A three compartment model of the patient flows in a geriatric department: a decision support approach.
A three compartment model of the patient flows in a geriatric department: a decision support approach.
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DOI：
10.1023/a:1019002804381
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发表时间：
1998-10-01
影响因子：
3.6
通讯作者：
Millard, P H
中科院分区：
文献类型：
--
作者：
McClean, S I;Millard, P H
由于长期老年人服务的用户占用病床的时间很长，重要的是，决策者了解临床和社会决策如何相互作用，影响长期护理费用。流程建模方法使我们能够估计当前的住院活动并测试不同的护理方案，从而优化决策。在以前的工作中，我们开发了一个两室模型的病人流量在老年医院，病人最初入院的急性或康复状态，他们要么出院或死亡或转换为长期住院状态。长期住院的病人出院或死亡的速度较慢。这一初步研究讨论了使用一个房室模型来描述通过医院系统的流量。我们现在讨论一个三室模型，其中室可以被描述为包括急性护理，康复和长期护理。马尔可夫模型，然后使用计数和成本的医院系统内的老年患者的运动。这种方法使卫生服务管理人员和临床医生能够评估性能并评估系统可能变化的影响。通过将成本附加到系统的各个部分，我们可以促进对不同战略和方案的评估和比较。使用该模型，我们表明，老年医疗服务，改善急性管理住院病人变得更具成本效益。因此，医院规划者可以确定具有成本效益的选择。
As users of long term geriatric services occupy the beds for prolonged periods of time it is important that decision makers understand how clinical and social decisions interact to influence long term care costs. A flow modelling approach enables us to estimate current inpatient activity and to test different care options, thereby optimising decision making. In previous work we developed a two compartment model of patient flows within a geriatric hospital, where patients are initially admitted to an acute or rehabilitative state from which they either are discharged or die or are converted to a long-stay state. Long-stay patients are discharged or die at a slower rate. This initial research discussed the use of a compartmental model to describe flows through the hospital system. We now discuss a three compartment model where the compartments may be described as consisting of acute care, rehabilitation and long-stay care. A Markov model is then used to count and cost the movements of geriatric patients within a hospital system. Such an approach enables health service managers and clinicians to assess performance and evaluate the effect of possible changes to the system. By attaching costs to various parts of the system we may facilitate the evaluation and comparison of different strategies and scenarios. Using the model, we show that a geriatric medical service that improved the acute management of in-patients became more cost-efficient. Hospital planners may thus identify cost-effective options.