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CAPACITY EVALUATION AND PLANNING IN INTENSIVE CARE UNITS: SIMULATION MODELING FOR LEVEL III HOSPITALS

Yıl 2023, Cilt: 25 Sayı: 2, 599 - 620, 15.06.2023
https://doi.org/10.16953/deusosbil.1254173

Öz

Health systems are human based systems comprising a high number of stakeholders who interact with each other in complex ways. Due to the stochastic nature of health systems and the complex dynamics and interactions of their inputs, processes and outputs; providers of health services require tools tat allow them to comprehend the said complexity and improve system performance. Intensive care units (ICUs) may fall short in treating patients due to insufficient capacity and patients may be transferred to other hospitals under certain circumstances, and waiting times can get longer. Efficient use and management of a scarce resource such as the ICU is of critical importance for trouble-free operation of a hospital. Capacity planning, in other words, determination of optical bed configuration based on current knowledge of future demand and capacity, is very difficult due to high uncertainty in both bed capacity and demand. The paper at hand proposes a simulation model to allow an easier decision-making process in the planning of bed capacity in ICU. The study focuses on improving the capacity planning of a level III university hospital in Turkey that specializes in education and research. The objective of the study is to determine optimal bed requirement by matching the resources of the ICU with demand. We provide forecasts of ICU capacity by evaluating the simulation models based on patient waiting times and bed quantity. Considered in the context of the vital importance of intensive care units and the uncertainties in their management, it is thought that the use of simulation modeling in the making of capacity decisions can prove useful for decision makers in assessing their resource allocation strategies under different regional and hospital conditions.

Kaynakça

  • Altıok, T. & Melamed, B. (2007). Simulation Modeling and Analysis with Arena. London: Elsevier.
  • Alvarado, M., Lawley, M. & Li, Y. (2016 ). Healthcare Simulation Tutorial: Methods, Challenges, And Opportunities. 2016 Winter Simulation Conference (WSC) (ss. 236-247). Washington: IEEE.
  • Antmen, Z. F. & Oğulata, S. N. (2013). The Capacity Planning of Intensive Care Units via Simulation: A Case Study in University Hospital. Int.J.Appl. Math. Stat., 51 (21), 214-235.
  • Bai, J., Fügener, A., Gönsch, J., Brunner, J. O. & Blobner, M. (2021). Managing Admission And Discharge Processes İn İntensive Care Units. Health Care Manag Sci., 24 (4), 666-685.
  • Bai, J., Fügener, A., Schoenfelder, J. & Brunner , J. O. (2018). Operations Research İn İntensive Care Unit Management: A Literature Review. Health Care Management Science, 21, 1–24.
  • Bamford, D. C. & Chatziaslan E. (2010). Healthcare Capacity Measurement. International Journal of Productivity and Performance Management, 58 (8), 748–766.
  • Banks, J., Carson II, J. S., Nelson, B. L. & Nicol, D. M. (2005). Discrete-Event System Simulation. New Jersey: Pearson.
  • Barado, J., Guergué, J. M., Esparza, L., Azcárate, C., Mallor, F. & Ochoa, S. (2012). A Mathematical Model For Simulating Daily Bed Occupancy İn An İntensive Care Unit. Crit Care Med., 40 (4), 1098-1104.
  • Batun, S. & Begen, M. A. (2013). Optimization in Healthcare Delivery Modeling: Methods and Applications. B. T. Denton içinde, Handbook of Healthcare Operations Management (ss. 75-120). New York: Springer Science+Business Media.
  • Bountourelis, T., Ulukus, M. Y., Kharoufeh, J. P. & Nabors, S. G. (2013). The Modeling, Analysis, and Management of Intensive Care Units. B. T. Denton içinde, Handbook of Healthcare Operations Management (ss. 153-183). New York: Springer Science+Business Media.
  • Bowers, J. (2013). Balancing Operating Theatre And Bed Capacity İn A Cardiothoracic Centre. Health Care Management Science, 16, 236–244.
  • Brailsford, S. C., Harper, P. R., Patel, B. & Pitt , M. (2009). An Analysis Of The Academic Literature On Simulation And Modelling İn Health Care. Journal of Simulation, 3, 130–140.
  • Cohen, M. A., Hershey, J. C. & Weiss, E. N. (1980). Analysis Of Capacity Decisions For Progressive Patient Care Hospital Facilities. Health Serv Res., 15 (2), 145–160.
  • Costa, A., Ridley, S., Shahani, A., Harper, P., De Senna, V. & Nielsen, M. (2003). Mathematical Modelling And Simulation For Planning Critical Care Capacity. Anaesthesia, 58, 320–327.
  • Davis, M. M., Aquilano, N. D., Chase, R. B. & Balakrishnan, J. (2005). Fundamentals of Operations Management (1st Canadian Edition). Toronto: McGraw-Hill Ryerson.
  • De Lange, D. W., Soares, M. & Pilcher, D. (2020). ICU Beds: Less İs More? No. Intensive Care Medicine, 46, 1597–1599.
  • De vries, G., Bertrand, J. W. & Vissers, J. M. (1999). Design Requirements For Health Care Production Control Systems. Production Planning & Control, 10 (6), 559-569.
  • Garland, A., Olafson, K., Ramsey, C. D., Yogendran, M. & Fransoo, R. (2013). Epidemiology Of Critically İll Patients İn İntensive Care Units: A Population-Based Observational Study. Critical Care, 17 (5), 1-7.
  • Goldhill, D. R. & Sumner, A. (1998). Outcome Of İntensive Care Patients İn A Group Of British İntensive Care Units. Critical Care Medicine, 26 (8), 1337-1345.
  • Griffiths, J. D., Jones, M., Read, M. S. & Williams, J. E. (2010). A Simulation Model Of Bed-Occupancy İn A Critical Care Unit. Journal of Simulation, 4 (1), 52–59.
  • Griffiths, J. D., Price-Lloyd, N., Smithies, M. & Williams, J. (2006). A Queueing Model Of Activities İn An İntensive Care Unit. IMA Journal of Management Mathematics, 17 (3), 277–288.
  • Guerriero, F. & Guido , R. (2011). Operational Research İn The Management Of The Operating Theatre: A Survey. Health Care Management Science, 14, 89–114.
  • Günal, M. M. (2012). A Guide For Building Hospital Simulation Models. Heath Systems, 1 (1), 17–25.
  • Halpern, N. A., Pastores, S. M. & Greenstein, R. J. (2004). Critical Care Medicine İn The United States 1985–2000: An Analysis Of Bed Numbers, Use, And Costs. Critical care medicine, 32 (6), 1254-1259.
  • Hamrock, E., Kerrie, P., Parks, J., Scheulen, J. & Levin, S. (2013). Discrete Event Simulation for Healthcare Organizations: A Tool For Decision Making. Journal of Healthcare Management, 58 (2 ), 110-124.
  • Harper, P. R. & Shanani, A. K. (2002). Modelling For The Planning And Management Of Bed Capacities İn Hospitals. J. Oper. Res. Soc., 53, 11–18.
  • Hickman, B. G. (1964). On a New Method of Capacity Estimation. Journal of the American Statistical Association, 59 (306), 529–549.
  • Jack, E. P. & Powers, T. L. (2009). A Review And Synthesis Of Demand Management, Capacity Management And Performance İn Health-Care Services. International Journal of Management Reviews, 11 (2), 149–174.
  • Jacobs, P. & Noseworthy, T. W. (1990). National Estimates Of İntensive Care Utilization And Costs: Canada And The United States. Crit Care Med., 18, 1282-1286.
  • Jonsson, P. & Mattsson, S. A. (2009). Manufacturing Planning and Control. Berkshire: McGraw-Hill Education.
  • Karnon, J., Stahl, J., Brennan, A., Caro, J. J., Mar, J. & Möller, J. (2012). Modeling Using Discrete Event Simulation: A Report Of The ISPOR-SMDM Modeling Good Research Practices Task Force–4. Medical decision making, 32 (5), 701-711.
  • Katsaliak, K. & Mustafee, N. (2011). Applications Of Simulation Within The Healthcare Context. J Oper Res Soc., 62 (8), 1431–1451.
  • Kim, S. H., Chan, C. W., Olivares, M. & Escobar, G. (2015). ICU Admission Control: An Empirical Study of Capacity Allocation and Its Implication for Patient Outcomes. Management Science, 61 (1), 19–38.
  • Kim, S.-C., Horowitz, I., Young, K. K. & Buckley, T. A. (1999). Analysis Of Capacity Management Of The İntensive Care Unit İn A Hospital. European Journal of Operational Research, 115, 36-46.
  • Kokangül, A. (2008). A Combination Of Deterministic And Stochastic Approaches To Optimize Bed Capacity İn A Hospital Unit. Computer Methods and Programs in Biomedicine, 90 (1), 56-65.
  • Lamooki, G. R., Maleki, F. & Hajihosseini, A. (2014). A Mathematical Model For The Admission Process İn İntensive Care Units. Communications in Nonlinear Science and Numerical Simulation, 19 (1), 8-18.
  • Law, A. M. (2019). How To Build Valid And Credible Simulation Models. 2019 Winter Simulation Conference (WSC) (ss. 1402-1414). National Harbor: IEEE.
  • Litvak, N., van Rijsbergen, M., Boucherie, R. J. & van Houdenhoven, M. (2008). Managing The Overflow Of İntensive Care Patients. Eur J Oper Res., 185 (3), 998–1010.
  • Lyons, R. A., Wareham, K., Hutchings, H. A., Major, E. & Ferguson, B. (2000). Population Requirement For Adult Critical-Care Beds: A Prospective Quantitative And Qualitative Study.The Lancet, (355), 595-598.
  • Mallor, F. & Azcárate, C. (2014). Combining Optimization With Simulation To Obtain Credible Models For İntensive Care Units. Annals of Operations Research, 221, 255–271.
  • Maria, A. (1997). Introduction To Modeling And Simulation. Proceedings of the 29th conference on Winter simulation (ss. 7–13). Washington: IEEE.
  • Marmor, Y. N., Rohleder, T. R., Cook,, D. J. & Huschka, T. R. (2013). Recovery Bed Planning İn Cardiovascular Surgery: A Simulation Case Study. Health Care Management Science, 16, 314–327.
  • Marshall, D. A., Burgos-Liz, L., IJzerman, M. J., Crown, W., Padula, W. V., Wong, P. K., . . . ISPOR Emerging Good Practices Task Force. (2015). Selecting a Dynamic Simulation Modeling Method for Health Care Delivery Research—Part 2: Report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force. Value in Health, 18 (2), 147-160.
  • Masterson, B. J., Mihara, T. G., Miller, G., Randolph, S. C., Forkner, E. M. & Crouter, A. L. (2004). Using Models And Data To Support Optimization Of The Military Health System: A Case Study İn An İntensive Care Unit. Health Care Manag Sci 2004;. Health Care Manag Sci., 7, 217–224.
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YOĞUN BAKIM ÜNİTELERİNDE KAPASİTE DEĞERLENDİRMESİ VE PLANLAMASI: 3. BASAMAK HASTANELER İÇİN SİMÜLASYON MODELLEMESİ

Yıl 2023, Cilt: 25 Sayı: 2, 599 - 620, 15.06.2023
https://doi.org/10.16953/deusosbil.1254173

Öz

Sağlık sistemleri, birbiriyle karmaşık yollarla etkileşime giren çok sayıda paydaşı içeren insan temelli sistemlerdir. Sağlık sistemlerinin stokastik doğası ve girdilerinin, etkinliklerinin ve çıktılarının karmaşık dinamikleri ve etkileşimleri nedeniyle sağlık hizmeti sağlayıcıları, bu karmaşıklığı anlamalarını ve bu şekilde sistem performanslarını geliştirmelerini sağlayan araçlara ihtiyaç duyar. Yoğun bakım üniteleri (YBÜ), kapasite yetersizliği nedeniyle hastaları tedavi edememekte ve bazı durumlarda hastalar, başka hastanelere sevk edilmekte ve hasta bekleme süreleri uzamaktadır. YBÜ gibi kıt bir kaynağın verimli kullanımı ve yönetimi, bir hastanenin sorunsuz çalışması için kritik öneme sahiptir. Kapasite planlaması, yani gelecekteki talep ve kapasite ile ilgili mevcut bilgilere dayanarak optimal yatak konfigürasyonunun belirlenmesi hem kapasite hem de talepteki yüksek belirsizlikler nedeniyle çok zordur. Bu problemin çözümü için çalışmada, yoğun bakım yatak kapasitesi planlamasının karar verme sürecini kolaylaştırmak için simülasyon modeli önerilmektedir. Bu çalışma, Türkiye’de faaliyette bulunan 3. basamak bir üniversite eğitim araştırma hastanesindeki YBÜ’nün kapasite planlamasını geliştirmeye odaklanmaktadır. Çalışmanın amacı, YBÜ’nün kaynaklarını taleple eşleştirerek optimum yatak ihtiyacını belirlemek olarak tanımlanabilir. Çalışmanın sonucunda oluşturulan simülasyon modelleri, hastaların bekleme süreleri ve yatak sayılarına göre değerlendirilerek yoğun bakım kapasitesi hakkında öngörülerde bulunulmuştur. YBÜ’lerin hayati önemi, yönetiminde belirsizlik durumları gözönüne alındığında, farklı bölge ve hastane koşullarında kapasite kararlarının alınmasında bir araç olarak simülasyon yönteminin kullanılması, karar alıcılara kaynak tahsis stratejilerini değerlendirmelerinde yardımcı olabileceği öngörülmektedir.

Kaynakça

  • Altıok, T. & Melamed, B. (2007). Simulation Modeling and Analysis with Arena. London: Elsevier.
  • Alvarado, M., Lawley, M. & Li, Y. (2016 ). Healthcare Simulation Tutorial: Methods, Challenges, And Opportunities. 2016 Winter Simulation Conference (WSC) (ss. 236-247). Washington: IEEE.
  • Antmen, Z. F. & Oğulata, S. N. (2013). The Capacity Planning of Intensive Care Units via Simulation: A Case Study in University Hospital. Int.J.Appl. Math. Stat., 51 (21), 214-235.
  • Bai, J., Fügener, A., Gönsch, J., Brunner, J. O. & Blobner, M. (2021). Managing Admission And Discharge Processes İn İntensive Care Units. Health Care Manag Sci., 24 (4), 666-685.
  • Bai, J., Fügener, A., Schoenfelder, J. & Brunner , J. O. (2018). Operations Research İn İntensive Care Unit Management: A Literature Review. Health Care Management Science, 21, 1–24.
  • Bamford, D. C. & Chatziaslan E. (2010). Healthcare Capacity Measurement. International Journal of Productivity and Performance Management, 58 (8), 748–766.
  • Banks, J., Carson II, J. S., Nelson, B. L. & Nicol, D. M. (2005). Discrete-Event System Simulation. New Jersey: Pearson.
  • Barado, J., Guergué, J. M., Esparza, L., Azcárate, C., Mallor, F. & Ochoa, S. (2012). A Mathematical Model For Simulating Daily Bed Occupancy İn An İntensive Care Unit. Crit Care Med., 40 (4), 1098-1104.
  • Batun, S. & Begen, M. A. (2013). Optimization in Healthcare Delivery Modeling: Methods and Applications. B. T. Denton içinde, Handbook of Healthcare Operations Management (ss. 75-120). New York: Springer Science+Business Media.
  • Bountourelis, T., Ulukus, M. Y., Kharoufeh, J. P. & Nabors, S. G. (2013). The Modeling, Analysis, and Management of Intensive Care Units. B. T. Denton içinde, Handbook of Healthcare Operations Management (ss. 153-183). New York: Springer Science+Business Media.
  • Bowers, J. (2013). Balancing Operating Theatre And Bed Capacity İn A Cardiothoracic Centre. Health Care Management Science, 16, 236–244.
  • Brailsford, S. C., Harper, P. R., Patel, B. & Pitt , M. (2009). An Analysis Of The Academic Literature On Simulation And Modelling İn Health Care. Journal of Simulation, 3, 130–140.
  • Cohen, M. A., Hershey, J. C. & Weiss, E. N. (1980). Analysis Of Capacity Decisions For Progressive Patient Care Hospital Facilities. Health Serv Res., 15 (2), 145–160.
  • Costa, A., Ridley, S., Shahani, A., Harper, P., De Senna, V. & Nielsen, M. (2003). Mathematical Modelling And Simulation For Planning Critical Care Capacity. Anaesthesia, 58, 320–327.
  • Davis, M. M., Aquilano, N. D., Chase, R. B. & Balakrishnan, J. (2005). Fundamentals of Operations Management (1st Canadian Edition). Toronto: McGraw-Hill Ryerson.
  • De Lange, D. W., Soares, M. & Pilcher, D. (2020). ICU Beds: Less İs More? No. Intensive Care Medicine, 46, 1597–1599.
  • De vries, G., Bertrand, J. W. & Vissers, J. M. (1999). Design Requirements For Health Care Production Control Systems. Production Planning & Control, 10 (6), 559-569.
  • Garland, A., Olafson, K., Ramsey, C. D., Yogendran, M. & Fransoo, R. (2013). Epidemiology Of Critically İll Patients İn İntensive Care Units: A Population-Based Observational Study. Critical Care, 17 (5), 1-7.
  • Goldhill, D. R. & Sumner, A. (1998). Outcome Of İntensive Care Patients İn A Group Of British İntensive Care Units. Critical Care Medicine, 26 (8), 1337-1345.
  • Griffiths, J. D., Jones, M., Read, M. S. & Williams, J. E. (2010). A Simulation Model Of Bed-Occupancy İn A Critical Care Unit. Journal of Simulation, 4 (1), 52–59.
  • Griffiths, J. D., Price-Lloyd, N., Smithies, M. & Williams, J. (2006). A Queueing Model Of Activities İn An İntensive Care Unit. IMA Journal of Management Mathematics, 17 (3), 277–288.
  • Guerriero, F. & Guido , R. (2011). Operational Research İn The Management Of The Operating Theatre: A Survey. Health Care Management Science, 14, 89–114.
  • Günal, M. M. (2012). A Guide For Building Hospital Simulation Models. Heath Systems, 1 (1), 17–25.
  • Halpern, N. A., Pastores, S. M. & Greenstein, R. J. (2004). Critical Care Medicine İn The United States 1985–2000: An Analysis Of Bed Numbers, Use, And Costs. Critical care medicine, 32 (6), 1254-1259.
  • Hamrock, E., Kerrie, P., Parks, J., Scheulen, J. & Levin, S. (2013). Discrete Event Simulation for Healthcare Organizations: A Tool For Decision Making. Journal of Healthcare Management, 58 (2 ), 110-124.
  • Harper, P. R. & Shanani, A. K. (2002). Modelling For The Planning And Management Of Bed Capacities İn Hospitals. J. Oper. Res. Soc., 53, 11–18.
  • Hickman, B. G. (1964). On a New Method of Capacity Estimation. Journal of the American Statistical Association, 59 (306), 529–549.
  • Jack, E. P. & Powers, T. L. (2009). A Review And Synthesis Of Demand Management, Capacity Management And Performance İn Health-Care Services. International Journal of Management Reviews, 11 (2), 149–174.
  • Jacobs, P. & Noseworthy, T. W. (1990). National Estimates Of İntensive Care Utilization And Costs: Canada And The United States. Crit Care Med., 18, 1282-1286.
  • Jonsson, P. & Mattsson, S. A. (2009). Manufacturing Planning and Control. Berkshire: McGraw-Hill Education.
  • Karnon, J., Stahl, J., Brennan, A., Caro, J. J., Mar, J. & Möller, J. (2012). Modeling Using Discrete Event Simulation: A Report Of The ISPOR-SMDM Modeling Good Research Practices Task Force–4. Medical decision making, 32 (5), 701-711.
  • Katsaliak, K. & Mustafee, N. (2011). Applications Of Simulation Within The Healthcare Context. J Oper Res Soc., 62 (8), 1431–1451.
  • Kim, S. H., Chan, C. W., Olivares, M. & Escobar, G. (2015). ICU Admission Control: An Empirical Study of Capacity Allocation and Its Implication for Patient Outcomes. Management Science, 61 (1), 19–38.
  • Kim, S.-C., Horowitz, I., Young, K. K. & Buckley, T. A. (1999). Analysis Of Capacity Management Of The İntensive Care Unit İn A Hospital. European Journal of Operational Research, 115, 36-46.
  • Kokangül, A. (2008). A Combination Of Deterministic And Stochastic Approaches To Optimize Bed Capacity İn A Hospital Unit. Computer Methods and Programs in Biomedicine, 90 (1), 56-65.
  • Lamooki, G. R., Maleki, F. & Hajihosseini, A. (2014). A Mathematical Model For The Admission Process İn İntensive Care Units. Communications in Nonlinear Science and Numerical Simulation, 19 (1), 8-18.
  • Law, A. M. (2019). How To Build Valid And Credible Simulation Models. 2019 Winter Simulation Conference (WSC) (ss. 1402-1414). National Harbor: IEEE.
  • Litvak, N., van Rijsbergen, M., Boucherie, R. J. & van Houdenhoven, M. (2008). Managing The Overflow Of İntensive Care Patients. Eur J Oper Res., 185 (3), 998–1010.
  • Lyons, R. A., Wareham, K., Hutchings, H. A., Major, E. & Ferguson, B. (2000). Population Requirement For Adult Critical-Care Beds: A Prospective Quantitative And Qualitative Study.The Lancet, (355), 595-598.
  • Mallor, F. & Azcárate, C. (2014). Combining Optimization With Simulation To Obtain Credible Models For İntensive Care Units. Annals of Operations Research, 221, 255–271.
  • Maria, A. (1997). Introduction To Modeling And Simulation. Proceedings of the 29th conference on Winter simulation (ss. 7–13). Washington: IEEE.
  • Marmor, Y. N., Rohleder, T. R., Cook,, D. J. & Huschka, T. R. (2013). Recovery Bed Planning İn Cardiovascular Surgery: A Simulation Case Study. Health Care Management Science, 16, 314–327.
  • Marshall, D. A., Burgos-Liz, L., IJzerman, M. J., Crown, W., Padula, W. V., Wong, P. K., . . . ISPOR Emerging Good Practices Task Force. (2015). Selecting a Dynamic Simulation Modeling Method for Health Care Delivery Research—Part 2: Report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force. Value in Health, 18 (2), 147-160.
  • Masterson, B. J., Mihara, T. G., Miller, G., Randolph, S. C., Forkner, E. M. & Crouter, A. L. (2004). Using Models And Data To Support Optimization Of The Military Health System: A Case Study İn An İntensive Care Unit. Health Care Manag Sci 2004;. Health Care Manag Sci., 7, 217–224.
  • McManus, M. L., Long, L. C., Cooper, A. & Litvak, E. (2004). Queuing Theory Accurately Models the Need for Critical Care Resources. Anesthesiology, 100, 1271–1276.
  • Milbrandt, E. B., Kersten, A., Rahim, M. T., Dremsizov, T. T., Clermont, G., Cooper, L. M., . . . Linde-Zwirble, W. T. (2008). Growth Of İntensive Care Unit Resource Use And İts Estimated Cost İn Medicare. Crit Care Med., 36 (9), 2504-2510.
  • Monks, T., Worthington, D., Allen, M., Pitt, M., Stein, K. & James , M. A. (2016). A Modelling Tool For Capacity Planning İn Acute And Community Stroke Services. BMC Health Services Research, 16 (530), 1-8.
  • Nguyen, J. M., Six, P., Parisot, R., Antonioli, D., Nicolas, F. & Lombrail , P. (2003). A Universal Method For Determining İntensive Care Unit Bed Requirements. Intensive Care Medicine, (29), 849–852.
  • Ouyang, H., Argon, N. T. & Ziya, S. (2020). Allocation of Intensive Care Unit Beds in Periods of High Demand. Operations research, 68 (2), 591–608.
  • Parker, A., Wyatt, R. & Ridley, S. (1998). Intensive Care Services; A Crisis Of İncreasing Expressed Demand. Anaesthesia, 53, 113–120.
  • Phua, J., Hashmi, M. & Haniffa, R. (2020). ICU Beds: Less İs More? Not Sure. Intensive Care Med., 46 (8), 1600–1602.
  • Rewa, O. G., Stelfox, H. T., Ingolfsson, A., Zygun, D. A., Featherstone, R., Opgenorth, D. & Bagshaw, S. M. (2018). Indicators Of İntensive Care Unit Capacity Strain: A Systematic Review. Crit Care., 22 (86), 1-13.
  • Rhodes, A., Chiche, J.-D. & Moreno, R. (2011). Improving The Quality Of Training Programs İn İntensive Care: A View From The ESICM. Intensive Care Med., 37, 377–379.
  • Ridge, J. C., Jones, S. K., Nielsen, M. S. & Shahani, A. K. (1998). Capacity Planning For İntensive Care Units. European Journal of Operational Research, 105 (2), 346-355.
  • Rodrigues, F. F., Zaric, G. S. & Stanford, D. A. (2018). Discrete Event Simulation Model For Planning Level 2 “Step-Down” Bed Needs Using NEMS. Operations Research for Health Care, 17, 42-54.
  • Sarode, V. V. & Hawker, F. H. (2019). Design And Organisation Of İntensive Care Units. A. D. Bersten, & N. Soni, Oh's Intensive Care Manual içinde (ss. 3-11). China: Elsevier.
  • Shahani, A. K., Ridley, S. A. & Nielsen, M. S. (2008). Modelling Patient Flows As An Aid To Decision Making For Critical Care Capacities And Organisation. Anaesthesia, 63, 1074–1080.
  • Siebers, P. O., Macal, C. M., Garnett, J., Buxton, D. & Pidd, M. (2010). Discrete-Event Simulation İs Dead, Long Live Agent-Based Simulation. Journal of Simulation, 4 (3), 204-210.
  • Silvester, K., Lendon, R., Bevan, H., Steyn, R. & Walley, P. (2004). Reducing Waiting Times At The NHS: İs Lack Of Capacity The Problem? Clinician in Management, 12 (3), 105-111.
  • Singer, M., Myers, S., Hall, G. & Cohen, S. L. (1994). The Cost Of İntensive Care: A Comparison On One Unit Between 1988 And 1991. Intensive Care Medicine, 20, 542–549.
  • Sobolev, B. G., Sanchez, V. & Vasilakis, C. (2011). Systematic Review Of The Use Of Computer Simulation Modeling Of Patient Flow İn Surgical Care. J Med Syst., 35 (1), 1-16.
  • Steins, K. & Walther, S. M. (2013). A Generic Simulation Model For Planning Critical Care Resource Requirements. Anaesthesia, 68 (11), 1148-1155.
  • Tao, L. & Liu, J. (2019). Healthcare Service Management. Switzerland: Springer Nature Switzerland AG .
  • Thorwarth, M., Rashwan, W. & Arisha, A. (2016). An Analytical Representation Of Flexible Resource Allocation İn Hospitals. Flexible Services and Manufacturing Journal, 28, 148–165.
  • Topoyan, M. (2021). Kuyruk (Bekleme Hattı) Teorisi, Ankara: Seçkin Yayıncılık.
  • Troy, P. M. & Rosenberg, L. (2009). Using Simulation To Determine The Need For ICU Beds For Surgery Patients. Surgery, 146 (4), 608-620.
  • Özdemir, A. & Maruf, M. (2018). Differentiation of Service Speed With Multi Criteria Decision Making Techniques in Waiting Line Problems. Ankara Hacı Bayram Veli Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 20 (3), 470-482.
  • Vlachos, D., Georgiadis, P. & Iakovou, E. (2007). A System Dynamics Model For Dynamic Capacity Planning Of Remanufacturing İn Closed-Loop Supply Chains. Computers & Operations Research, 34 (2), 367-394.
  • West, R. (2001). Objective Standards For The Emergency Services: Emergency Admission To Hospital. Journal of the Royal Society of Medicine, 39, 4-8.
  • Zhu, Z., Hen, B. H. & Teow, K. L. (2012). Estimating ICU Bed Capacity Using Discrete Event Simulation. International Journal of Health Care Quality Assurance, 25 (2), 134-144.
Toplam 70 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Alkan Durmuş 0000-0002-5806-9962

Ali Özdemir 0000-0003-3555-2123

Necati Gökmen 0000-0002-3225-7666

Yayımlanma Tarihi 15 Haziran 2023
Gönderilme Tarihi 21 Şubat 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 25 Sayı: 2

Kaynak Göster

APA Durmuş, A., Özdemir, A., & Gökmen, N. (2023). YOĞUN BAKIM ÜNİTELERİNDE KAPASİTE DEĞERLENDİRMESİ VE PLANLAMASI: 3. BASAMAK HASTANELER İÇİN SİMÜLASYON MODELLEMESİ. Dokuz Eylül Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 25(2), 599-620. https://doi.org/10.16953/deusosbil.1254173