• Gunn Kristin Tjoflot, Hans Th Waaler, and Tor Iversen.
• Institutt for helseledelse og helseøkonomi, Universitetet i Oslo, Postboks 1089, 0317 Oslo. gtjoflot@medisin.uio.no
• Tidsskr. Nor. Laegeforen. 2005 Jun 2;125(11):1472-5.

BackgroundMany Norwegian hospitals have to cancel elective surgery because of acute cases, and ring fencing of elective surgery is a frequently discussed measure. In this article we discuss advantages and disadvantages of ring fencing in relation to the results from a simulation model.Material And MethodsModel simulations were done in the computer program Powersim Constructor 2.5.ResultsWe found that combined acute and elective departments are expected to have shorter waiting time and less use of overtime compared with separate acute and elective departments, as more flexible use of capacity results in higher average capacity utilization. In a combined department, elective patients run the risk of having their operation cancelled, but they may expect a shorter waiting time before treatment.InterpretationOur results indicate that ring fencing in itself is not beneficial, as total capacity utilization declines. On the other hand, separate departments may facilitate an increase in efficiency in the elective surgery department; this may shorten waiting time.

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