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A rational approach to estimating the surgical demand elasticity needed to guide manpower reallocation during contagious outbreaks.

Tsao HM, Sun YC, Liou DM - PLoS ONE (2015)

Bottom Line: Appendectomy, 'open reduction of fracture with internal fixation' and 'free skin graft' were in the low demand elasticity group.In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated.Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.

View Article: PubMed Central - PubMed

Affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan.

ABSTRACT

Background: Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs.

Aim: To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks.

Materials and methods: Based on a nationwide research database in Taiwan, we extracted the monthly volumes of major surgery types for the period 1998-2003, which covered the SARS period, in order to carry out a time series analysis. The demand elasticity of each surgery type was then estimated by autoregressive integrated moving average (ARIMA) analysis.

Results: During the study period, the surgical volumes of most selected surgery types either increased or remained steady. We categorized these surgery types into low-, moderate- and high-elastic groups according to their demand elasticity. Appendectomy, 'open reduction of fracture with internal fixation' and 'free skin graft' were in the low demand elasticity group. Transurethral prostatectomy and extracorporeal shockwave lithotripsy (ESWL) were in the high demand elasticity group. The manpower of the departments carrying out the surgeries with low demand elasticity should be maintained during outbreaks. In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated.

Conclusions: Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.

No MeSH data available.


Related in: MedlinePlus

Trends in surgical volumes over the period 1998–2002.(A) Open reductions of fracture (B) Procedures related to hemorrhoids (C) appendectomies, and (D) total abdominal hysterectomies.
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pone.0122625.g001: Trends in surgical volumes over the period 1998–2002.(A) Open reductions of fracture (B) Procedures related to hemorrhoids (C) appendectomies, and (D) total abdominal hysterectomies.

Mentions: During the study period, the surgical demands grew steadily with the expanding and aging population of Taiwan. The surgical volumes of the selected surgery types either increased or remained steady over time, with the exception of total abdominal hysterectomy (ICD9 code 68.4X) (Fig 1). Several studies have reported that vaginal hysterectomy is safer and has fewer complications than abdominal hysterectomy, thus, the route for carrying out hysterectomy is shifting toward the vaginal approach. In fact, the total volume for hysterectomies showed a growing trend over the study period.


A rational approach to estimating the surgical demand elasticity needed to guide manpower reallocation during contagious outbreaks.

Tsao HM, Sun YC, Liou DM - PLoS ONE (2015)

Trends in surgical volumes over the period 1998–2002.(A) Open reductions of fracture (B) Procedures related to hemorrhoids (C) appendectomies, and (D) total abdominal hysterectomies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383619&req=5

pone.0122625.g001: Trends in surgical volumes over the period 1998–2002.(A) Open reductions of fracture (B) Procedures related to hemorrhoids (C) appendectomies, and (D) total abdominal hysterectomies.
Mentions: During the study period, the surgical demands grew steadily with the expanding and aging population of Taiwan. The surgical volumes of the selected surgery types either increased or remained steady over time, with the exception of total abdominal hysterectomy (ICD9 code 68.4X) (Fig 1). Several studies have reported that vaginal hysterectomy is safer and has fewer complications than abdominal hysterectomy, thus, the route for carrying out hysterectomy is shifting toward the vaginal approach. In fact, the total volume for hysterectomies showed a growing trend over the study period.

Bottom Line: Appendectomy, 'open reduction of fracture with internal fixation' and 'free skin graft' were in the low demand elasticity group.In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated.Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.

View Article: PubMed Central - PubMed

Affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan.

ABSTRACT

Background: Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs.

Aim: To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks.

Materials and methods: Based on a nationwide research database in Taiwan, we extracted the monthly volumes of major surgery types for the period 1998-2003, which covered the SARS period, in order to carry out a time series analysis. The demand elasticity of each surgery type was then estimated by autoregressive integrated moving average (ARIMA) analysis.

Results: During the study period, the surgical volumes of most selected surgery types either increased or remained steady. We categorized these surgery types into low-, moderate- and high-elastic groups according to their demand elasticity. Appendectomy, 'open reduction of fracture with internal fixation' and 'free skin graft' were in the low demand elasticity group. Transurethral prostatectomy and extracorporeal shockwave lithotripsy (ESWL) were in the high demand elasticity group. The manpower of the departments carrying out the surgeries with low demand elasticity should be maintained during outbreaks. In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated.

Conclusions: Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.

No MeSH data available.


Related in: MedlinePlus