A norm utilisation for scarce hospital resources: evidence from operating rooms in a Dutch university hospital.
BACKGROUND
Utilisation of operating rooms is high on the agenda of hospital managers and researchers. Many efforts in the area of maximising the utilisation have been focussed on finding the holy grail of 100% utilisation. The utilisation that can be realised, however, depends on the patient mix and the willingness to accept the risk of working in overtime.


METHODS
This is a mathematical modelling study that investigates the association between the utilisation and the patient mix that is served and the risk of working in overtime. Prospectively, consecutively, and routinely collected data of an operating room department in a Dutch university hospital are used. Basic statistical principles are used to establish the relation between realistic utilisation rates, patient mixes, and accepted risk of overtime.


RESULTS
Accepting a low risk of overtime combined with a complex patient mix results a low utilisation rate. If the accepted risk of overtime is higher and the patient mix is less complex, the utilisation rate that can be reached is closer to 100%.


CONCLUSIONS
Because of the inherent variability of healthcare processes, the holy grail of 100% utilisation is unlikely to be found. The method proposed in this paper calculates a realistic benchmark utilisation that incorporates the patient mix characteristics and the willingness to accept risk of overtime.
Division of Operating Rooms, ICU, and Anaesthesiology, ErasmusMC University Medical Centre, Rotterdam, The Netherlands.
Mark
M
Van Houdenhoven
Erwin W
EW
Hans
Jan
J
Klein
Gerhard
G
Wullink
Geert
G
Kazemier
D017048:Health Care Costs; D006751:Hospital Information Systems; D006785:Hospitals, University; D006801:Humans; D017059:Models, Econometric; D009426:Netherlands; D009873:Operating Rooms / Q000191:economics / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000191:economics / Q000706:statistics & numerical data