HA 2012 Abstracts

Full Papers
Paper Nr: 1

MetSim: A Simulation Decision Support Tool using Meteorological Information for Short-Term Planning of Hospital Services


Paul Harper, John Minty, Sujit Sahu, Bernard Baffour and Christophe Sarran

Abstract: Improved short-term predictions of hospital admissions and bed occupancy offer the potential to plan resource needs more accurately and effectively. The MetSim project explores the relationship between weather and health, building novel Bayesian models that are more sensitive to fluctuations in weather. Short-term forecasts of the numbers of admissions, categorised by age, gender and medical condition, are produced. In turn, coupled with predictions on length of stay and information on current occupancy, MetSim uses hazard ratios embedded within a simulation framework to provide forecasts of short-term bed needs. MetSim is a collaboration between Cardiff University, the University of Southampton, and the Met Office. Cardiff and Vale University Health Board and Southampton University Hospitals NHS Trust have guided the development of MetSim, provided data and piloted the tool.

Paper Nr: 2

Sensitivity Analysis in Bed Capacity Studies including the Medical Staff’s Decision Making


Cristina Azcárate, Julio Barado and Fermín Mallor

Abstract: This paper deals with capacity planning studies in intensive care units (ICU). Our aim is to provide a framework in which the discharge policy from an ICU can be modelled and included in a simulation model. This is a very unique contribution of this research. We highlight the influence of the assumed policy in the ICU quality of service. A high quality of service means a low percentage of rejected patients and a length of stay in the ICU as long as necessary for the patient recovery. We introduce a parameterized set of rules to mathematically model the discharging decisions made by the physicians of an ICU. Then we present a sensitivity study carried out for the ICU of the Hospital of Navarra in Spain. The set of discharge policies is represented in the space of the performance measures to distinguish efficient from no efficient policies. Finally, the sensitivity analysis is extended, firstly, by considering variation in the number of beds and, then, by varying the patient arrival ratio.

Paper Nr: 3

How to Build an Agent-based Model to Assess the Impact of Co-payment for Health Services


Angela Testi, Michele Sonnessa and Elena Tànfani

Abstract: Some forms of co-payment are required in insurance markets to avoid moral hazard that in health sector entails excessive consumption and costs. Literature and empirical findings, however, do not agree about the effectiveness of co-payment in practical situations. Moreover, in health systems co-payment seems to be more aimed to help in financing than to reduce moral hazard. The final impact of co-payment is rather difficult to predict due to these conflicting aims. Assessing the impact of a co-payment policy is, however, very important, because it affects also the principles of universalistic health systems threatening equity attainment. The specific aim of this paper is to propose an Agent-based simulation model that allows both i) to take into account all these contradictory effects at the same time, ii) to compare different co-payment models. The model development is presented mixing empirical data with some stochastic assumptions the authors intend to test.