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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

Observed and predicted monthly volumes for various surgeries in 2003.Monthly volume (y axis) is plotted against time (x axis). The solid line shows the observed values. The dashed line shows the predicted values and 95% confidence intervals (dotted lines). The vertical dotted line indicates the period with an outbreak of SARS in Taiwan. (A) During the SARS epidemic, the observed surgical volume for appendectomy remained stable. (B) The observed volume for transurethral prostatectomy during the SARS epidemic decreased dramatically, which implies that transurethral prostatectomy has a high demand elasticity.
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pone.0122625.g002: Observed and predicted monthly volumes for various surgeries in 2003.Monthly volume (y axis) is plotted against time (x axis). The solid line shows the observed values. The dashed line shows the predicted values and 95% confidence intervals (dotted lines). The vertical dotted line indicates the period with an outbreak of SARS in Taiwan. (A) During the SARS epidemic, the observed surgical volume for appendectomy remained stable. (B) The observed volume for transurethral prostatectomy during the SARS epidemic decreased dramatically, which implies that transurethral prostatectomy has a high demand elasticity.

Mentions: Table 1 shows the monthly volume and the demand elasticity of each selected surgery type. We arbitrarily classified the surgery types into three categories according to their demand elasticity indices. Indices below 30, in the range 30–190 and above 190, represented low, moderate and high demand elasticity, respectively. Appendectomy (ICD9 code 47.0X) was found to have the lowest elasticity index, followed in order by ‘open reduction of fracture with internal fixation’ (ICD9 code 79.3X) and ‘free skin graft’ (ICD9 code 86.6X) as having the next lowest elasticity indices. A low demand elasticity implies that the fear for SARS did not make any significant change in the elasticity and that the observed values for the relevant month, May 2003, fall into the expected range obtained using the ARIMA models. Fig 2A illustrates the monthly volume of appendectomies in 2003.


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)

Observed and predicted monthly volumes for various surgeries in 2003.Monthly volume (y axis) is plotted against time (x axis). The solid line shows the observed values. The dashed line shows the predicted values and 95% confidence intervals (dotted lines). The vertical dotted line indicates the period with an outbreak of SARS in Taiwan. (A) During the SARS epidemic, the observed surgical volume for appendectomy remained stable. (B) The observed volume for transurethral prostatectomy during the SARS epidemic decreased dramatically, which implies that transurethral prostatectomy has a high demand elasticity.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0122625.g002: Observed and predicted monthly volumes for various surgeries in 2003.Monthly volume (y axis) is plotted against time (x axis). The solid line shows the observed values. The dashed line shows the predicted values and 95% confidence intervals (dotted lines). The vertical dotted line indicates the period with an outbreak of SARS in Taiwan. (A) During the SARS epidemic, the observed surgical volume for appendectomy remained stable. (B) The observed volume for transurethral prostatectomy during the SARS epidemic decreased dramatically, which implies that transurethral prostatectomy has a high demand elasticity.
Mentions: Table 1 shows the monthly volume and the demand elasticity of each selected surgery type. We arbitrarily classified the surgery types into three categories according to their demand elasticity indices. Indices below 30, in the range 30–190 and above 190, represented low, moderate and high demand elasticity, respectively. Appendectomy (ICD9 code 47.0X) was found to have the lowest elasticity index, followed in order by ‘open reduction of fracture with internal fixation’ (ICD9 code 79.3X) and ‘free skin graft’ (ICD9 code 86.6X) as having the next lowest elasticity indices. A low demand elasticity implies that the fear for SARS did not make any significant change in the elasticity and that the observed values for the relevant month, May 2003, fall into the expected range obtained using the ARIMA models. Fig 2A illustrates the monthly volume of appendectomies in 2003.

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