Health economic modeling to support surgery management at a Swedish hospital

Elective surgery management typically deals with a queue of patients that have to be scheduled for surgery within a certain time frame, considering both medical and economic constraints. In order to prevent the patient queue and waiting times from growing, surgery management has to decide whether to temporarily increase patient throughput at the regional hospital or have some patients scheduled for surgery at another hospital. In Sweden, a newly passed law states that patients who decide to receive surgery should not have to wait more than 90 days before this surgery is carried out. Therefore, if a patient decides to apply the new law by requesting surgery within 90 days, the regional hospital is obliged to arrange and pay for either in-house surgery or surgery at another hospital. In this paper, we suggest an approach using simulation including optimization for modeling surgery management decisions. We study a case based on data from a General Surgery Department at a Swedish hospital and present our results as a health economic evaluation. The results indicate an increase in the mean waiting times for medium prioritized patients when the new law is applied.