Optimizing home hospital health service delivery in norway using a combined geographical information system, agent based, discrete event simulation model

Abstract

Home hospital services; provide some hospital level services at the patient's residence. The services include for example: palliative care, administering chemotherapy drugs, changing dressings and care for newborns. The rationale of the service is that by providing high quality care to patients at their homes their experience of the care is better and hence they respond to the treatment and/or recover quicker and are less likely to need to report to hospital to receive care for more serious/expensive conditions. The aim of this study is to evaluate the effectiveness of the home hospital service, to optimize the current configuration given existing constraints and to evaluate potential future scenarios. Using a combined discrete event simulation, agent based model and geographical information system we assess the system effects of different demand patterns, appointment scheduling algorithms (e.g. travelling salesman problem), varying levels of resource on patient outcomes and impact on hospital visits.