SummaryUsing average number of patients expected in a year, average length of stay and a target occupancy level to calculate the number of critical care beds needed is mathematically incorrect because of nonlinearity and variability in the factors that control length of stay. For a target occupancy in excess of 80%, this simple calculation will typically underestimate the number of beds required. More seriously, it provides no quantitative guidance information about other aspects of critical care demand such as the numbers of emergency patients transferred, deferral rates for elective patients and overall utilisation. The combination of appropriately analysing raw data and detailed mathematical modelling provides a much better method for estimating numbers of beds required. We describe this modelling approach together with evidence of its performance.

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It has long been recognised that the structure of social networks plays an important role in the dynamics of disease propagation. The spread of HIV results from a complex network of social interactions and other factors related to culture, sexual behaviour, demography, geography and disease characteristics, as well as the availability, accessibility and delivery of healthcare. The small world phenomenon has recently been used for representing social network interactions. It states that, given some random connections, the degrees of separation between any two individuals within a population can be very small. In this paper we present a discrete event simulation model which uses a variant of the small world network model to represent social interactions and the sexual transmission of HIV within a population. We use the model to demonstrate the importance of the choice of topology and initial distribution of infection, and capture the direct and non-linear relationship between the probability of a casual partnership (small world randomness parameter) and the spread of HIV. Finally, we illustrate the use of our model for the evaluation of interventions such as the promotion of safer sex and introduction of a vaccine.

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