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Towards a macro model of National Health Service waiting lists
Author(s) -
van Ackere Ann,
Smith Peter C.
Publication year - 1999
Publication title -
system dynamics review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.491
H-Index - 57
eISSN - 1099-1727
pISSN - 0883-7066
DOI - 10.1002/(sici)1099-1727(199923)15:3<225::aid-sdr171>3.0.co;2-p
Subject(s) - macro , pace , service (business) , elective surgery , operations research , operations management , perspective (graphical) , waiting list , marketing , computer science , actuarial science , economics , business , medicine , engineering , surgery , geodesy , artificial intelligence , transplantation , programming language , geography
Waiting lists for elective surgery have been endemic to the UK National Health Service since its inception in 1948. The lists arise as a result of interaction between supply factors (the provision of resources and the efficiency of their use) and demand factors (arising from a complex conjunction of the perceptions and preferences of patients and physicians). This article takes the first steps towards the development of a macro model of the NHS waiting list. It adopts an economics perspective and assumes that the waiting time for surgery, as perceived by patients, physicians and managers, is a central influence on the quantity of elective surgery demanded and supplied. Using the methods of system dynamics, econometric results are integrated into a dynamic model that seeks to illustrate the path taken over time by the national system of elective surgery. It explores a number of future scenarios, and finds that the NHS will quickly cease to be a universal service if resources fail to keep pace with increases in demand. Copyright © 1999 John Wiley & Sons, Ltd.