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Modelling trauma hip fracture hospital activities

Voake, Cheryl 2012. Modelling trauma hip fracture hospital activities. PhD Thesis, Cardiff University.
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Abstract

Hip fracture is the most common reason for an elderly person to be admitted to an acute orthopaedic ward. The main aim of this research is to provide a statistical evaluation of a hip fracture database, and then to use Operational Research (OR) techniques, using the statistical output, to model activities associated with the care of hip fracture patients. OR techniques employed in this thesis include simulation and queuing theory. This research focuses on hip fracture admissions to the University Hospital of Wales in Cardiff, with a primary aim of ascertaining whether the time between admission and surgical intervention has any impact upon patient outcome. Outcome is considered in terms of mortality, hospital length of stay and discharge destination. Statistical analyses are performed, via regression and CART analysis, to investigate length of stay and mortality variables. The results from these statistical tests are compiled, compared and investigated in more depth. Additionally, a principal component analysis is performed to investigate whether it would be feasible to reduce the dimensionality of the dataset, and subsequently principal component regression methodology is used to complement the output. Simulation is used to model activities in both the hip fracture ward and the trauma theatre. These models incorporate output from the statistical analysis and encompass complexities within the patient group and theatre process. The models are then used to test a number of ‘what-if’ type scenarios, including the future anticipated increase in demand. Finally, results from queuing theory are applied to the trauma theatre in order to determine a desired daily theatre allocation for these patients. Specifically, the M | G | 1 queuing system and results from queues with vacations are utilised. The thesis concludes with some discussion of how this research could be further expanded. In particular, two areas are considered; risk scoring systems and the Fenton-Wilkinson approximation.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Mathematics
Subjects: Q Science > QA Mathematics > QA76 Computer software
R Medicine > RA Public aspects of medicine
Uncontrolled Keywords: Hip fracture; Simulation Operating theatre Ageing population Surgical delay
Date of First Compliant Deposit: 30 March 2016
Last Modified: 25 Oct 2016 02:59
URI: http://orca.cardiff.ac.uk/id/eprint/42402

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