Abstract

Subject/Research problem: Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and efficiency in service delivery can be achieved when services are organized around patient groups. Examples are specialized clinics for breast cancer patients and clinical pathways for diabetes patients. Hospitals are struggling with the question whether to become more centralized to achieve economies of scale or more decentralized to achieve economies of focus. In this paper service and patient group characteristics are examined to determine conditions where a centralized model is more efficient and conversely where a decentralized model is more efficient. - Research Question: When organizing hospital capacity what service and patient group characteristics indicate efficiency can be gained through economies of scale vs. economies of focus? - Approach: Using quantitative Queueing Theory and Simulation models the performance of centralized and decentralized hospital clinics is compared. This is done for a variety of services and patient groups. - Result: The study results in a model measuring the tradeoffs between economies of scale and economies of focus. From this model management guidelines are derived. - Application: The general results support strategic planning for a new facility at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital. A model developed during this research is also applied in the Chemotherapy Department of the same hospital.
Original languageEnglish
Place of PublicationEnschede, the Netherlands
PublisherUniversity of Twente, Department of Applied Mathematics
Number of pages10
Publication statusPublished - 2010

Publication series

NameMemorandum / Department of Applied Mathematics
PublisherUniversity of Twente, Department of Applied Mathematics
No.1919

Fingerprint

Economies of scale
Diagnostics
Trade-offs
Quality of care
Queueing theory
Breast cancer
Nursing
Diabetes
Chemotherapy
Simulation model
Service delivery
Resources
The Netherlands
Ambulatory care
Organizing
Model management
Pathway
Strategic planning
Cancer

Cite this

Vanberkel, P. T., Boucherie, R. J., Hans, E. W., Hurink, J. L., & Litvak, N. (2010). Designing for Economies of Scale vs. Economies of Focus in Hospital Departments. (Memorandum / Department of Applied Mathematics; No. 1919). Enschede, the Netherlands: University of Twente, Department of Applied Mathematics.
Vanberkel, Peter T. ; Boucherie, Richardus J. ; Hans, Elias W. ; Hurink, Johann L. ; Litvak, Nelli. / Designing for Economies of Scale vs. Economies of Focus in Hospital Departments. Enschede, the Netherlands : University of Twente, Department of Applied Mathematics, 2010. 10 p. (Memorandum / Department of Applied Mathematics; 1919).
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abstract = "Subject/Research problem: Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and efficiency in service delivery can be achieved when services are organized around patient groups. Examples are specialized clinics for breast cancer patients and clinical pathways for diabetes patients. Hospitals are struggling with the question whether to become more centralized to achieve economies of scale or more decentralized to achieve economies of focus. In this paper service and patient group characteristics are examined to determine conditions where a centralized model is more efficient and conversely where a decentralized model is more efficient. - Research Question: When organizing hospital capacity what service and patient group characteristics indicate efficiency can be gained through economies of scale vs. economies of focus? - Approach: Using quantitative Queueing Theory and Simulation models the performance of centralized and decentralized hospital clinics is compared. This is done for a variety of services and patient groups. - Result: The study results in a model measuring the tradeoffs between economies of scale and economies of focus. From this model management guidelines are derived. - Application: The general results support strategic planning for a new facility at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital. A model developed during this research is also applied in the Chemotherapy Department of the same hospital.",
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Vanberkel, PT, Boucherie, RJ, Hans, EW, Hurink, JL & Litvak, N 2010, Designing for Economies of Scale vs. Economies of Focus in Hospital Departments. Memorandum / Department of Applied Mathematics, no. 1919, University of Twente, Department of Applied Mathematics, Enschede, the Netherlands.

Designing for Economies of Scale vs. Economies of Focus in Hospital Departments. / Vanberkel, Peter T.; Boucherie, Richardus J.; Hans, Elias W.; Hurink, Johann L.; Litvak, Nelli.

Enschede, the Netherlands : University of Twente, Department of Applied Mathematics, 2010. 10 p. (Memorandum / Department of Applied Mathematics; No. 1919).

Research output: Book/ReportReportOther research output

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AB - Subject/Research problem: Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and efficiency in service delivery can be achieved when services are organized around patient groups. Examples are specialized clinics for breast cancer patients and clinical pathways for diabetes patients. Hospitals are struggling with the question whether to become more centralized to achieve economies of scale or more decentralized to achieve economies of focus. In this paper service and patient group characteristics are examined to determine conditions where a centralized model is more efficient and conversely where a decentralized model is more efficient. - Research Question: When organizing hospital capacity what service and patient group characteristics indicate efficiency can be gained through economies of scale vs. economies of focus? - Approach: Using quantitative Queueing Theory and Simulation models the performance of centralized and decentralized hospital clinics is compared. This is done for a variety of services and patient groups. - Result: The study results in a model measuring the tradeoffs between economies of scale and economies of focus. From this model management guidelines are derived. - Application: The general results support strategic planning for a new facility at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital. A model developed during this research is also applied in the Chemotherapy Department of the same hospital.

M3 - Report

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ER -

Vanberkel PT, Boucherie RJ, Hans EW, Hurink JL, Litvak N. Designing for Economies of Scale vs. Economies of Focus in Hospital Departments. Enschede, the Netherlands: University of Twente, Department of Applied Mathematics, 2010. 10 p. (Memorandum / Department of Applied Mathematics; 1919).