测量和建模 NHS 连续医疗保健中的占用时间。

Measuring and modelling occupancy time in NHS continuing healthcare.

机构信息

Department of Information Systems and Computing, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK.

出版信息

BMC Health Serv Res. 2011 Jun 29;11:155. doi: 10.1186/1472-6963-11-155.

DOI:10.1186/1472-6963-11-155

PMID:21714903

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3152883/

Abstract

BACKGROUND

Due to increasing demand and financial constraints, NHS continuing healthcare systems seek to find better ways of forecasting demand and budgeting for care. This paper investigates two areas of concern, namely, how long existing patients stay in service and the number of patients that are likely to be still in care after a period of time.

METHODS

An anonymised dataset containing information for all funded admissions to placement and home care in the NHS continuing healthcare system was provided by 26 (out of 31) London primary care trusts. The data related to 11289 patients staying in placement and home care between 1 April 2005 and 31 May 2008 were first analysed. Using a methodology based on length of stay (LoS) modelling, we captured the distribution of LoS of patients to estimate the probability of a patient staying in care over a period of time. Using the estimated probabilities we forecasted the number of patients that are likely to be still in care after a period of time (e.g. monthly).

RESULTS

We noticed that within the NHS continuing healthcare system there are three main categories of patients. Some patients are discharged after a short stay (few days), some others staying for few months and the third category of patients staying for a long period of time (years). Some variations in proportions of discharge and transition between types of care as well as between care groups (e.g. palliative, functional mental health) were observed. A close agreement of the observed and the expected numbers of patients suggests a good prediction model.

CONCLUSIONS

The model was tested for care groups within the NHS continuing healthcare system in London to support Primary Care Trusts in budget planning and improve their responsiveness to meet the increasing demand under limited availability of resources. Its applicability can be extended to other types of care, such as hospital care and re-ablement. Further work will be geared towards updating the dataset and refining the results.

摘要

背景

由于需求增加和资金限制，英国国民保健制度（NHS）持续医疗保健系统正在寻求更好的方法来预测需求和规划护理预算。本文研究了两个关注领域，即现有患者在服务中的停留时间以及一段时间后仍在护理中的患者数量。

方法

26 个（31 个中的 26 个）伦敦初级保健信托基金提供了一个包含 NHS 持续医疗保健系统中所有资金安置和家庭护理入院信息的匿名数据集。首先分析了 2005 年 4 月 1 日至 2008 年 5 月 31 日期间在安置和家庭护理中停留的 11289 名患者的数据。使用基于逗留时间（LoS）建模的方法，我们捕获了患者逗留时间的分布，以估计患者在一段时间内（例如，每月）留在护理中的概率。使用估计的概率，我们预测了一段时间后仍在护理中的患者数量。