Optimisation of elective care patient allocation over multiple locations based on patient preferences

Abstract

With the implementation of the “Zorgverzekeringswet” in 2006, the healthcare system has changed over the years from a supply-driven system to a more demand-driven system. Service for patients have become increasingly important for healthcare providers, for example hospitals. Due to this change, hospitals experience more pressure to find the perfect balance between the components of the Triangle of Health Care: accessible, cost-friendly and high quality care. In order to improve the accessibility of care for patients, care parties have set up an initiative: “the right care in the right place”(JZOJP). This initiative is setup with the aim to shift the perspective of healthcare providers from their interests and what they have to offer, to what people need from them to live independently as long as possible. Furthermore, transmural care and concentration and decentralisation are also developments to improve the accessibility of care for patients. One way hospitals can contribute to these initiatives and developments is by setting up external outpatient clinics (EOCs). These clinics are located on the edge of their care areas or between hospital locations. These EOCs are set up to provide care closer the homes of patient and to attract patients living on the edge of care area. However, nowadays hospital are more focussed on the service for patients and less on competition with other hospitals. Franciscus Gasthuis & Vlietland is a hospital group in the area of Rotterdam. Franciscus has seven locations: Franciscus Gasthuis, Franciscus Vlietland, EOC Berkel, EOC Maassluis, EOC Hoogvliet Haven polikliniek and het Oogziekenhuis, Rotterdam. The performance of the EOC locations have not yet been researched in detail before. However, after a first analysis of the patient flow it was concluded that the patient flow for Maassluis and Hoogvliet were decreasing. Also, Franciscus believes that the locations are not optimally used due to empty rooms during opening hours and lack of work for employees at the locations. With focus on the service for patients, the increasing pressure on the main locations and the vacancy of rooms at EOCs, Franciscus aims to use the EOC locations more efficient.