Use of queue modelling in the analysis of elective patient treatment governed by a maximum waiting time policy

Many public healthcare systems struggle with excessive waiting lists for elective patient treatment. Different countries address this problem in different ways, and one interesting method entails a maximum waiting time guarantee. Introduced in Denmark in 2002, it entitles patients to treatment at a private hospital in Denmark or at a hospital abroad if the public healthcare system is unable to provide treatment within the stated maximum waiting time guarantee. Although clearly very attractive in some respects, many stakeholders have been very concerned about the negative consequences of the policy on the utilization of public hospital resources. This paper illustrates the use of a queue modelling approach in the analysis of elective patient treatment governed by the maximum waiting time policy. Drawing upon the combined strengths of analytic and simulation approaches we develop both Continuous-Time Markov Chain and Discrete Event Simulation models, to provide an insightful analysis of the public hospital performance under the policy rules. The aim of this paper is to support the enhancement of the quality of elective patient care, to be brought about by better understanding of the policy implications by hospital planners and strategic decision makers.