System Dynamic Modelling of Patient Flow and Transferral Problem in a Mixed Public-Private Healthcare System: A Case Stu
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ISSN: 1004-3756 (paper), 1861-9576 (online) CN 11-2983/N
System Dynamic Modelling of Patient Flow and Transferral Problem in a Mixed Public-Private Healthcare System: A Case Study of Hong Kong SAR C.K.M. LEE,a W.C. TAI,a Kam K.H. NGb a Department
of Industrial and Systems Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China [email protected], [email protected] b School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore [email protected] ()
Abstract. The current healthcare system in Hong Kong is experiencing pressure due to constrained re-
sources, with dramatic increases in inpatient services queue lengths, dissatisfaction with the working environment, unacceptable workforce arrangements and high turnover rate of hospital staff. To maintain the robustness of the healthcare system and a sustainable inpatients flow, the Food and Health Bureau launched a public-private partnership programme to utilise the resources of the public and private hospitals. This research investigates the potential for extension of the programme and further enhancing the sustainability of the long-term inpatient services under a mixed public-private healthcare policy via system dynamic modelling. The findings show that an increase of human resources in public hospitals does not substantially improve inpatient flow rate performance. Further, the results from the system dynamic approach provide insights into the expansion of the service areas of the programme and suggest increasing the number of referrals to private hospitals. Keywords: System dynamic models, scenario analysis, inpatient transferral, mixed public-private health-
care system
1. Introduction Healthcare systems all over the world face the challenges of diminishing human resources, reducing expenditure and increasing demands (Cavicchi and Vagnoni 2017, Faezipour and Ferreira 2013). The rapid growth of the population ageing problem has triggered strong growth in the demand for healthcare services, especially in long-term care and inpatient service (Hejazi et al. 2019). Countries are reforming their future healthcare systems to overcome the challenges, as in Hong Kong. According to the Hong Kong Population Projection 2015–2064 (Census Statistics Department 2015), the Hong Kong Population is projected to increase at an average annual growth of 0.4%, from 7.24 million in 2014 to 8.22 mil-
lion in 2043. The proportion of the population aged over 65 years is also projected to reach 33% of the total population by 2064, as the life expectancy of people increases. The increase of the population and the change of the age structure are expected to lead to a growing demand for quality healthcare services in Hong Kong. The sustainability in the healthcare sector is important for social development (Ahsan and Rahman 2017, Chiarini et al. 2017). Mixed public-private healthcare partnerships could be a tentative approach to relieve the prolonged inpatient service (Comendeiro et al. 2
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