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dc.contributor.authorMelman, GJen
dc.contributor.authorParlikad, Ajithen
dc.contributor.authorCameron, EABen
dc.date.accessioned2021-01-27T00:30:07Z
dc.date.available2021-01-27T00:30:07Z
dc.date.issued2021-06en
dc.identifier.issn1386-9620
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/316742
dc.description.abstractCOVID-19 has disrupted healthcare operations and resulted in large-scale cancellations of elective surgery. Hospitals throughout the world made life-altering resource allocation decisions and prioritised the care of COVID-19 patients. Without effective models to evaluate resource allocation strategies encompassing COVID-19 and non-COVID-19 care, hospitals face the risk of making sub-optimal local resource allocation decisions. A discrete-event-simulation model is proposed in this paper to describe COVID-19, elective surgery, and emergency surgery patient flows. COVID-19-specific patient flows and a surgical patient flow network were constructed based on data of 475 COVID-19 patients and 28,831 non-COVID-19 patients in Addenbrooke's hospital in the UK. The model enabled the evaluation of three resource allocation strategies, for two COVID-19 wave scenarios: proactive cancellation of elective surgery, reactive cancellation of elective surgery, and ring-fencing operating theatre capacity. The results suggest that a ring-fencing strategy outperforms the other strategies, regardless of the COVID-19 scenario, in terms of total direct deaths and the number of surgeries performed. However, this does come at the cost of 50% more critical care rejections. In terms of aggregate hospital performance, a reactive cancellation strategy prioritising COVID-19 is no longer favourable if more than 7.3% of elective surgeries can be considered life-saving. Additionally, the model demonstrates the impact of timely hospital preparation and staff availability, on the ability to treat patients during a pandemic. The model can aid hospitals worldwide during pandemics and disasters, to evaluate their resource allocation strategies and identify the effect of redefining the prioritisation of patients
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherSpringer
dc.rightsAll rights reserved
dc.subjectHumansen
dc.subjectCritical Careen
dc.subjectEquipment and Supplies, Hospitalen
dc.subjectResource Allocationen
dc.subjectOperating Roomsen
dc.subjectHospitalsen
dc.subjectEfficiency, Organizationalen
dc.subjectPandemicsen
dc.subjectElective Surgical Proceduresen
dc.subjectUnited Kingdomen
dc.subjectCOVID-19en
dc.subjectSARS-CoV-2en
dc.titleBalancing scarce hospital resources during the COVID-19 pandemic using discrete-event simulation.en
dc.typeArticle
prism.endingPage374
prism.issueIdentifier2en
prism.publicationDate2021en
prism.publicationNameHealth care management scienceen
prism.startingPage356
prism.volume24en
dc.identifier.doi10.17863/CAM.63856
dcterms.dateAccepted2021-01-25en
rioxxterms.versionofrecord10.1007/s10729-021-09548-2en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2021-06en
dc.contributor.orcidMelman, GJ [0000-0002-8920-8435]
dc.contributor.orcidParlikad, Ajith [0000-0001-6214-1739]
dc.identifier.eissn1572-9389
rioxxterms.typeJournal Article/Reviewen
cam.orpheus.successMon Apr 12 07:31:28 BST 2021 - Embargo updated*
cam.orpheus.counter10*
rioxxterms.freetoread.startdate2022-04-09


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