Browsing by Author "Amunjela, Abimelek Shikongo"

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    The normalisation of resource efficiency measures in healthcare facilities: the case of energy and water
    (Stellenbosch : Stellenbosch University, 2019-04) Amunjela, Abimelek Shikongo; De Kock, Imke; Brent, Alan C.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Energy and water consumption performance comparisons are used at a healthcare management and policy formulation level when formulating benchmarks and energy improvement targets. Normalising for the differences between hospitals is a key part of hospital consumption performance comparisons. It ensures that the measures used in these comparisons are commensurate, thereby increasing the reliability and robustness of the comparisons. Currently, the measures used in these comparisons are only normalised for the size of a hospital and are not adjusted to account for the inter-hospital differences in the level of medical service provision. This study investigated the feasibility of including normalisation factors that are representative of the level of medical service provision in the normalisation model used to compare the energy and water performance of hospitals. The complexity and level of specialisation of the composition of a hospital’s diagnostic caseload and the output of a hospital were used to quantify the level of medical service provision at a hospital. Measures were also formulated to quantify the size of a hospital. Statistically-based modelling methods were used to conduct an exhaustive analysis of the relationships between combinations of the normalising factors in the analysis and the energy and water consumption of the respective hospitals. Multiple linear regression (MLR) models were developed for all the possible combinations of normalising factors. These models were used to assess and rank the explanatory power provided by each combination of normalising factors in explaining the variations in the energy and water consumption of hospitals. Based on these MLR analyses and the rankings of the explanatory power provided by the respective models, it was concluded that the level of medical service provision of a hospital (as represented by its output, complexity and level of specialisation), does not significantly contribute to increasing the reliability or robustness of the current normalisation model. Furthermore, accounting for the level of medical service provision in the normalisation model would complicate the model without providing any significant additional explanatory power or increasing the objectivity of hospital consumption performance comparisons.