Analyzing the Efficiency of Health Resources of Health Institutions in Computer Environment and Calculating Optimum Values

Abstract

As health systems have a dynamic and complex structure, obtaining tangible results usually requires a long time and high cost. In this study, a three-dimensional discrete-event simulation model has been developed in order to analyze the efficiency of health resources of health institutions in a computer environment and to calculate optimum values. The simulation model has been developed by taking into account the most intense and active emergency service unit of health institutions. The patient flow chart in the simulation model was created according to the Turkish health system. In this study, the number of patients treated, patient waiting and length of stay, staff productivity, and location-based resources were calculated by taking into account the available health resources. With the statistical experimental design, 16 scenarios were created considering the number of beds, doctors, and nurses, and optimum results were obtained by running each scenario with 3 repetitions. At least 2 doctors, 1 nurse, and 4 beds are required to minimize the patient waiting time and patient stay, in the emergency room, while a patient waits for an average of 9.34 minutes, the average stay of a patient in the emergency room is calculated as 36.92 minutes. By employing 1 doctor, 1 nurse, and 2 beds in order to maximize the number of patients treated with human and location-based resource efficiencies, the optimum values for staff and location efficiencies and the number of patients treated were calculated as 51%, 61%, and 275, respectively. As a result, the simulation model developed in this study to calculate the efficiency and optimum health resource number values of a dynamic and complex health institution has provided important results in terms of health management.

Keywords

• health resources
• efficiency
• discrete-event simulation
• optimum
• statistical experiment design
• emergency room

Sağlık Kuruluşlarına ait Sağlık Kaynaklarının Bilgisayar Ortamında Verimliliklerinin Analiz Edilmesi ve Optimum Değerlerin Hesaplanması

Abstract

Sağlık sistemleri dinamik ve karmaşık yapıya sahip olması ile somut sonuçların elde edilmesi genellikle uzun zaman ve yüksek maliyet gerektirmektedir. Bu çalışmada sağlık kuruluşlarına ait sağlık kaynaklarının bilgisayar ortamında verimliliklerinin analiz edilmesi ve optimum değerlerin hesaplanması adına üç boyutlu simülasyon modeli geliştirilmiştir. Simülasyon modeli sağlık kuruluşlarının en yoğun ve hareketli olan acil servis birimi dikkate alarak geliştirilmiştir. Simülasyon modelinde yer alan hasta akış çizelgesi Türk sağlık sistemine göre oluşturulmuştur. Bu çalışmada mevcut sağlık kaynakları dikkate alınarak tedavi edilen hasta sayısı, hasta bekleme ve kalış süreleri, personel verimlilikleri, lokasyon bazlı kaynakların verimlilikleri hesaplanmıştır. İstatistiksel deney tasarımı ile yatak, doktor ve hemşire sayıları dikkate alınarak 16 senaryonun oluşturulması ve her bir senaryonun 3 tekrar ile çalıştırılması ile optimum sonuçların elde edilmesi sağlanmıştır. Hasta bekleme süresinin ve hasta kalış süresinin miminize edilmesi için acil serviste en az 2 doktor, 1 hemşire ve 4 yatak çalışması ile bir hasta ortalama 9,34 dakika beklerken bir hastanın acil serviste kalma süresi ortalama olarak 36,92 dakika olarak hesaplanmıştır. İnsan ve lokasyon bazlı kaynak verimlikleri ile tedavi edilen hasta sayısının maksimize edilmesi adına 1 doktor, 1 hemşire ve 2 yatağın çalıştırılmasıyla personel ve lokasyon verimliliklerine ve tedavi edilen hasta sayısına ait optimum değerler sırasıyla %51, %61 ve 275 olarak hesaplanmıştır. Sonuç olarak, bu çalışma ile dinamik ve karmaşık yapılı bir sağlık kuruluşuna ait verimlilik ve optimum sağlık kaynak sayısı değerlerinin hesaplanması için geliştirilen simülasyon modeli sağlık yönetimi bakımından önemli sonuçlar sağlamıştır.

Keywords

• sağlık kaynakları
• verimlilik
• kesikli-olay simülasyon
• optimum
• istatistiksel deney tasarımı
• acil servis

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