. The model applied routinely collected health service data to forecast the impacts of future endoscopic demand over 5 years and to identify the level of service activity required to address patient waiting times and meet key policy targets. The approach incorporated evidence from the literature to produce estimates of cost-effectiveness by showing longer term costs and Quality Adjusted Life Years (QALYs) associated with service expansion. Results The modelling revealed that doing nothing would lead to the number of patients waiting longer than clinically recommended doubling across each health service within 5 years. A 38% overall increase in the number of monthly procedures available was required to meet and maintain a target of 95–98% of patients being seen within clinically recommended timeframes to the year 2021. This was projected to cost the funder approximately $140 million in additional activity over a 5 year period. Due to improved patient outcomes associated with timely intervention, it was estimated that the increased activity would generate over 22,000 additional QALYs across the two health services. This translated to an incremental cost-effectiveness ratio of $6467 and $5974 per QALY for each health service respectively. Conclusions Discrete event simulation modelling provided a rational, data based approach that allowed decision makers to quantify the future demand for endoscopy services and identify cost-effective strategies to meet community needs. Electronic supplementary material The online version of this article (10.1186/s12913-019-4438-x) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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