Analytical models for decision making

248 Pages·2006·7.542 MB·English

by  Sanderson, Colin J

D
o
w
n
P UN Colin Sanderson load
UBLIC DERS & Reinhold Gruen ed by [ Fac
HEA TAN ulty of N
LTH DIN ursing
UNDERSTANDING PUBLIC HEALTH G , C
h
ia
n
g
SERIES EDITORS:NICK BLACK & ROSALIND RAINE m
a
i U
Analytical Models for There is an increasing niv
e
Decision Making global awareness of the rsity
inevitable limits of A Analytical 5.62
Health care systems are complex and, as a individual health care and n .15
roefs cuhlta,n itg iess o inft epno luicnyc olera sre wrvhicaet pthroev eisfifoencts osuf cthh es enreveicde tso w ciothm epffleecmtievnet alytic 8.117] at [0
might be. At the same time, resources for public health strategies. a Models for 7/1
l 8
health care tend to be in short supply, Understanding Public Health M /16
which means that public health is an innovative series of o ]. C
o
practitioners have to make difficult twenty books, published by de pyrig
dqeucainsitoitnast.i vTeh ias nbdo oqku adleitsactriivbee sm tehtehods that Ocoplleanb oUrnaitvioenrs iwtyit Phr ethsse in ls f Decision Making ht © M
o c
G
can help decision makers to structure and London School of Hygiene r D raw
cthlaer iifmy pdliifcfaictuioltn ps roofb pleumrsus ianngd d tioff eexrepnlotre &It pTrroovpiidceasl Mseelfd-dicirinecet.ed ecis -Hill Glo
options. The accompanying CD-ROM learning covering the major io bal E
provides the opportunity to try some of issues in public health n du
M ca
the proposed solutions. affecting low, middle and tio
The book examines: high income countries. aki n Hold
◗ hMeoadltehl sc aanred decision making in Tsthued syeinrige sp ius baliimc ehdea altth t,hose ng ings, LL
C
◗ Methods for clarifying complex either by distance learning . N
o
decisions or more traditional & t to
C b
◗◗ rMMesoooddueerllcslie nf ogarl l fsooecrra vetivicoaenl upalatninngin cgh aanngdes mhpeoealtilchtyho mdpsra,a kacestri twsi.oenlle arss panudblic Reinh olin S e redistribu
in systems old G ande ted or mo
Colin Sandersonis Reader in Health Services ru rso dified
Research and Reinhold Gruenis Honorary e n in
n a
n
Senior Lecturer in Health Services y w
a
Management at the London School of y w
Hygiene & Tropical Medicine. ith
o
u
t p
e
rm
issio
n
Cover design Hybert Design •www.hybertdesign.com .
UNDERSTANDING PUBLIC HEALTH
www.openup.co.uk
D
o
w
n
lo
a
d
e
d
b
y
[ F
a
c
u
lty
o
f N
u
rsin
g
, C
h
ia
n
g
m
a
i U
n
iv
e
rsity
5
.6
2
.1
5
8
.1
1
7
] a
t [0
7
/1
8
/1
6
]. C
o
p
y
rig
h
t ©
M
c
G
ra
w
-H
ill G
lo
b
a
l E
d
u
c
a
tio
n
H
o
ld
in
g
s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.
D
o
w
n
lo
a
d
e
d
b
y
[ F
a
c
u
lty
o
Analytical Models for f N
u
rsin
g
Decision Making , C
h
ia
n
g
m
a
i U
n
iv
e
rsity
5
.6
2
.1
5
8
.1
1
7
] a
t [0
7
/1
8
/1
6
]. C
o
p
y
rig
h
t ©
M
c
G
ra
w
-H
ill G
lo
b
a
l E
d
u
c
a
tio
n
H
o
ld
in
g
s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.
D
o
w
n
lo
a
d
e
d
b
y
Understanding Public Health [ F
a
c
u
Series editors: Nick Black and Rosalind Raine, London School of Hygiene & Tropical Medicine lty o
f N
u
Throughout the world, recognition of the importance of public health to sustainable, safe and rsin
healthy societies is growing. The achievements of public health in nineteenth-century Europe were g, C
for much of the twentieth century overshadowed by advances in personal care, in particular in hia
hospital care. Now, with the dawning of a new century, there is increasing understanding of the ng
m
inevitable limits of individual health care and of the need to complement such services with effective a
i U
public health strategies. Major improvements in people’s health will come from controlling com- n
municable diseases, eradicating environmental hazards, improving people’s diets and enhancing the ive
availability and quality of effective health care. To achieve this, every country needs a cadre of know- rsity
ledgeable public health practitioners with social, political and organizational skills to lead and bring 5.6
2
about changes at international, national and local levels. .1
5
8
This is one of a series of 20 books that provides a foundation for those wishing to join in and .11
7
contribute to the twenty-first-century regeneration of public health, helping to put the concerns and ] a
perspectives of public health at the heart of policy-making and service provision. While each book t [0
7
stands alone, together they provide a comprehensive account of the three main aims of public health: /1
8
protecting the public from environmental hazards, improving the health of the public and ensuring /1
6
high quality health services are available to all. Some of the books focus on methods, others on key ]. C
topics. They have been written by staff at the London School of Hygiene & Tropical Medicine with op
y
considerable experience of teaching public health to students from low, middle and high income rig
h
countries. Much of the material has been developed and tested with postgraduate students both in t ©
face-to-face teaching and through distance learning. M
c
G
The books are designed for self-directed learning. Each chapter has explicit learning objectives, key ra
w
terms are highlighted and the text contains many activities to enable the reader to test their own -H
understanding of the ideas and material covered. Written in a clear and accessible style, the series will ill G
be essential reading for students taking postgraduate courses in public health and will also be of lo
b
interest to public health practitioners and policy-makers. al E
d
Titles in the series uc
a
tio
Analytical models for decision making: Colin Sanderson and Reinhold Gruen n H
Controlling communicable disease: Norman Noah old
Economic analysis for management and policy: Stephen Jan, Lilani Kumaranayake, in
g
Jenny Roberts, Kara Hanson and Kate Archibald s, L
Economic evaluation: Julia Fox-Rushby and John Cairns (eds) LC
Environmental epidemiology: Paul Wilkinson (ed) . N
o
Environment, health and sustainable development: Megan Landon t to
Environmental health policy: David Ball (ed) be
Financial management in health services: Reinhold Gruen and Anne Howarth red
GHleoabltahl ccharaen egvea alunadt hioena:l tSha:r Kahel Slemy iLthee, Danodn JSeifnf cClaoilrl,i nR o(esadlsi)nd Raine and Barnaby Reeves istribu
te
Health promotion practice: Wendy Macdowall, Chris Bonell and Maggie Davies (eds) d o
Health promotion theory: Maggie Davies and Wendy Macdowall (eds) r m
Introduction to epidemiology: Lucianne Bailey, Katerina Vardulaki, Julia Langham and od
Daniel Chandramohan ifie
d
Introduction to health economics: David Wonderling, Reinhold Gruen and Nick Black in
a
Issues in public health: Joceline Pomerleau and Martin McKee (eds) n
y
Making health policy: Kent Buse, Nicholas Mays and Gill Walt w
a
y
Managing health services: Nick Goodwin, Reinhold Gruen and Valerie Iles w
Medical anthropology: Robert Pool and Wenzel Geissler ith
o
Principles of social research: Judith Green and John Browne (eds) ut p
Understanding health services: Nick Black and Reinhold Gruen erm
issio
n
.
D
o
w
n
lo
a
d
e
d
b
y
[ F
a
c
u
lty
o
Analytical Models for f N
u
rsin
g
Decision Making , C
h
ia
n
g
m
a
i U
n
iv
e
rsity
5
.6
2
.1
5
Colin Sanderson and Reinhold Gruen 8.1
1
7
] a
t [0
7
/1
8
/1
6
]. C
o
p
y
rig
h
t ©
M
c
G
ra
w
-H
ill G
lo
b
a
l E
d
u
c
a
tio
n
H
o
ld
in
g
s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
Open University Press erm
issio
n
.
D
o
w
n
lo
a
d
e
d
b
y
Open University Press [ F
McGraw-Hill Education ac
u
McGraw-Hill House lty
o
Shoppenhangers Road f N
u
Maidenhead rsin
Berkshire g, C
England h
ia
SL6 2QL ng
m
a
email: [email protected] i U
n
world wide web: www.openup.co.uk iv
e
and Two Penn Plaza, New York, NY 10121-2289, USA rsity 5
.6
2
.1
5
8
First published 2006 .11
7
] a
Copyright © London School of Hygiene & Tropical Medicine 2006 t [0
7
/1
All rights reserved. Except for the quotation of short passages for the purpose of 8
/1
criticism and review, no part of this publication may be reproduced, stored in a 6]. C
retrieval system, or transmitted, in any form or by any means, electronic, o
p
mechanical, photocopying, recording or otherwise, without the prior written yrig
permission of the publisher or a licence from the Copyright Licensing Agency ht ©
Limited. Details of such licences (for reprographic reproduction) may be obtained M
c
from the Copyright Licensing Agency Ltd of 90 Tottenham Court Road, London G
ra
W1T 4LP. w
-H
A catalogue record of this book is available from the British Library ill G
lo
b
ISBN-10: 0 335 21845 8 (pb) al E
ISBN-13: 978 0 335 218 455 (pb) d
u
c
a
Library of Congress Cataloging-in-Publication Data tio
n
CIP data applied for H
o
ld
Typeset by RefineCatch Limited, Bungay, Suffolk ing
Printed in Poland by OZGraf S.A. s, L
L
www.polskabook.pl C. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.
D
o
w
n
lo
a
d
e
d
Contents by
[ F
a
c
u
lty
o
f N
u
rsin
g
, C
h
ia
n
g
m
Overview of the book 1 ai U
n
iv
Section 1 Models and decision making in health care ersity
1 The role of models 7 5.6
2
2 Building a decision support model 28 .1
5
3 Strategic Options Development and Analysis 43 8.1
1
7
] a
Section 2 Methods for clarifying complex decisions t [0
7
/1
4 Many criteria 65 8
/1
5 Uncertainty 84 6]. C
6 Risk 103 o
p
y
rig
Section 3 Models for service planning and resource allocation ht ©
M
7 Population need for a specific service 121 c
G
8 Balanced service provision 142 ra
w
9 Hospital models 164 -H
ill G
Section 4 Modelling for evaluating changes in systems lob
a
l E
10 Modelling flows through systems 181 d
u
c
11 Irregular flows: systems with queues 202 atio
12 Outline review 223 n H
o
Glossary 227 ldin
g
Index 231 s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.
D
o
w
n
lo
a
d
e
d
b
y
[ F
a
c
u
lty
o
f N
u
rsin
g
, C
h
ia
n
g
m
a
i U
n
iv
e
rsity
5
.6
2
.1
5
8
.1
1
7
] a
t [0
7
/1
8
/1
6
]. C
o
p
y
rig
h
t ©
M
c
G
ra
w
-H
ill G
lo
b
a
l E
d
u
c
a
tio
n
H
o
ld
in
g
s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.
D
o
w
n
lo
a
d
e
d
Acknowledgements by
[ F
a
c
u
lty
o
f N
u
rsin
g
, C
h
ia
n
g
m
Open University Press and the London School of Hygiene & Tropical Medicine have ai U
made every effort to obtain permission from copyright holders to reproduce material in n
iv
tahttiesn btoioonk wanilld b teo r eamckendoiewdl eidng feu ttuhrees ee dsiotiuornces.s correctly. Any omissions brought to our ersity
5
.6
2
We would like to express our grateful thanks to the following copyright holders for .1
5
granting permission to reproduce material in this book. 8.1
1
7
p.18 Bcoemnspleuyt eDr-Csi,m Wualtastoionn P mS aondde lM ofo rtrhieso pno GteWnt,i a‘Pl aftohr whaeyaslt ohf gcaoirno’n, Maryat chaerme –a ta- ] at [07
/1
ics Medicine and Biology, Vol 12, pp315–28, 1993, by permission of 8/1
pp.155–6 OS xCfroorpdp Uenr iavnerds itPy FPorerstes. (eds), Enhancing Health Service Management, 6]. Co
p
©O p1e9n9 7U,n Oivpeernsi tUyn Pirveesrss.ity Press. Reproduced with the kind permission of yrigh
p.68 Cushman M and Rosenhead J, 2004, ‘Planning in the face of politics: t ©
M
reshaping children’s health services in Inner London’ in Brandeau M et al c
G
(eds), Handbook of Operations Research and Health Care. Springer ra
w
Science + Business Media. -H
p.192 Doll et al, British Medical Journal, 2004, Vol 328, pp 1519–1528. Repro- ill G
duced with permission from the BMJ Publishing Group lo
b
pp.133–6 Reprinted with permission from Elsevier (The Lancet, 1999, Vol 353, al E
pp1304–9) d
u
c
pp.52–4 Gains A, and Rosenhead J, LSEOR Working Paper 93.8 ‘Problem structur- a
ing for medical quality assurance’, LSEOR, 1993 tion
H
p.167,175 Gruen RP, Constantinovici N, Normand C and Lamping DL, ‘Costs o
ld
for dialysis for elderly people in the UK’, Nephrology Dialysis Trans- in
g
plantation, 18, 2122–2127, by permission from Oxford University Press. s, L
pp.1–6 Lane D, Monefeldt C & Rosenhead J, Looking in the wrong place for L
C
healthcare improvements: a system dynamics study of an accident and . N
o
emergency department, 2000, Journal of the Operational Research Soci- t to
ety, reproduced with permission of Palgrave Macmillan b
e
pp.18–20 Luckman J and Stringer J, ‘The operational research approach to problem re
d
sOoxlvfoinrdg ’U, Bnriviteisrhsi tMy Perdeiscsa.l Bulletin, 1974, 30, 257–261, by permission of istribu
pp.57–59,93 Rational analaysis for a problematic world revisited, Rosenhead J and ted
o
Mingers J (editors). 2001, © John Wiley & Sons Limited. Reproduced with r m
permission. o
d
p.137 Sanderson C, ‘Limitations of epidemiological needs assessment: the case ifie
d
of prostatectomy,’ Medical Care, 35:669-85 by permission of Lippincott in
Williams and Wilkins. an
y
pp.24–6 Sterman J, Business dynamics: systems thinking and modelling for a w
a
complex world, 2000, Mc-Graw-Hill Education, reproduced with permis- y w
sion of The McGraw-Hill Companies. ith
o
p.171 Soderlund Neil et al, British Medical Journal, 1997, Vol 315, pp1126-1129. u
t p
Reproduced with permission from the BMJ Publishing Group e
rm
issio
n
.
D
o
w
viii ACKNOWLEDGEMENTS nlo
a
d
e
d
b
y
p.190,210 Sonnenberg FA and Beck JR, Markov models in medical decision [ F
making: a practical guide, Medical Decision Making, 1993, Vol 13, issue 4, ac
u
pp322–338 lty
p.104,105–7 Thornton JG, Lilford RJ, Johnson N, British Medical Journal, 1992, of N
Vol 304, pp1099–1103. Reproduced with permission from the BMJ u
Publishing Group rsin
g
, C
h
ia
n
g
m
a
i U
n
iv
e
rsity
5
.6
2
.1
5
8
.1
1
7
] a
t [0
7
/1
8
/1
6
]. C
o
p
y
rig
h
t ©
M
c
G
ra
w
-H
ill G
lo
b
a
l E
d
u
c
a
tio
n
H
o
ld
in
g
s, L
L
C
. N
o
t to
b
e
re
d
istrib
u
te
d
o
r m
o
d
ifie
d
in
a
n
y
w
a
y
w
ith
o
u
t p
e
rm
issio
n
.