Modularising Outpatient Care Delivery: A Mixed Methods Case Study At A Finnish University Hospital

HEALTH SERVICES MANAGEMENT RESEARCH(2018)

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摘要
Background Modularisation is a potential means to develop health care delivery by combining standardisation and customisation. However, little is known about the effects of modularisation on hospital care. The objective was to analyse how modularisation may change and support health care delivery in specialised hospital care. Methods A mixed methods case study methodology was applied using both qualitative and quantitative data, including interviews, field notes, documents, service usage data, bed count and personnel resource data. Data from a reference hospital's unit were used to understand the context and development of care delivery in general. Results The following outcome themes were identified from the interviews: balance between demand and supply; support in shift from inpatient to outpatient care; shorter treatment times and improved management of service production. Modularisation supported the shift from inpatient towards outpatient care. Changes in resource efficiency measures were both positive and negative; the number of patients per personnel decreased, while the number of visits per personnel and the bed utilisation rate increased. Conclusions Modularisation may support health care providers in classifying patients and delivering services according to patients' needs. However, as the findings are based on a single university hospital case study, more research is needed.
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关键词
healthcare, healthcare delivery, mixed methods case study, modularisation, operations management, outpatient care
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