The northern community of Assiniboine Narrows has a population of 12,000. It has

Question

The northern community of Assiniboine Narrows has a population of 12,000. It has one medical clinic with three doctors, each working 40hours per week. Each Doctor sees four patients per hour. The clinic would like to hire one or two more doctors.

The mortality rate in the community is 11 per 1,000 population. This rate will fall to 9.5 per thousand if one doctor is added and to 9 per thousand if two doctors are added. Each new doctor will cost the system $250,000 per year.

An alternative plan is to bring in two home care nurses. Each home care nurse will see two patients per hour. The addition of the first nurse will reduce the mortality rate by 0.8 per thousand, and the addition of a second nurse will reduce the mortality rate by 0.6 per thousand. Each home care nurse will cost the system $100,000 per year.

Use your calculations to examine the alternative available to Assiniboine Narrows. Then based on your calculations, make a recommendation as to the preferred course of action. Ensure that you calculate the output and outcome of each additional health professional.

Explanation / Answer

The population of the northern community of Assiniboine Narrows is 12000. The mortality rate is 11 per thousand or, 132 for the entire population. If one additional doctor is hired at a cost of $ 250000 per year, the mortality rate falls to 9.5 per thousand or to (9.5/1000.)*12000 = 114 for the entire population i.e. 132 -114 = 18 lives can be saved. Further, if yet another doctor is hired, the mortality rate falls further to 9 per thousand or to (9/1000.)*12000 = 108 for the entire population i.e. 114 -108 = 6 additional lives can be saved at a further cost of $ 250000 per year.However, if a home care nurse is hired, the mortality rate can be reduced by 0.8 per thousand. This means that the mortality will be [( 11 - 0.8)/1000] * 12000 = 122.4 or say 122 ( on rounding off to the nearest whole number) for the entire population i.e. 132 -122 = 10 lives can be saved at a cost of $ 100000 per year. Now, if one more home care nurse is hired at a further cost of $ 100000 per year, the mortality rate will fall further by 0.56 per thousand i.e. the mortality rate will get reduced to (11 -0.8 - 0.6) = 9.6 per thosand so that the mortality rate will be (9.6/1000)*12000 = 115.2 for the entire population. Thus, by hiring 2 home care nurses, 132 -115.2 = 16.8, say 17 additional lives can be saved. Now, it is abundantly clear that the best option is to hire 1 additional doctor and 2 additional home care nurses. Then 18 +17 = 35 lives can be saved at an additional expenditure of $ 250000 + 2 *10000 = $ 450000, whereas if 2 additional doctors are hired, the number of lives saved will be 18 +6 = 24 and the additional expenditure will be $ 2 * 250000 = $ 500000.

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