TY - JOUR
T1 - Reduced Waiting Times by Preference-Based Allocation of Patients to Nursing Homes
AU - Arntzen, R.J.
AU - Bekker, R.
AU - Smeekes, O.S.
AU - Buurman, B.M.
AU - Willems, H.C.
AU - Bhulai, S.
AU - van der Mei, R.D.
N1 - Funding Information: This research is funded by the Open Technology Program of the Dutch Research Council (NWO), project number 17710 , DOLCE VITA (Data-driven Optimization for a Vital Elderly Care System in the Netherlands). Publisher Copyright: © 2022 The Authors
PY - 2022/12/1
Y1 - 2022/12/1
N2 - © 2022 The AuthorsObjectives: 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.
AB - © 2022 The AuthorsObjectives: 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.
KW - Nursing homes
KW - long-term care
KW - mathematical optimization
KW - waiting-list management
UR - http://www.scopus.com/inward/record.url?scp=85131260459&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2022.04.012
DO - https://doi.org/10.1016/j.jamda.2022.04.012
M3 - Article
C2 - 35609636
SN - 1525-8610
VL - 23
SP - 2010-2014.e1
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 12
ER -