Healthcare Resource Planning for Senior and End-of-life Patients

老年和临终患者的医疗资源规划

• 批准号: RGPIN-2019-05680
• 负责人: Taghavi, Majid
• 金额: $ 1.89万
• 依托单位: Saint Mary's University
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2020
• 资助国家: 加拿大
• 起止时间: 2020-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=715738
• 关键词: Healthcare; Resource; Planning; Senior; End

Canada has an aging population with seniors outnumbered children since 2016. Over the past years, there was a change in the causes of deaths, mostly due to the improvements in medical treatments for chronic diseases. Such chronic conditions result in people living longer, but with more life-limiting conditions, which leads to more needs for healthcare facilities and personnel. Hospital congestion and over-crowdedness have been a major problem of the Canadian healthcare system. One of the main contributors to this problem is occupying the inpatient beds by patients who suffer from life-limiting and chronic conditions, but no longer require the intensity of resources or services provided in the hospital and are ready to be discharged to non-acute care providers such as home care and Long-Term Care (LTC) facilities and hospices. However, due to lack or shortage of available beds in LTC facilities, they end up waiting days, weeks, and even sometimes months in hospitals occupying in-patient beds. This results in various issues such as blocking access of other patients, cancellation of elective surgeries, increasing the emergency department wait times, ambulance offload delay, and many cost implications. This research proposal aims at dealing with the problem mentioned above by planning for LTC facilities and human resources needed for them. The results of this research will help policymakers and healthcare management to better observe the existing and enlarging problems of hospital congestion, shortage of capacity, and the imbalance between supply and demand for LTC professionals. In my research, I propose a novel model for facility location, demand allocation, and capacity expansion of LTC resources over the next years in a stochastic setting. The model will identify the destination of the patient (LTC, hospice, homecare) after discharge based on the patient's health situation. In addition, I propose new models to plan for human resources needed to provide care to life-limiting and end-of-life patients. A team approach will work the best for these patients, and my models will examine the team composition to provide the care out of acute-care units. My models will take into account the existing workforce and explore issues such as the education of the new workforce, the promotion, and retirement of the current workforce, the timeline for hiring, etc. I see all healthcare facilities as a chain in which inefficiency in one unit will affect the performance of other units. My program of research will improve the efficiency of this chain by focusing on planning for senior's healthcare facilities. Overall, my research program will lead to significant methodological and practical advancements in healthcare operations. This research will improve access to LTC facilities for seniors and end-of-life patients. Therefore, hospital efficiency and quality of life for Canadian patients and their caregivers will be enhanced.

自2016年以来，加拿大人口老龄化，老年人人数超过儿童。在过去几年中，死亡原因发生了变化，主要是由于慢性病医疗的改善。这种慢性病导致人们寿命更长，但具有更多的生命限制条件，这导致对医疗保健设施和人员的更多需求。 医院拥挤和过度拥挤一直是加拿大医疗系统的一个主要问题。造成这一问题的主要原因之一是，住院床位被患有限制生命和慢性疾病的患者占用，但他们不再需要医院提供的资源或服务强度，并且准备出院到非急症护理提供者那里，例如家庭护理和长期护理（LTC）设施和临终关怀医院。然而，由于长期护理设施缺乏或短缺可用床位，他们最终要在医院等待数天、数周甚至数月，占用住院床位。这导致了各种问题，例如阻止其他患者的访问，取消择期手术，增加急诊室等待时间，救护车卸载延迟以及许多成本问题。 本研究建议旨在解决上述问题，规划长期护理中心的设施和人力资源。这项研究的结果将有助于政策制定者和医疗保健管理人员更好地观察现有的和扩大的问题，医院拥挤，能力短缺，以及长期护理专业人员的供需不平衡。在我的研究中，我提出了一个新的模型，设施的位置，需求分配，并在未来几年的LTC资源的容量扩展在一个随机设置。该模型将根据患者的健康状况确定患者出院后的目的地（LTC、临终关怀、家庭护理）。此外，我还提出了新的模式，以规划为生命有限和生命末期患者提供护理所需的人力资源。团队方法将最适合这些患者，我的模型将检查团队组成，以提供急诊室的护理。我的模型将考虑现有的劳动力，并探讨新劳动力的教育，现有劳动力的晋升和退休，招聘的时间轴等问题。 我认为所有的医疗机构都是一个链条，其中一个单位的效率低下会影响其他单位的绩效。我的研究计划将通过专注于规划老年人的医疗设施来提高这一链条的效率。总的来说，我的研究计划将导致医疗保健业务的重大方法和实践进步。这项研究将改善老年人和临终病人使用LTC设施的机会。因此，加拿大患者及其护理人员的医院效率和生活质量将得到提高。