A simulation model for capacity planning in community care

Abstract

Sustainable health care requires the building of sufficient capacity in order to ensure that patients receive the right care in a timely fashion. Often the efficient use of available capacity at one level (ie, acute care) is hindered by insufficient capacity at a downstream level (ie, long-term care (LTC)). This paper provides a simulation that helps determine the necessary downstream capacity in LTC in order to maintain smooth patient flow out of the hospitals in the region while still maintaining wait times within a target for those accessing LTC directly from the community. The model is complicated by multiple demand classes, client preferences, competing performance metrics, clients transferring between servers (ie, LTC facilities), significant wait time-dependent reneging and non-homogeneous servers. We provide policy recommendations for capacity planning in the region both for LTC and for supportive housing.