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dc.contributor.authorStandfield, L
dc.contributor.authorComans, T
dc.contributor.authorRaymer, M
dc.contributor.authorO'Leary, S
dc.contributor.authorMoretto, N
dc.contributor.authorScuffham, P
dc.date.accessioned2018-09-28T07:18:02Z
dc.date.available2018-09-28T07:18:02Z
dc.date.issued2016
dc.identifier.issn1175-5652
dc.identifier.doi10.1007/s40258-016-0246-1
dc.identifier.urihttp://hdl.handle.net/10072/100570
dc.description.abstractBackground: Hospital outpatient orthopaedic services traditionally rely on medical specialists to assess all new patients to determine appropriate care. This has resulted in significant delays in service provision. In response, Orthopaedic Physiotherapy Screening Clinics and Multidisciplinary Services (OPSC) have been introduced to assess and co-ordinate care for semi- and non-urgent patients. Objectives: To compare the efficiency of delivering increased semi- and non-urgent orthopaedic outpatient services through: (1) additional OPSC services; (2) additional traditional orthopaedic medical services with added surgical resources (TOMS + Surg); or (3) additional TOMS without added surgical resources (TOMS − Surg). Methods: A cost-utility analysis using discrete event simulation (DES) with dynamic queuing (DQ) was used to predict the cost effectiveness, throughput, queuing times, and resource utilisation, associated with introducing additional OPSC or TOMS ± Surg versus usual care. Results: The introduction of additional OPSC or TOMS (±surgery) would be considered cost effective in Australia. However, OPSC was the most cost-effective option. Increasing the capacity of current OPSC services is an efficient way to improve patient throughput and waiting times without exceeding current surgical resources. An OPSC capacity increase of ~100 patients per month appears cost effective (A$8546 per quality-adjusted life-year) and results in a high level of OPSC utilisation (98 %). Conclusion: Increasing OPSC capacity to manage semi- and non-urgent patients would be cost effective, improve throughput, and reduce waiting times without exceeding current surgical resources. Unlike Markov cohort modelling, microsimulation, or DES without DQ, employing DES-DQ in situations where capacity constraints predominate provides valuable additional information beyond cost effectiveness to guide resource allocation decisions.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherAdis International
dc.relation.ispartofpagefrom479
dc.relation.ispartofpageto491
dc.relation.ispartofissue4
dc.relation.ispartofjournalApplied Health Economics and Health Policy
dc.relation.ispartofvolume14
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchApplied economics
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.fieldofresearchcode3801
dc.titleThe Efficiency of Increasing the Capacity of Physiotherapy Screening Clinics or Traditional Medical Services to Address Unmet Demand in Orthopaedic Outpatients: A Practical Application of Discrete Event Simulation with Dynamic Queuing
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.facultyGriffith Health, School of Medicine
gro.hasfulltextNo Full Text
gro.griffith.authorScuffham, Paul A.


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