Munich – 1976

Report on the Second Meeting held in Munich, Germany, 2nd-4th June 1976
Edited by Dr. Duncan Boldy, Chairman of the Working Group and Dr. Clemens Dietrich, Organiser of the Munich Meeting, May 1977

Introduction and Summary

The second meeting of the working group “O.R. Applied to Health Services” was held in June 1976 in Munich, Germany, attended by 18 representatives, covering the covering the countries of Denmark, Germany (West), Greece, Italy, Switzerland, The Netherlands and the United Kingdom and including a representative from the W.H.O.  The general theme of the meeting was “Efficiency in Hospitals”, with an emphasis on the hospital as a whole, rather than on specific, rather specialised aspects.

A total of ten sessions were held over the three days of the meeting.  In the first session the chairman of the working group, Dr. Duncan Boldy, reported on the first meeting in Exeter, its contributions and resolutions.  Copies of the report of this meeting have been distributed among the participants of the working group and other interested persons and a copy has also been sent to EURO, the Association of European Operational Research Societies within IFORS. – In the second session Dr. Boldy reported on the status of national registers of current projects.  Dr. Herbert Zollner reported on the O.R. and related activities of the Regional Office for Europe of the World Health Organisation.  In particular, he mentioned that a list of “health economics” projects was being prepared covering the countries of Belgium, France, Norway and Sweden.  This information will be made available to the working group by Dr. Zollner.

In the third session the participants took part in what could be called an “experimental O.R exercise”.  We estimated the waiting times at various stages of the treatment chain on our own countries, in order to get a better feel for some of the differences between the various national health care systems.

The fourth session was devoted to classification problems of hospitals in the Netherlands.  Mr. Joseph van Aert presented a paper on the functional classification of general hospitals worked out both with the help of “expert opinion” and by the use of statistical techniques.

The fifth session concentrated on a linear programming study of the “optimal size of hospitals” by Mr. Dietrich Fischer.  One main outcome of his study is that the optimal stratification strategy is likely to emphasise decentralisation rather than centralisation of hospital facilities.

In the sixth session, Dr. Boldy outlined a mathematical programming study concerned with the desirable “Balance of Care” between different forms of health and social services (e.g. hospital care, community care) and different types of patient/client (e.g. elderly, mentally ill).  The model allows the resource consequences of adopting different policies for the provision of health and social services care for a defined population, to be estimated.

In the seventh session, Mr. John Luckman reported on work concerning “Admission Policies for Hospital Surgical Units”, dealing with both un-planned and planned admissions.  The primary objectives of admission policy were high utilisation of beds and operating theatre time.

In the eighth session Mr. Ove Hedegaard reported on a possible classification of management problems in hospitals according to the two dimensions:- – l1 level1 lfo1;tab-stops:list 18.0pt'>a)     strategic, tactical, operational, – l1 level1 lfo1;tab-stops:list 18.0pt'>b)     stable environment, adaptation to environmental changes, development for influencing the environment.

In the ninth session Mr. Lars Villemoes presented a paper concerning the desirability, or otherwise, of co-operation between the specialist functions of hospital services.  Based on an assessment of the facilities etc. required by patients, the paper argues for a strong decentralisation of hospitals with extensive co-operation, especially between larger hospitals (greater than about 500 beds) and university clinics.

The final session concentrated on decisions concerning the next meeting (place, time, theme, structure) and future activities of the working group.

Review Papers

1.      Waiting Times in Health Care Systems of Different EURO Countries – Clemens Dietrich. – 2.      Function Classification of General Hospitals – An Empirical Investigation – Joseph van Aert.

3.      Optimum Hospital Size – Dietrich Fischer.

4.      “Balance of Care” – Outline of an Approach to the Strategic Planning of Health and Social Services – Duncan Boldy.

5.      Admission Policies for Hospital Surgical Units – John Luckman.

6.      Hospital Management – A Frame of Reference – Ove Hedegaard.

7.      Co-operation between the Specialist Functions of Hospital Services – Lars Villemoes.

List of Participants

Mr. Joseph van Aert – The Netherlands

Dr. Duncan Boldy – United Kingdom

Dr. Clemens E.M. Dietrich – West Germany

Mr. Dietrich Fischer – West Germany

Mr. Arne M. Frederiksen – Denmark

Mr. Mark Füllemann – Switzerland

Dr. Klaus Hansen – West Germany

Mr. Heinz Harland – West Germany

Mr. Ove Hedegaard – Denmark

Mr. Michael Kirkels – The Netherlands

Mr. John Luckman – England

Mr. Elvezio Montesarchio – Italy

Mr. Sune V. Petersen – Denmark

Mr. Wolfgang Rieger – West Germany

Dr. Chris J. Sanctuary – England

Dr. Aris Sissouras – Greece

Mr. Lars Villemoes – Denmark

Dr. Herbert Zöllner – Denmark