Decongesting surgery appointments, reducing patient waiting time and even lowering costs in terms of public health services can be achieved in a win-win relationship between public and private services.
In several regions of the world, outsourcing of surgical procedures is being used, which means that if a patient who requires an operation cannot be operated on in public hospitals, he/she is taken to a private center, which generally has uncongested operating rooms.
Outsourcing provides benefits to all involved from two main points of view:
""It allows governments and social security institutes to meet patients' needs without incurring large investments.
"Private care centers increase the utilization of their installed capacity, which could mean an increase in their efficiency and profitability.
Making decisions that involve lowering costs without affecting patients is a challenge faced by public health systems around the world, especially in countries where resources are scarce.
Faced with this reality, several public health systems have sought alternative solutions to meet the demands of the population.
In Nicaragua, for example, many of the operations that have to be performed through Social Security are transferred to private centers, through contracts with per capita payment and payment for events.
Because of the size of the population served and the diversity of surgical procedures demanded, there is a great opportunity for outsourcing, even for hospitals with a high demand for private patients.
procedures demanded, there is a great opportunity for outsourcing, even for hospitals with a high demand for private patients.
Decision-making in a hospital, thinking about a better scheduling of its services, generates a lot of uncertainty, mainly due to the complexity of collecting reliable information through a historical record regarding the use of operating rooms.
The fact that there are several medical specialties, with different surgical procedures in which the duration of each intervention is completely different from the others, makes it difficult to apply deterministic methods used in industries with more easily standardized processes.
In view of this, there are simulation methods that allow decisions to be made that take into account variability, a characteristic that is deeply rooted in hospital industry procedures.
There are generally three sources of variability that affect the estimation of operating room utilization rates: demand, procedure duration times, and cleaning and instrument preparation times.
The demand for surgeries by type of specialty could be found in a monthly report generated by the medical directorates of the hospitals on the number of surgeries performed.
Duration times can be calculated using information on the start and end times of surgeries recorded in the operating room usage log.
Regarding cleaning and instrument preparation times, hospitals generally do not keep records, but a study can be made to obtain the data.
With the model built and the data defined, there are many options for obtaining the utilization percentage, depending on the needs and resources of each hospital.
Opportunities to improve the efficiency of a hospital's overall operations through modeling is just one step that healthcare institutions can take for the benefit of themselves and their patients.
Excerpt from the article "Quantitative methods in hospital management", published in the journal INCAE Business Review.
