Response times in healthcare systems

It is a goal universally acknowledged that a healthcare system should treat its patients – and especially those in need of critical care – in a timely manner. However, this is often not achieved in practice, particularly in state-run public healthcare systems that suffer from high patient demand and limited resources. In particular, Accident and Emergency (AE this prompts us to investigate characterisation by a non-homogeneous Poisson process. Next we present a hierarchical multiclass queueing network model of patient flow in our case study A&E department. We investigate via a discrete-event simulation the impact of class and time-based priority treatment of patients, and compare the resulting service-time densities and moments with actual data. Then, by performing bottleneck analysis and investigating various workload and resource scenarios, we pinpoint the resources that have the greatest impact on mean service times. Finally we describe an approximate generating function analysis technique which efficiently approximates the first two moments of customer response time in class-dependent priority queueing networks with population constraints. This technique is applied to the model of A&E and the results compared with those from simulation. We find good agreement for mean service times especially when minors patients are given priority.

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