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Appears in Collections:Management, Work and Organisation Journal Articles
Peer Review Status: Refereed
Title: Location of services and the impact on healthcare quality: insights from a simulation of a musculoskeletal physiotherapy service
Author(s): Bowers, John
Mould, Gillian
Marshall, Carol
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Keywords: simulation
health service
Issue Date: 2015
Date Deposited: 1-May-2015
Citation: Bowers J, Mould G & Marshall C (2015) Location of services and the impact on healthcare quality: insights from a simulation of a musculoskeletal physiotherapy service. Journal of the Operational Research Society, 66 (7), pp. 1212-1221.
Abstract: Many healthcare systems are being redesigned to deliver local care with more services within the community. Relocation may enhance access but other aspects of healthcare quality should also be considered, notably waiting times and equity of care. This study examined a musculoskeletal physiotherapy service using a discrete-event simulation with simple heuristics to model patient behaviour. This combination provided an effective mechanism for incorporating the individuality of the patients in the flows along the patient pathways, subject to the varying availabilities of key resources. In particular, it captured the feedback that is critical in system performance, especially where waiting times are important. The model recognised the heterogeneity of patient attitudes and demonstrated how the behaviour of a relatively small proportion can affect the experience of all patients. The study suggested that, with careful operational management, more care could be delivered locally while exploiting many of the benefits of a centralised service.
DOI Link: 10.1057/jors.2014.85
Rights: This item has been embargoed for a period. During the embargo please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study. This is an Accepted Manuscript of an article published by Taylor & Francis Group in Journal of the Operational Research Society on 21 Dec 2017, available online:

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