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: 2021
• 资助国家: 加拿大
• 起止时间: 2021-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=738447
• 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，老年人数量超过儿童。在过去几年中，死亡原因发生了变化，这主要是由于慢性病医疗方法的改进。这些慢性疾病导致人们寿命更长，但更多的限制生命的条件，这导致对医疗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保健系统的一个主要问题。造成这一问题的主要原因之一是，患有生命受限和慢性疾病的患者占用了住院床位，但他们不再需要医院提供的大量资源或服务，并准备出院到非急性护理提供者，如家庭护理和长期护理设施以及临终关怀院。然而，由于LTC设施中可用床位的缺乏或短缺，他们最终要在占用住院床位的医院等待数天、数周甚至有时数月。这导致了各种各样的问题，如阻止其他病人进入，取消选择性手术，增加急诊科的等待时间，救护车卸载延迟，以及许多成本问题。本研究计划旨在通过规划LTC设施和所需的人力资源来解决上述问题。本研究的结果将有助于决策者和医疗保健管理人员更好地观察医院拥挤、能力不足、LTC专业人员供需失衡等问题的存在和扩大。在我的研究中，我提出了一个新的模型，用于随机设置下未来几年LTC资源的设施选址、需求分配和产能扩张。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，我提出了新的模型来规划为生命受限和临终病人提供护理所需的人力资源。对于这些病人来说，团队合作的方法是最有效的，我的模型将检查团队组成，以提供急症护理单位以外的护理。我的模型将考虑到现有的劳动力，并探讨诸如新劳动力的教育，现有劳动力的晋升和退休，招聘的时间表等问题。我认为所有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。我的研究项目将通过专注于老年人医疗保健设施的规划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。