Mapping care pathways for the elderly

J Health Organ Manag. 2005;19(1):57-72. doi: 10.1108/14777260510592130.

Abstract

Purpose: Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations.

Design/methodology/approach: A discrete-event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs.

Findings: A prototype simulation model was developed showing the potential value of this approach.

Research limitations/implications: Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach.

Practical implications: Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services' traditional post-acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so-called "bed-blocking" problem, a new range of services termed "Intermediate Care" has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness.

Originality/value: This paper fulfils an identified need to record and evaluate the new post-acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.

MeSH terms

  • Aftercare / economics
  • Aftercare / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Computer Simulation
  • Critical Pathways*
  • England
  • Health Services Accessibility
  • Health Services for the Aged / economics
  • Health Services for the Aged / statistics & numerical data*
  • Health Services for the Aged / supply & distribution
  • Home Care Services / economics
  • Home Care Services / statistics & numerical data
  • Home Care Services / supply & distribution
  • Humans
  • Intermediate Care Facilities / economics
  • Intermediate Care Facilities / statistics & numerical data
  • Intermediate Care Facilities / supply & distribution
  • Length of Stay / statistics & numerical data
  • Needs Assessment*
  • Organizational Case Studies
  • Rehabilitation Centers / economics
  • Rehabilitation Centers / statistics & numerical data
  • Rehabilitation Centers / supply & distribution
  • Social Work / standards*
  • State Medicine / organization & administration
  • Stochastic Processes