Efficiency evaluation for pooling resources in health care: An interpretation for managers


Vanberkel, Peter T. and Boucherie, Richard J. and Hans, Erwin W. and Hurink, Johann L. and Litvak, Nelly (2009) Efficiency evaluation for pooling resources in health care: An interpretation for managers. [Report]

open access
Abstract:Subject/Research problem
Hospitals traditionally segregated resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and efficiency in service delivery can be achieved when services are organized around patient groups. Examples are specialized clinics for breast cancer patients and clinical pathways for diabetes patients. Hospitals are grappling more and more with the question, should we become more centralized to achieve economies of scale or more decentralized to achieve economies of focus. In this paper service and patient group characteristics are examined to determine conditions where a centralized model is more efficient and conversely where a decentralized model is more efficient.
Research Question
When organizing hospital capacity what service and patient group characteristics indicate that efficiency can be gained through economies of scale vs. economies of focus?
Using quantitative models from the Queueing Theory and Simulation disciplines the performance of centralized and decentralized hospital clinics are compared. This is done for a variety of services and patient groups.
The study results in a model measuring the tradeoffs between economies of scale and economies of focus. From this model “rules of thumb” for managers are derived.
The general results support strategic planning for a new facility at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital. A model developed during this study is also applied in the Chemotherapy Department of the same hospital.
Item Type:Report
Additional information:This paper is a management interpretation of: Vanberkel P.T., Boucherie R.J., Hans E.W., Hurink J.L., Litvak N. (2009) Efficiency evaluation for pooling resources in health care, Memorandum 1902, Department of Applied Mathematics, University of Twente, Enschede. http://eprints.eemcs.utwente.nl/15762/ It appeared in the unpublished proceedings of the Research Day "Innovation in Design and Management of Healthcare Facilities and Healthy Environments", Rotterdam, The Netherlands, 26 May 2009.
Electrical Engineering, Mathematics and Computer Science (EEMCS)
Faculty of Behavioural, Management and Social sciences (BMS)
Research Chair:
Research Group:
Link to this item:http://purl.utwente.nl/publications/67567
Publisher URL:http://www.math.utwente.nl/publications
Export this item as:BibTeX
HTML Citation
Reference Manager


Repository Staff Only: item control page