通过改善对中介护理的准入,避免住院和延迟护理转移:一项模拟研究
Rebekka J Arntzen1, Judith H van den Besselaar2, René Bekker3
1Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Stochastics group, Centrum Wiskunde & Informatica, Amsterdam, the Netherlands.
概括
荷兰中介护理的长时间等待导致不必要的住院治疗. 改善分拣和申请流程,而不仅仅是床位容量,可以显著减少这些延迟,并改善患者获得护理的机会.
科学领域:
- 医疗保健管理的管理
- 医疗服务研究 医疗服务研究
- 运营研究 运营研究
背景情况:
- 荷兰目前的中期护理等待时间阻碍了患者及时获得护理.
- 这种延迟往往导致可避免且昂贵的住院治疗.
- 需要进行政策评估,以改善中介护理的获取和效率.
研究的目的:
- 提出和评估改善中介护理获取的替代政策.
- 估计这些政策对等待时间,住院和患者流量的影响.
- 确定中介护理等待时间的主要驱动因素.
主要方法:
- 一个离散事件模拟 (DES) 模型是使用阿姆斯特丹 (2019) 中介护理的真实世界数据开发的.
- 该研究分析了进出流,患者特征以及进入和退出中间护理的途径.
- 通过敏感性分析,DES模型被用来评估潜在的政策变化.
主要成果:
- 阿姆斯特丹中介护理的等待时间主要是由于低效的分拣和申请流程造成的,而不是由于缺乏床位容量.
- 老年人面临的平均等待时间为1.8天,这有助于医院入院.
- 实施更有效的申请流程,并允许晚上/周末入院,可以大大减少不必要的住院治疗.
结论:
- 数据驱动的模拟模型可以有效地为中间护理的政策决策提供信息.
- 仅仅增加病床容量并不总是减少医疗等待时间的解决方案.
- 优化后勤流程,如分拣和入院,对于提高医疗机构效率至关重要.
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