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

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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.