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dc.contributor.authorBarton, Maria-
dc.contributor.authorMcClean, Sally-
dc.contributor.authorGarg, Lalit-
dc.contributor.authorFullerton, Ken-
dc.identifier.citationBarton, M., McClean, S. I., Garg, L., & Fullerton, K. (2009). Modelling stroke patient pathways using survival analysis and simulation modelling. XIII International Conference on Applied Stochastic Models and Data Analysis, Vilnius. 370-373.en_GB
dc.description.abstractStroke disease is the third leading cause of death in the UK, placing a heavy burden on society at a cost of 7 billion pounds per year. Prolonged length of stay in hospital is considered to be an inefficient use of hospital resources. In this paper we present results of survival analysis that utilise length of stay and destination as outcome measures, based on data from the Belfast City Hospital. Survival probabilities were determined using Kaplan-Meier survival curves and log rank tests. Multivariate Cox proportional hazards models were also fitted to identify independent predictors of length of stay including age, gender and diagnosis. Elderly patients showed a decreased hazard ratio of discharge. However, gender was not a significant hazard risk for length of stay in hospital. Those patients with a diagnosis of cerebral haemorrhage showed an increased hazard ratio and hence were most likely to have a shorter length of stay and to die in hospital. Those who were eventually discharged to a Private Nursing Home had the lowest probability of early discharge. On the basis of these results we have created several groups, stratified by age, gender diagnosis and destination. These groups are then used to form the basis of a simulation model where each group is a patient pathway within the simulation. Various scenarios are explored with a particular focus on the potential efficiency gains if length of stay in hospital, prior to discharge to a Private Nursing Home, can be reduced.en_GB
dc.subjectMedical careen_GB
dc.subjectCerebrovascular disease -- Patientsen_GB
dc.subjectHospital utilization -- Length of stayen_GB
dc.titleModelling stroke patient pathways using survival analysis and simulation modellingen_GB
dc.rights.holderThe copyright of this work belongs to the author(s)/publisher. The rights of this work are as defined by the appropriate Copyright Legislation or as modified by any successive legislation. Users may access this work and can make use of the information contained in accordance with the Copyright Legislation provided that the author must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the prior permission of the copyright holderen_GB
dc.bibliographicCitation.conferencenameXIII International Conference on Applied Stochastic Models and Data Analysisen_GB
dc.bibliographicCitation.conferenceplaceVilnius, Lithuania, 30/06-3/07/2009en_GB
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