Queuing models for long term care wait time reduction & capacity optimization : a Nova Scotia study

Abstract

As Nova Scotia’s society ages, more personal and health care will be needed for people who require assistance to function; thus, policymakers face the challenge of balancing the fiscal burden with the need to ensure that seniors with long term needs receive proper care. This is a challenge best to be confronted before the wave of baby boomers begins to draw on long term care programs in few years. As this happens, demand to access long-term care increases. Also, waiting times escalate and alternative level of care is crowded, due to insufficient beddings in long-term care facilities. Keeping patients waiting too long could result in waiting costs to them; providing too much service to operate a system with less waiting time involves excessive capacity costs. However, not providing enough service capacity results in excessive waiting time and cost. This research presents models that seek to solve the long waiting time challenge in long term care system in Nova Scotia by finding the optimum capacity allocation. First, an analysis on data from the Department of Health Wellness is done to observe the difference in turnover rate and waiting time between different District Health Authorities in Nova Scotia. Second, using two different approaches, a Markov Chain model is used to reduce long-term care waiting time in Nova Scotia. Third, focusing on a case of a nursing home, a M/M/s queuing model is used to optimize the waiting time and resource allocation combination using scenario analysis, a detailed cost model is provided. The accuracy and behaviour of the queuing models are tested through simulation models and our results, comparisons, policy insights, recommendations, and conclusions are provided.