Tjoflot Gunn Kristin, Waaler Hans Th, Iversen Tor
Institutt for helseledelse og helseøkonomi, Universitetet i Oslo, Postboks 1089, 0317 Oslo.
Tidsskr Nor Laegeforen. 2005 Jun 2;125(11):1472-5.
Many Norwegian hospitals have to cancel elective surgery because of acute cases, and ring fencing of elective surgery is a frequently discussed measure. In this article we discuss advantages and disadvantages of ring fencing in relation to the results from a simulation model.
Model simulations were done in the computer program Powersim Constructor 2.5.
We found that combined acute and elective departments are expected to have shorter waiting time and less use of overtime compared with separate acute and elective departments, as more flexible use of capacity results in higher average capacity utilization. In a combined department, elective patients run the risk of having their operation cancelled, but they may expect a shorter waiting time before treatment.
Our results indicate that ring fencing in itself is not beneficial, as total capacity utilization declines. On the other hand, separate departments may facilitate an increase in efficiency in the elective surgery department; this may shorten waiting time.
许多挪威医院因急症不得不取消择期手术，而对择期手术进行围堵是一个经常被讨论的措施。在本文中，我们根据一个模拟模型的结果讨论围堵的优缺点。
在计算机程序Powersim Constructor 2.5中进行模型模拟。
我们发现，与单独设立急症科室和择期科室相比，急症与择期科室合并预计等待时间更短，加班情况更少，因为更灵活地利用能力会带来更高的平均能力利用率。在合并科室中，择期手术患者有手术被取消的风险，但他们可能预期在治疗前等待时间更短。
我们的结果表明，围堵本身并无益处，因为总能力利用率会下降。另一方面，单独设立科室可能有助于提高择期手术科室的效率；这可能缩短等待时间。
