The paper "Operations research within UK healthcare: a review" provides an overview of the application of operations research (OR) in the UK healthcare sector. The review highlights the contribution of OR in improving efficiency, reducing costs, and enhancing patient outcomes in various areas of healthcare, such as hospital management, patient flow, resource allocation, and scheduling. The paper also discusses the challenges and opportunities in applying OR in healthcare, such as data availability, ethical considerations, and stakeholder engagement. Overall, the review provides insights into the potential of OR to drive innovation and improve healthcare delivery in the UK.

1. OPERATIONS
RESEARCH
Research Paper:
Operations research within
UK healthcare: a review
PRN140
Shivang Gesota
PRN144
Mayank Singh
PRN099
Harender Singh
PRN069
Sourish Datta
PRN045
Mihir Pancholi
PRN018
Bipasa Chatterjee
Group 17

2. Operations research within UK healthcare: a review
Purpose of Paper
 Identify the existing literature on the wide
range of operations research (OR) studies
applied to healthcare.
 To classify studies based on application
type and on the OR technique employed.
OR techniques have been one of the most popular decision making and analysis tools in healthcare.
This research will inform decision makers, academics and researchers, practitioners and all other problem
stakeholders and will contribute to an increase in the awareness of the applicability of OR techniques for
solving specific problems related to healthcare operations management
 It is a literature review paper with the scope of
this study is limited to the UK healthcare sector.
 In total, 142 high-quality journal and conference
papers have been identified from ISI Web of
Knowledge data base for review and analysis.
Masoud Fakhimi and Jane Probert
School of Business and Economics, Swansea University, Swansea, UK
Scope of Paper
What to Expect?

3. EXISTING REVIEWS ON
OPERATIONS RESEARCH
APPLIED TO HEALTHCARE
The lack of the width of OR methods in studies, the breadth
of application areas and publication in outlets of different
fields of study (including operation research, healthcare MIS
and medical studies) has resulted in potentially obstructing
the extensive references and application of such studies.
However, there are many reviews that mostly have focused
on one OR method, namely, simulation.

4. Review on application of
computer simulation in modelling
healthcare delivery
01
Review on application of simulation techniques
for analysis of the economic effectiveness of
health-related products and technologies.
02
Review on Simulation in
pharmacoeconomic model
development.
03
Review analysed academic literature
on healthcare modelling and simulation
04
REVIEW FOCUSED ON OR METHOD SIMULATION
IN DIFFERENT RESEARCH PAPERS

5. Agent-based
Simulation
System
dynamics (SD)
Discrete-event
simulation (DES) Monte-Carlo
simulation (MCS)
APPLICATION OF FOUR DIFFERENT SIMULATION
TECHNIQUES IN HEALTHCARE CONTEXT

6. One study that closely relates to the work presented in this
paper is the survey of OR in healthcare by Rais and Viana
(2011). In their paper the authors present “selected” OR
studies under four major categories, namely, healthcare
planning, healthcare management and logistics, healthcare
practice and specialized and preventive healthcare.
However, unlike our study which has an underlying literature
review methodology, there is no such methodological
approach in the study Research paper by Rais and Viana.

7. 02
RESEARCH METHODOLOGY
Select keyword
Combinations
Query ISI Web of Science
database through use of
multiple keyword
combinations
Two Steps Process:
1. Search for OR papers
2. Search for papers on
simulation
Filter articles
01
04
Review articles
Abstract and full-text
review
Include the selected papers
as the underlying dataset for
this study
Build the dataset
03
Stage (a) – Paper Collection

8. 02
RESEARCH METHODOLOGY
Level-1 Categorization
Categories studies based on
the OR methods they
employed
Profile all studies based on
their application area,
healthcare specialty,
software used, etc.
Level-2 Categorization
01
01
Record Information
Use the “Information
Capture” template to capture
information pertaining to l1
and l2 categorization
Presentation of results and
discussion
Stage (c)
03
Stage (b) – Information Capturing

9. RESULTS

10. OR TECHNIQUES AND MAJOR APPLICATION AREAS
12 OR techniques used in the 142 studies
included in the review paper.
51
31
16
10
9
7
4
4 3 3
3
1
MTP DES MCS MOD MTH MKV
SD FC CS SCH DS SE
Number of Paper with
different OR techniques
Costeff
ective
and
econo
mic
evaluati
on in…
improving
clinical and
administrative
performance ,
47, 33%
literature and
methodology
review, 25,
18%
Major Application Area

11. Application of OR technique for economic and cost-
effectiveness analysis
• MTP: About 70 per cent of MTP studies have used or discussed MCS and Markov modelling
frameworks
• MCS: Studies have used MCS to evaluate the economic efficiency of a new method or technology for
treatment, for undertaking an economic comparative study between two different systems etc.
• DES: Studies have used DES to assess the impact of several alternative allocation policies upon the
cost-effectiveness of new technology
• MOD: Studies in this category is based on developing models including conceptual or logical models,
and physical schemes
• MTH: Studies have used MTH to develop models to determine resource costs and health benefits of
implementing guidelines for the prevention of various diseases
• CS:CS has been used in clinical and social studies for groups of individuals
• SE (real-time simulation): Studies have used SE to identify mostly operational issues

12. Application of OR technique for economic and cost-
effectiveness analysis
Healthcare
specialty
Applications of Health OR
Number of
studies
OR Technique
Clinical issues
Cost evaluation of new treatment methods (e.g., for
patients with diabetes, Alzheimer’s, heart failure,
cancer, transplants, schizophrenia)
58
MTP(29 Papers)
DES(10 Papers)
MCS(7 Papers)
MOD(4 Papers)
MKV(5 Papers)
CS(2 Papers)
Managerial issues
Cost and efficiency evaluation of performance
improvement (e.g., modelling occupancy time,
improving the demand response, improving
ambulance response time) Public health (e.g.,
preventing influenza, or preventing Cardiovascular
disease, smoking prevention childcare and care of
the elderly)Strategies and policies (e.g., comparing
cost-effectiveness of hospital at-home and inpatient
care, analyzing three key variables in the UK
healthcare)
12
MTP(3 Papers)
DES(3 Papers)
MCS(3 Papers)
MTH(2 Papers)
SE(1 Papers)

13. Improving clinical and administrative performance
• MTP: Studies have used MTP for improvements in patient care and for investigating managerial issues (through
use of scheduling, forecasting, quality control and process improvement)
• DES: Papers related to this category have discussed the application of DES with the purpose of improvements
in medical or administrative areas
• MOD: Papers have applied MOD to develop a model using IT tools to improve the processes of healthcare
organizations
• MTH: Studies have used MTH to develop a formula for allocating resources for commissioning hospital care to
all general practices etc
• MKV: Studies have applied MKV to estimate life expectancies in health and ill health and the transition between
them
• SD:SD has been applied to provide insight into the consequences of the trend of bringing services “closer to
home” by exploring the underlying feedback structure
• FC: Studies have used FC, to forecast and estimate hospital admission during pressure times
• SCH: Studies have used SCH, to analyse the nurse rostering system
• DS: Only one study has applied DS in this category to simulate the supply chain of blood from a National Blood
Service (NBS) Centre to hospitals

14. Improving clinical and administrative performance
Healthcare
specialty
Applications of health OR
Number of
studies
OR Technique
Clinical issues
Predictive modelling (e.g., clinical pregnancy, embryo
transfers, influenza dynamics, possible effect of new
treatments methods, )
Analysing new treatment methods (e.g. podiatric care, heart
disease, cancer)
Public health issues (e.g. mortality risk factor analysis,
evaluation vaccination program)
13
MTP(5 Papers)
DES(1 Paper)
MCS(3 Papers)
MOD(2 Papers)
MTH(2 Papers)
Managerial issues
Performance improvement modelling (e.g., reducing waiting
time, design and plan the operation of a NHS Walk-in Centre,
improve patient flow, supply chain management, analyse
resource requirements, minimise bottlenecks of clinical
processes, modelling risks, demand simulation)
Policy and strategy (e.g., ethnic difference analysis, evaluating
screening strategy) Public health issues (e.g., public health
scheme involving mobile-volunteer cardiac first-responders,
predict the performance targets in A&E department, estimation
of life expectancies in health and ill health)
34
MTP(6 Papers)
DES(13 Papers)
MCS(2 Papers)
MOD(1 Paper)
MTH(2 Papers)
SD(2 Papers)
FC(2 Papers)
SCH(3 Papers)
DS(3 Papers)

15. LAND METHODOLOGY REVIEW
• MTP: Review papers have referred to MTP to identify critical factors that influence patient waiting times and the
build-up of queues in the clinic
• DES: These papers refer to DES for reviewing the research opportunities in IT and computing to improve the
efficiency of OR techniques, to discuss the application of DES for improving and developing healthcare policies
• MOD: Review papers have referred to MOD to analyse the role of modelling techniques in leading
innovations effectively way
• MTH: Papers reviewed the application of MTH to guide policy decisions on the control of foot and mouth
disease through regular meetings with the science group
• MKV: Papers in this referred to MKV in order to describe the NICE requirements for both incidence-based cost-
effectiveness analyses and prevalence-based estimates of the aggregate NHS impact of the new drug
• CS: The study reviews publications on adherence to statin medication in clinical trials and in normal practice
• SD: Review papers have referred to SD to demonstrate embed a simple static economic model within a
dynamic framework
• FC: Review papers have referred to FC to review the relationship between the seasonality of various diseases
and the timing of the maximum prevalence of the pandemic wave, along with its amplitude and duration
• DS: Papers in this research referred to DS to investigate using conventional and distributed approaches to
simulating the supply chain of blood from an NBS Centre to hospitals

16. PUBLICATION TRENDS
Over last three decades, the application of OR methods for solving healthcare problems has
improved significantly. The papers includes in this study are gathered from 65 journals and
conferences
Health Technology Assessment 14
Journal of the Operational Research
Society
13
Pharmacoeconomics 11
Winter Simulation Conference 9
British Medical Journal 7
Classification of journal outlets and conf. proceedings
5
3
10
7
12 11 11
16
14 15
11
20
7
90 per cent of all such studies have
been
published from the year 2000 onwards

17. FUNDING AND REGIONAL CLASSIFICATIONS
Government
59%
Industry and
stakeholders
9%
Research
centres,
NGOs,charitie
s and
academic
institutes
11%
No direct
funding
7%
No data
available
14%
According to the findings, from the 142 papers
included in this review, about 60 per cent of the
papers are government funded, discuss healthcare
issues in the context of UK.
Government support for OR studies has been increasing in
healthcare especially because of the effectiveness of OR
techniques in conducting cost utility and cost-
effectiveness analysis.
Takeaways:

18. 20
16
13
9
8
Microsoft
Excel
TreeAge
Software
Simul8 Micro-Saint
Sharp
Stella
SOFTWARE PACKAGES
The increases in computer power have facilitated the
use of OR tools by managers and administrators in all
industries and sectors
There are many kinds of software packages on the
market now, for example: Anylogic, Simul8, Microsoft
Excel, TreeAge, Arena and Sigma.
According to the findings, “TreeAge”
and “Microsoft Excel” are the two
most popular OR software packages
used in UK healthcare used mostly for
cost-effectiveness models and Markov
chain modelling.
33 different software
packages were used for

19. LIMITATIONS AND
FINDINGS OF THE
STUDY
• Only 1 source of data is used i.e., Web of
Science
• Only scholarly articles are considered in
the paper
• Research is done but not published by
other stakeholders and journals
• The distribution of OR techniques is not
uniform i.e., majority of the studies have
been conducted on simulation model and
a smaller number of papers or articles
have been employed for multi method
approach

20. CONCLUSIONS
Use of OR techniques is
increasing in terms of
studies conducted.
Majority of studies focus on
simulation model of
operation research.
Simulation Tools and
Softwares can be developed
to enhance the application
of OR techniques in
different sectors
Use of simulation models
for healthcare system
analysis has helped in
reducing costs and
improving healthcare
operations.

21. THANKS!