Improving Access to Intermediate Care Through Flexibility: Simulation Study.

Area of Science:

• Healthcare management
• Health services research
• Operations research

Background:

• Growing demand for intermediate care services strains accessibility due to nurse shortages.
• Current intermediate care systems face challenges in meeting patient needs efficiently.
• Simulation offers an innovative approach to evaluate policy interventions.

Purpose of the Study:

• To assess the effectiveness of policy interventions on intermediate care waiting times and hospital admissions.
• To identify strategies for improving accessibility and meeting rising care demands.
• To utilize simulation modeling for evaluating system changes.

Main Methods:

• A discrete-event simulation model was developed to represent patient flow in intermediate care.
• The model incorporated insights from healthcare professionals on patient flow, admissions, and operational constraints.
• Interventions evaluated included bed pooling, flexible admission hours, and the use of emergency beds.

Main Results:

• Partial bed pooling (10%) reduced waiting times by 25%–42%.
• Expanding admission hours to 24/7 decreased waiting times and hospital congestion.
• Combined interventions (bed pooling, 24/7 admissions) reduced waiting times by 60% and hospital admissions by 60%.

Conclusions:

• Intermediate care accessibility can be enhanced through bed pooling and flexible admissions, without expanding bed capacity.
• These interventions optimize patient flow, reduce hospital admissions, and improve system efficiency.
• Simulation models are valuable tools for exploring policy and system changes in intermediate care.