Towards effective cancer care service delivery design in emerging economies: a real case-based simulation study

The COVID-19 pandemic exhausted global health resources and undermined the treatment of other critical illnesses such as cancer. Due to the cancellations of the planned cancer therapy, we observe a sudden surge of cancer patients seeking complex and variable chemotherapy treatment once the pandemic subsides. The chemotherapy service deliveries in emerging economies, especially grapple with this issue because of limited health resources. In this study, we present an effective chemotherapy service delivery that can handle the increased patient volume and treatment variety mix with restricted resources. We develop this care delivery system using the discrete-event simulation technique that would reduce waiting time for patients, enable hospitals to handle rising patient demand, and manage variability in patient arrivals. We suggest three interventions, namely, staggered shifts for medical assistants and junior oncologists; prioritizing shorter duration of patients; and using pooled junior oncologists, which, together, can aid the hospital in reducing up to 93.5% of the patient wait time and deliver effective cancer care. The study represents a novel attempt to capture operationally intricate in-patient chemotherapy procedures practiced in hospitals for the first time and provides a service blueprint to manage the spillover effect of the pandemic on cancer care.