Reduced Waiting Times by Preference-Based Allocation of Patients to Nursing Homes.

Autor:	Arntzen RJ; Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Stochastics Group, Centrum Wiskunde en Informatica, Amsterdam, The Netherlands. Electronic address: rebekka.arntzen@cwi.nl., Bekker R; Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Smeekes OS; Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Buurman BM; Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Willems HC; Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Bhulai S; Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Stochastics Group, Centrum Wiskunde en Informatica, Amsterdam, The Netherlands., van der Mei RD; Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Stochastics Group, Centrum Wiskunde en Informatica, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2022 Dec; Vol. 23 (12), pp. 2010-2014.e1. Date of Electronic Publication: 2022 May 21.
DOI:	10.1016/j.jamda.2022.04.012
Abstrakt:	Objectives: The long waiting times for nursing homes can be reduced by applying advanced waiting-line management. In this article, we implement a preference-based allocation model for older adults to nursing homes, evaluate the performance in a simulation setting for 2 case studies, and discuss the implementation in practice. Design: Simulation study. Setting and Participants: Older adults requiring somatic nursing home care, from an urban region (Rotterdam) and a rural region (Twente) in the Netherlands. Methods: Data about nursing homes and capacities for the 2 case studies were identified. A set of preference profiles was defined with aims regarding waiting time preferences and flexibility. Guidelines for implementation of the model in practice were obtained by addressing the tasks of all stakeholders. Thereafter, the simulation was run to compare the current practice with the allocation model based on specified outcome measures about waiting times and preferences. Results: We found that the allocation model decreased the waiting times in both case studies. Compared with the current practice policy, the allocation model reduced the waiting times until placement by at least a factor of 2 (from 166 to 80 days in Rotterdam and 178 to 82 days in Twente). Moreover, more of the older adults ended up in their preferred nursing home and the aims of the distinct preference profiles were satisfied. Conclusions and Implications: The results show that the allocation model outperforms commonly used waiting-line policies for nursing homes, while meeting individual preferences to a larger extent. Moreover, the model is easy to implement and of a generic nature and can, therefore, be extended to other settings as well (eg, to allocate older adults to home care or daycare). Finally, this research shows the potential of mathematical models in the care domain for older adults to face the increasing need for cost-effective solutions. (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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