Simulating the Impact of Long‐Term Care Policy on Family Eldercare Hours

Ansah, John P.; Matchar, David B.; Love, Sean; Malhotra, Rahul; Kyung, Young; Chan, Angelique; Eberlein, Robert

doi:10.1111/1475-6773.12030

Cited by 47 publications

(40 citation statements)

References 29 publications

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“…DES has been applied to health management since the 1990s driven by the increased complexity of health care systems, the considerable advancements in DES software capabilities, ease of use, and the shift to more evidence based decision making in the health sector [21–24]. The increased popularity of DES in health management is reflected in the literature, which show an upward trend in terms of the number of DES applications and the areas covered by these applications [23, 25].…”

Section: Methodsmentioning

confidence: 99%

A discrete event simulation model to evaluate the use of community services in the treatment of patients with Parkinson’s disease in the United Kingdom

Lebcir

Demir

Ahmad

et al. 2017

BMC Health Serv Res

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BackgroundThe number of people affected by Parkinson’s disease (PD) is increasing in the United Kingdom driven by population ageing. The treatment of the disease is complex, resource intensive and currently there is no known cure to PD. The National Health Service (NHS), the public organisation delivering healthcare in the UK, is under financial pressures. There is a need to find innovative ways to improve the operational and financial performance of treating PD patients. The use of community services is a new and promising way of providing treatment and care to PD patients at reduced cost than hospital care. The aim of this study is to evaluate the potential operational and financial benefits, which could be achieved through increased integration of community services in the delivery of treatment and care to PD patients in the UK without compromising care quality.MethodsA Discrete Event Simulation model was developed to represent the PD care structure including patients’ pathways, treatment modes, and the mix of resources required to treat PD patients. The model was parametrised with data from a large NHS Trust in the UK and validated using information from the same trust. Four possible scenarios involving increased use of community services were simulated on the model.ResultsShifting more patients with PD from hospital treatment to community services will reduce the number of visits of PD patients to hospitals by about 25% and the number of PD doctors and nurses required to treat these patients by around 32%. Hospital based treatment costs overall should decrease by 26% leading to overall savings of 10% in the total cost of treating PD patients.ConclusionsThe simulation model was useful in predicting the effects of increased use of community services on the performance of PD care delivery. Treatment policies need to reflect upon and formalise the use of community services and integrate these better in PD care. The advantages of community services need to be effectively shared with PD patients and carers to help inform management choices and care plans.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-1994-9) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

A discrete event simulation model to evaluate the use of community services in the treatment of patients with Parkinson’s disease in the United Kingdom

Lebcir

Demir

Ahmad

et al. 2017

BMC Health Serv Res

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“…SD models consist of an interconnecting set of differential and algebraic equations developed from a broad range of relevant empirical data. [24][25][26] The SD methodology depicts dynamic and detail complexity by focusing on causal relationships and dynamic feedback mechanism, [27] making it an appropriate method for understanding the forecasting approaches. The models are described in the following section.…”

Section: Methodsmentioning

confidence: 99%

“…To project the number of people with eye diseases, a detailed dynamic population model was developed. Based on other published population models, [27][28][29] the population model shows a detailed aging process of the Singapore population disaggregated by single age cohorts (age 0-age 100 and older), gender, ethnicity (Chinese, Malays, Indians, Others), and educational attaintment (no formal education, primary, secondary and tertiary). The population model herein shows births, deaths and net migration as the three main determinants of population change.…”

Section: Methodsmentioning

confidence: 99%

“…A detailed description of the population model can be found in the references as cited. [27][28][29] To project the number of people with eye disease, we applied the prevalence of eye diseases from the Singapore Epidemiology of Eye Diseases (SEED) study [30][31][32] for resident Singaporeans 40 years and older to the population model of resident Singaporeans. The prevalence of eye diseases was disaggregated by age, gender, ethnicity and educational attainment.…”

Section: Methodsmentioning

confidence: 99%

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Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

Ansah

Koh

Korne

et al. 2017

IJH

Self Cite

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Health workforce planning is essential in the provision of quality healthcare. Several approaches to planning are customarily used and advocated, each with unique underlying assumptions. Thus, a thorough understanding of each assumption is required in order to make an informed decision on the choice of forecasting approach to be used. For illustration, we compare results for eye care requirements in Singapore using three established workforce forecasting approaches -workforce-to-population-ratio, needs based approach, utilization based approach -and a proposed robust integrated approach to discuss the appropriateness of each approach under various scenarios. Four simulation models using the systems modeling methodology of system dynamics were developed for use in each approach. These models were initialized and simulated using the example of eye care workforce planning in Singapore, to project the number of ophthalmologists required up to the year 2040 under the four different approaches. We found that each approach projects a different number of ophthalmologists required over time. The needs based approach tends to project the largest number of required ophthalmologists, followed by integrated, utilization based and workforce-to-population ratio approaches in descending order. The four different approaches vary widely in their forecasted workforce requirements and reinforce the need to be discerning of the fundamental differences of each approach in order to choose the most appropriate one. Further, health workforce planning should also be approached in a comprehensive and integrated manner that accounts for developments in demographic and healthcare systems.

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“…Other than informing decisions regarding optimal allocation of resources, simulation modelling has found application to a diverse range of healthcare planning problems. Operational planning of emergency departments,4 assessment of screening programmes,5 treatment of infectious diseases,6 exploration of the impacts of telecare on containing costs and reducing numbers of institutionalised elders,7 and predicting the rising burden of informal care provision as a consequence of specific long-term care policies8 provide only some of the example applications of simulation modelling to healthcare planning problems. Modelling applications have focused on the patient and provider levels, as well as on individual units and hospital, regional and national levels.…”

mentioning

confidence: 99%

Simulation modelling and resource allocation in complex services

Bayer

2014

BMJ Qual Saf

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Simulating the Impact of Long‐Term Care Policy on Family Eldercare Hours

Abstract: System dynamics modeling was useful in providing policy makers with an overview of the levers available to them and in demonstrating the interdependence of policies and system components.

Cited by 47 publications

References 29 publications

A discrete event simulation model to evaluate the use of community services in the treatment of patients with Parkinson’s disease in the United Kingdom

A discrete event simulation model to evaluate the use of community services in the treatment of patients with Parkinson’s disease in the United Kingdom

Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

Simulation modelling and resource allocation in complex services

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