Development of a model for predicting hospital beds shortage and optimal policies using system dynamics approach.

BACKGROUND: Policymakers use simulation-based models to improve system feedback and model the reality of the problems in the system. This study uses the system dynamics approach to provide a model for predicting hospital bed shortages and determine the optimal policy in Shiraz, Southern Iran. METHODS: This study was designed based on Sterman's system dynamic modeling (SDM) process. Firstly, we determined the main variables affecting bed distribution using a mixed qualitative and quantitative study which includes scoping review, expert panel, Delphi, and DANP. Then, dynamic hypotheses were designed. Subsequently, we held several expert panels for designing the causal and stock-flow models, formulating and testing a simulation model, as well as developing various scenarios and policies. RESULTS: Dynamic modeling process resulted in four scenarios. All of the scenarios predicted a shortage of national hospital beds over a 20-year time horizon. Then, four policies were developed based on the changes in the number of beds and capacity of home care services; finally, the optimal policy was determined. CONCLUSIONS: Due to the high cost of setting up hospital beds, developing and supporting cost-effective home care services, strengthening the insurance coverage of these services, and improving the quantity and quality of community care, considering the real needs of the community could be considered as an optimal option for the future of the city.

Development of a scenario-based blood bank model to maximize reducing the blood wastage.

INTRODUCTION: Blood is a valuable as well as a perishable commodity that has a limited lifespan. So, keeping it in a blood bank requires careful attention and management. In this study, a management model has been designed for the blood bank that can cover all the requests sent through the hospital subunits in such a way that it has the least waste. MATERIALS AND METHODS: First, by examining the blood inventory system of a hospital, the number of inventories per month and the distribution of blood products in subunits of the hospital, and the amount of blood wastage every six months were estimated. Then, using ARENA simulation, all parts of the blood bank, including the request section, emergency blood section, donated blood section, and other sections were simulated. Finally, 10 scenarios were extracted by placing various parameters and the best scenarios were discussed and concluded. RESULTS AND DISCUSSION: The scenarios for the four blood groups included A, B, AB, and O were applied for six months in one year. The results showed that if the amount of blood injected into the blood bank is appropriate and at the right time, the amount of wastage can be reduced by up to 80% for most of the blood groups. CONCLUSION: The results of this study showed that if the system of receiving blood products built upon a precise management model is predetermined and placed with appropriate parameters, the amount of wastage will be reduced to the minimum possible number.