A system dynamics-based model to implement the Theory of Constraints in a healthcare system

Grida, Mohamed; zeid, Mahmoud Mesalam Bendary

doi:10.1177/0037549718788953

Cited by 21 publications

(20 citation statements)

References 43 publications

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“…It has been reported that more than 75% of instances of delayed discharge were a result of delays in making long-term care arrangements for elderly patients [ 36 , 37 ]. Several studies evaluated the impact of hospital resources on the length of stay [ 35 , 38 , 39 ], while others focused on elderly individuals, chronically ill patients, and their impact on bed occupancy, the average length of stay, and resource consumption [ 40 , 41 ]. The main conflicting results are the impact of changing bed capacity on performance.…”

Section: Discussionmentioning

confidence: 99%

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

Davahli

Karwowski

Taı̈ar

2020

IJERPH

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In recent years, there has been significant interest in developing system dynamics simulation models to analyze complex healthcare problems. However, there is a lack of studies seeking to summarize the available papers in healthcare and present evidence on the effectiveness of system dynamics simulation in this area. The present paper draws on a systematic selection of published literature from 2000 to 2019, in order to form a comprehensive view of current applications of system dynamics methodology that address complex healthcare issues. The results indicate that the application of system dynamics has attracted significant attention from healthcare researchers since 2013. To date, articles on system dynamics have focused on a variety of healthcare topics. The most popular research areas among the reviewed papers included the topics of patient flow, obesity, workforce demand, and HIV/AIDS. Finally, the quality of the included papers was assessed based on a proposed ranking system, and ways to improve the system dynamics models’ quality were discussed.

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Section: Discussionmentioning

confidence: 99%

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

Davahli

Karwowski

Taı̈ar

2020

IJERPH

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“…While Vanderby, Carter, Latham and Feindel [18] considers a single specialty at a national level, and provides a tool that helps decision managers planning future workforce, Morgan and Graber-Naidich [19] focused on policies to alleviate the rural care gap in the future. Grida and Zeid [20] proposed a system dynamics model simulating a typical hospital where different types of patients are served using the same limited resources. The model is used to study system capacity, and then to identify bottleneck resources.…”

Section: Empirical Studies Related To This Researchmentioning

confidence: 99%

A Systems Thinking Model to Support Long-Term Bearability of the Healthcare System: The Case of the Province of Quebec

Lagarda-Leyva

Ruiz

2019

Sustainability

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This paper describes the modeling efforts devoted by the Ministry of Health and Social Services of Québec, Canada (MSSS), to ensure the long-term bearability of their care system. To this end, it studies the relationships between four entities that self-regulate and interact to form the complex care-providing system: (1) universities; (2) hospitals and doctors; (3) the ministry; and (4) society. The first phase of this research focuses on modeling such relationships and relies on the system dynamics methodology to adequately capture the long-term dynamics of the system. The methodology encompasses three phases: (a) determination of the critical variables and parameters of each entity; (b) development of the causal diagram of each entity; and (c) integration of the individual causal diagrams to form the global system diagram. The final casual model illustrates and explains the relationships between all the entities and constitutes an excellent tool to support experts during discussions or focus groups where critical variables that positively or negatively affect the system can be evaluated. We intend to enrich this casual model in a further phase of the project, which will hopefully lead to a simulation and scenario analysis tool that can be used to support managers in their long-term decision-making process.

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“…The policy is focused on cooperation between health sectors when serving patients, thereby reducing patient numbers requiring continuous care in health facilities. Grida and Zeid (2019) also applied SD to simulate the hospital system with a scenario that all types of patients were served. However, all hospital systems have limited resources.…”

Section: Introductionmentioning

confidence: 99%

Reforming premium amount in the Indonesian National Health Insurance System program using system dynamics

2021

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The National Health Insurance System (NHIS) is a government program to help the health needs of its population such as in Indonesia (INHIS). However, there are obstacles to implementing it, which is shown by the results of program evaluations every year that there is a deficit problem, starting in 2014 until 2019 to and even expected to increase in the following years. One of the possible deficits is due to inefficient patient behavior and referral system which will affect the premium amount. The goal is to evaluate and plan further policies with efficient premiums amount. System dynamics is used to simulate the effects of ability-topay, willingness-to-pay, salary, age, health cost each customer, and fund inventory. The historical data are used from INHIS from 2014 to 2019, then projected until 2030. The simulation results show that the health costs considered for determining the premiums are critical to the financial stability. If the premium is not in accordance with the customer's ability, the government will have to subsidise to avoid deficit. In addition, PPU customers who are already retired will automatically become to BP customers, which will also affect INHIS 'financial condition.

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A system dynamics-based model to implement the Theory of Constraints in a healthcare system

Cited by 21 publications

References 43 publications

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

A Systems Thinking Model to Support Long-Term Bearability of the Healthcare System: The Case of the Province of Quebec

Reforming premium amount in the Indonesian National Health Insurance System program using system dynamics

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