Katsaliaki Korina, Brailsford Sally, Browning David, Knight Peter
School of Management, University of Southampton, Southampton, UK.
J Health Organ Manag. 2005;19(1):57-72. doi: 10.1108/14777260510592130.
Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations.
DESIGN/METHODOLOGY/APPROACH: A discrete-event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs.
A prototype simulation model was developed showing the potential value of this approach.
RESEARCH LIMITATIONS/IMPLICATIONS: Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach.
Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services' traditional post-acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so-called "bed-blocking" problem, a new range of services termed "Intermediate Care" has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness.
ORIGINALITY/VALUE: This paper fulfils an identified need to record and evaluate the new post-acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.
旨在描述汉普郡社会服务部门开展的一个项目，该项目调查老年人出院后的潜在护理途径，并展示模拟方法在这种情况下的潜力。
设计/方法/途径：采用离散事件模拟来确定系统容量并估算可能的相关报销成本。
开发了一个原型模拟模型，展示了这种方法的潜在价值。
研究局限性/影响：数据获取的限制使重点从定量服务映射转向更具描述性的方法。
目前，由于社会服务部门传统的急性后期护理服务能力有限，许多老年患者从急性病床出院延迟。同时，新规定要求地方当局在医院出院延迟完全是由于社会护理评估和服务提供不足的情况下，向国民保健制度急性信托基金报销费用。为了克服所谓的“床位阻塞”问题，引入了一系列新的服务，称为“中间护理”，为老年患者提供替代选择。从能力和适用性方面对这些服务进行了研究。
原创性/价值：本文满足了记录和评估社会服务部门和国民保健制度引入的新急性后期套餐的既定需求，并提出模拟是实现此类目标最合适的方法之一。
