The research presented in this thesis focuses on the investigation of whether the compartmental flow models of bed occupancy originally described by Harrison and Millard (1991) for decision-making around geriatric service care in the English National Health Service can be used to describe data from acute care hospitals in Australia and New Zealand. Australia’s total health expenditure for 2004-05 was $87.3 billion. The use of health care services and expenditure pattern is well established and Australia follows the pattern found in most developed countries, with the greatest expenditure occurring on services for the elderly. Australia is experiencing a shift in population structure, with the proportion of older people forecast to increase. It is expected there will be a need for a greater level of expenditure on health care as the number of elderly people increase. There is an emerging gap between the ability to supply health services and the demand for them. Furthermore, acute care hospital treatment is generally considered expensive and governments have been keen to control this expenditure. It is imperative that governments are able to make decisions based upon robust policy advice. There are serious consequences in both economic resource allocation and patient (and population) health outcomes if decisions about future health service structures are incorrect. In particular, there is a need for better decision-making around bed management at the strategic level. Strategic decision-making relates to decisions that will occur in a longer time frame. Decision-making can benefit from the use of modelling. Models represent a simplified version of reality that preserve the essential features of the situation being examined and can be used as a tool to investigate decision-making options, particularly in complex environments such as the health sector. Historically decision-making relating to hospital beds has used either simple “back of the envelope” calculations or adherence to “rule of thumb” approaches. Most of the approaches have relied upon using the average length of stay metric. While the modelling of hospital bed numbers is not new, much of this work has relied upon the average length of stay, which is known to be a poor measure. Harrison and Millard (1991) introduced the application of the compartmental flow model for modelling hospital bed occupancy and noted its potential to be used to influence policy decision-making. The flow model results are plausible and easily interpreted. However, relatively little work has focussed on the ability of these models to be generalized and be used for predictive purposes. The research undertaken for this thesis consisted of a series of modelling experiments that can be grouped into two key stages: whether the models could be successfully applied to the acute care data; and whether the models could be used for novel purposes, such as forecasting, evaluation of service change, and benchmarking. This entailed the further development of the model, and a consideration of basic modelling issues such as the balance between data-fit and model complexity, in order to capture better variation in the data and also to facilitate linkage to changes in population and seasonality. / http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1301698 / Thesis(Ph.D.) -- School of Psychology, 2007

Thesis (M.S.H.A.)--University of Michigan, 1981.

Thesis (M.S.H.A.)--University of Michigan, 1981.

Bakgrund: Brist på vårdplatser innebär att en patient får vårdas på en vårdplats som inte uppfyller kraven på utformning, utrustning och säkerhet eller att kunskapen hos sjuksköterskor inte stämmer överens med vårdbehovet (Socialstyrelsen 2016, s. 93). Syfte: Att undersöka om patientsäkerheten påverkas vid platsbrist och överbeläggning. Metod: Examensarbetet är en litteraturstudie där 11 artiklar granskats och analyserats samt presenteras i resultatet. Resultat: Överbeläggningar och utlokaliseringar leder till ökade vårdskador och orsakar ett lidande för patienten. Brister i sjukvårdsmiljön visade sig genom att utrustning eller läkemedel inte var tillgängliga, vilket ledde till ytterligare fördröjning av behandling för patienten och till en förlängd sjukhusvistelse. En annan effekt var ökad risk att smittas av vårdrelaterade infektioner.

Master of Public Health - MPH / Background: The largest focus areas for the department of health is ensuring access to quality healthcare. The district health system (DHS) model remains the vehicle used by the district managers to deliver on the health department’s goals, objectives and priority focus areas. Strengthening the district health system platform is therefore important to the department to improve access and quality of care to the clients serviced in the province. The district hospitals play a fundamental role since they support primary health care (PHC) and serve as the entry point to more specialised care. The efficient management of beds in the district hospitals is the key in ensuring access to care and preventing bed blocking. Bed Utilisation Rate (BUR) and Average Length of Stay (ALOS) are indicators used to measure the efficiency of hospital beds. This study provides a description of the trends in bed utilisation within the inpatient wards of eight district hospitals in the Cape Town metro district in the 2016-2017 financial period. Methodology: To analyse and compare wards a quantitative approach was used. Inpatient ward activity reports for eight district hospitals were accessed from the department of health’s routine data collection repository. A total of fifty-five wards were compared across small and large hospitals for BUR and ALOS during the financial year period 1 April 2016 to 31 March 2017. Data entry was done in MS EXCEL and analyses were done using STATA 11.0.

Les structures des urgences (SU) sont une porte d'entrée importante de l'hôpital, fortes d'un personnel dont les capacités progressent et aidées par un plateau technique hospitalier de qualité. Dès son arrivée en SU, la prise en charge du patient s'inscrit dans un circuit qui a pour objectif l'optimisation des soins. Ce circuit patient peut être ralenti ou altéré lorsqu'il y a une surcharge de la SU, c'est-à-dire lorsque les capacités de celle-ci sont dépassées par le nombre de patients en attente d'être vu, d'évaluation, de traitement et de place d'hospitalisation. La surcharge des SU est associée à de nombreux effets indésirables et il est démontré que l'origine de cette surcharge est multifactorielle. Pour y trouver des solutions, il convient d'examiner la surcharge dans la globalité de l'institution hospitalière et du système de soins. L'objectif de ce travail est de décrire le circuit du patient de son arrivée en SU jusqu'à son départ et, parfois, son retour. Chaque article de ce travail, constituant autant d'étapes dans le circuit patient, place en perspective la surcharge de la SU ou de l'institution dans sa globalité. Cet ensemble d'articles souligne la complexité de la problématique et la nécessaire mobilisation de toute l'institution pour y répondre. / Emergency departments (ED) are an important front gate of the hospital with strong skill staff and helped by a high quality technical platform. After his/her arrival at the hospital, the patient follow a pathway which aims to optimize the healthcare. This patient's pathway may be slowed down or alter when there is an overcrowding of the ED, when capacities are exceeded by the number of patients to be seen, evaluated, treated, and to hospitalize. ED overcrowding is associated with many adverse effects and it is shown that the origin of this overcrowding is multifactorial. To find solutions, we must observe overcrowding in the whole of the hospital institution and of the healthcare system. The aim of this thesis is to describe the patient's pathway from his/her arrival at the ED to his/her departure, and sometimes his/her come back. Each article of this thesis represents a step of the patient's pathway. Then, the overcrowding of the ED, or of the hospital, is studied in its entirety. This collection of articles highlights the complexity of the issue and the need to mobilize the whole institution to respond.

No description available.

Thesis (M.H.A.)--University of Michigan, 1969.

Thesis (M.H.A.)--University of Michigan, 1969.

SAMMANFATTNING Syftet med studien var att undersöka patienters inställning till att dela rum med patienter av motsatt kön och ålder. Metoden som användes var en deskriptiv tvärsnittsstudie med kvantitativ ansats som utfördes på två akutkirurgiska avdelningar. Det var 33 inneliggande patienter som deltog i studien. En studiespecifik enkät delades ut med tio frågor och två frågor om kön och ålder. Frågorna rörde olika synpunkter om hur det är att dela rum med andra patienter och om hur det är att dela rum med patienter med motsatt kön och ålder. Enkäten innehöll även en öppen fråga där deltagarna kunde lämna övriga synpunkter. Materialet analyserades med beskrivande statistik. För att jämföra skillnaden mellan män och kvinnor användes Mann Whitney U test och för att jämföra skillnader mellan de olika åldersgrupperna användes Kruskall Wallis. Resultatet visade att kvinnor ansåg att det var något obekvämare att dela rum med motsatt kön än vad det var för männen. Kvinnorna ville också i större utsträckning få information om detta innan man blev tilldelad en sal och plats. Den yngsta åldersgruppen 18-30 år upplevde sig mest besvärad av störd nattsömn jämfört med de två äldre grupperna. Slutsatsen var att kvinnor tyckte att det var mer obekvämt att dela rum med personer av motsatt kön. De yngsta deltagarna ansåg att det var mest besvärande att dela rum med andra och då med tanke på störd nattsömn. Det som skapade mest oro på patientsalen var när medpatienterna inte visade hänsyn eller om det var medicinskt oroliga. / ABSTRACT The aim of this study was to investigate the patient´s views on their expirience and preference of sharing a patient room with other patients of the opposite sex en age. The metod was a deskriptive cross-sectional study with a quantitavie analyxix. A survey was conducted at two surgical departments. The sample consisted of 33 inpatients. The investigation included questions of gender and age in order to compare differances between men and women and between age groups. The differences between sexes were analysed using Mann Whitney U test and the Kruskall Wallis test was used to determine differances between age groups. The results showed that women felt it somewhat inconvenient to share a room with the opposite sex than men did. The women would also like to receive information about this before the were assigned a room and place. the youngest age group of 18-30 years was the most troubled by disturbed sleep compared with the two older groups. The conclusion was that women found it more uncomfortable to share a room with people of the opposite sex. Among age groups the youngest participants experienced that it was most embarrassing to share a room with others and especially when considering distrubed sleep. What created the most concern was when the other patients did not show respect or if they were medically worried.