Subject(s)
Body Mass Index , Body Weight , Classification , Humans , Reference Values , World Health OrganizationABSTRACT
BACKGROUND: Many Norwegian hospitals have to cancel elective surgery because of acute cases, and ring fencing of elective surgery is a frequently discussed measure. In this article we discuss advantages and disadvantages of ring fencing in relation to the results from a simulation model. MATERIAL AND METHODS: Model simulations were done in the computer program Powersim Constructor 2.5. RESULTS: We found that combined acute and elective departments are expected to have shorter waiting time and less use of overtime compared with separate acute and elective departments, as more flexible use of capacity results in higher average capacity utilization. In a combined department, elective patients run the risk of having their operation cancelled, but they may expect a shorter waiting time before treatment. INTERPRETATION: Our results indicate that ring fencing in itself is not beneficial, as total capacity utilization declines. On the other hand, separate departments may facilitate an increase in efficiency in the elective surgery department; this may shorten waiting time.
Subject(s)
Computer Simulation , Efficiency, Organizational , Hospital Administration , Operating Rooms/organization & administration , Surgery Department, Hospital/organization & administration , Waiting Lists , Appointments and Schedules , Elective Surgical Procedures , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Models, Organizational , Norway , Operating Rooms/statistics & numerical data , Software , Surgery Department, Hospital/statistics & numerical dataABSTRACT
BACKGROUND: We aimed at investigating whether disabled old people can get sufficient care in residential facilities for the elderly. MATERIALS AND METHODS: All residents in our community's care facilities for the elderly in 2001 were registered. Those living in their own homes with a substantial need for care were also registered. Burden of care was assessed by six items measuring activities of daily life and two items measuring cognitive decline. RESULTS: 309 persons were registered; mean age was 84. Those living in residential care facilities staffed 24 hours a day represented the highest average burden of care, though many elderly living in their own homes also need a great deal of care. In our community, the number of nursing home beds set aside for short-term stays has decreased from 24 to 11 over a eight-year period. The burden of care has increased since 1992 in nursing homes as well as in other residential care units. INTERPRETATION: Group-dwelling unit staffed around the clock can be a good alternative to nursing homes for many demented patients. While a high number of such units have been built, the local authorities have found it increasingly difficult to provide a sufficient number of nursing home beds for short-term stays. Most changes observed can be related to the growing number of inhabitants above 80 years of age.
