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Mapping care pathways for the elderly.

Korina Katsaliaki1, Sally Brailsford, David Browning

  • 1School of Management, University of Southampton, Southampton, UK.

Journal of Health Organization and Management
|June 9, 2005
PubMed
Summary
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This study explored care pathways for older patients post-hospital discharge using simulation. The discrete-event simulation model demonstrated potential for optimizing intermediate care services and addressing delayed hospital discharges.

Area of Science:

  • Health Services Research
  • Gerontology
  • Health Informatics

Background:

  • Delayed hospital discharge for older adults is a significant issue, often caused by limited post-acute care capacity within Social Services.
  • New regulations mandate reimbursement for delayed discharges due to social care, increasing pressure to find solutions.
  • Intermediate Care services have been introduced to provide alternative post-acute options for older patients.

Purpose of the Study:

  • To investigate potential care pathways for older individuals after hospital discharge.
  • To evaluate the capacity and appropriateness of new Intermediate Care services.
  • To demonstrate the utility of simulation methodology in analyzing healthcare systems.

Main Methods:

  • Discrete-event simulation was employed to model system capacities and estimate reimbursement costs.

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  • A prototype simulation model was developed to assess the effectiveness of proposed care pathways.
  • Data access limitations necessitated a shift towards a more descriptive analytical approach.

    • Main Results:

    • A functional prototype simulation model was successfully created, illustrating the approach's potential value.
    • The study identified capacity limitations in traditional post-acute care services as a key factor in delayed discharges.
    • The simulation approach showed promise in evaluating intermediate care options.

    Conclusions:

    • Simulation offers a valuable methodology for evaluating post-acute care services and optimizing patient flow.
    • Addressing capacity constraints in Social Services is crucial to reduce hospital bed blocking.
    • The study highlights the need for effective evaluation of new care models for older adults.