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Publication Detail
Modelling patient flow and outcomes within community healthcare
  • Publication Type:
  • Authors:
    Palmer R, Utley M
  • Presented date:
An ambition of UK healthcare policy has been to deliver more care in the community by moving services from acute settings closer to patient homes. However, questions remain over the impact of shifting these services. This is complicated by a lack of comparable measures, nationally and locally, for evaluating quality across differing community services. One stand out challenge for these services is how they may best be organised to provide co-ordinated patient care given the physical distribution of services, interrelated patient use and increased episodic use by patients with differing needs. In this project, we develop a novel patient flow model which incorporates patient outcomes to aid the evaluation of community services. We extend a first order fluid approximation of a stochastic queueing system with reuse. In doing so we model dynamics of patient flow common to community care, such as re-entrant patients, patient mix and the use of multiple services. Outcomes are represented as states which patients may move between during a course of care and are used to model differentiated care. We use state dependent parameters to model the impact of patient mix on the performance of the system. In considering differentiated service, we implement a novel method for dynamically allocating servers across parallel queues and patient groups to overcome problems of server inactivity. Finally, we develop the concept of “the flow of outcomes” – a measure of how individual services contribute to the output of outcomes from a system of care over time – to provide insight and understanding into the clinical and operational performance of interrelated healthcare services.
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