Abstract
This chapter discusses the use of analytical approaches for residential long-term care (LTC) capacity planning. The recommended method integrates demographic and survival analysis, discrete event simulation, and optimization. Through a case study based in British Columbia, Canada, it illustrates results of using this approach. Further, it discusses shortcomings of a fixed-ratio approach widely used in practice and the SIPP (stationary, independent, period by period) approach and its modifications developed in the call center literature. It also proposes an easy-to-use and effective planning method, the Average Flow Model. It concludes with a discussion of policy implications and extensions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
World Health Organization (2009) http://www.who.int/ageing/primary_health_care/en/index.html
Statistics Canada (2009) http://www12.statcan.ca/census-recensement/2006/rt-td/as-eng.cfm
BC Stats (2008) British Columbia population projection—PEOPLE 32. http://www.bcstats.gov.bc.ca/
Canadian Medical Association (2009) http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/WhatWePublish/LeadershipSeries/English/pg17EC.pdf
Canadian Institute for Health Information (2009) http://secure.cihi.ca/cihiweb/
Wiener JM, Stevenson DG, Goldenson SM (1998) Controlling the supply of long-term care providers at the state level. Occasional Paper Number 22, Urban Institute, Washington, DC
West Virginia Health Care Authority (2003) Long term care task force. http://www. hcawv.org/PolicyPlan/wr16.htm
Legislative Assembly of British Columbia (2006) http://www.llbc.leg.bc.ca/Public/PubDocs/bcdocs/401348/Creating Patient Flow.pdf
Canadian Union of Public Employees (2009) Residential long-term care in Canada: our vision for better seniors’ care. http://www cupe.ca/updir/CUPE-long-term-care-seniors-care-vision.pdf
Gibson D, Liu Z (2008) Planning ratios and population growth: will there be a shortfall in residential aged care by 2021? Australas J Ageing 14(2):57–62
Cohen M, Jeremy T, Baumbusch J (2009) An uncertain future for seniors: BC’s restructuring of home and community health care, 2001–2008. http://www.policyalternatives.ca/reports/2009/04/uncertain future
Zhang Y, Puterman ML, Nelson M, Atkins D (2012) A simulation optimization approach to long-term care capacity planning. Oper Res 60(2):1–13
Zhang Y, Puterman ML, Atkins D (2012) Residential long-term care capacity planning: the shortcomings of ratio-based forecasts. Healthc Policy 7(4):68–81
Hare WL, Alimadad A, Dodd H, Ferguson R, Rutherford A (2009) A deterministic model of home and community care client counts in British Columbia. Health Care Manag Sci 12(1):80–98
Lin F, Kong N, Lawley M (2012) Capacity planning for publicly funded community based long-term care services. In: Johnson MP (ed) Community-based operations research. International series in operations research & management science, vol 167. Springer, New York, pp 297–315
Ridge JC, Jones SK, Nielsen MS, Shahani AK (1998) Capacity planning for intensive care units. Eur J Oper Res 105:346–355
Green LV (2003) How many hospital beds? Inquiry 39:400–412
Harper PR, Shahani AK (2002) Modelling for the planning and management of bed capacities in hospitals. J Oper Res Soc 53(1):11–18
Kao EPC, Tung GG (1981) Bed allocation in a public health care delivery system. Manag Sci 27(5):507–520
Vassilacopoulos G (1985) A simulation model for bed allocation to hospital inpatient departments. Simulation 45:233–241
Smith-Daniels VL, Schweikhart SB, Smith-Daniels DE (1988) Capacity management in health care services: review and future research directions. Decis Sci 19:898–919
Green LV (2004) Capacity planning and management in hospitals. In: Brandeau ML, Sainfort F, Pierskalla WP (eds) Operations research and health care: a handbook of methods and applications. Kluwer, London
Green LV, Kolesar PJ, Soares J (2001) Improving the SIPP approach for staffing service systems that have cyclic demand. Oper Res 49(4):549–564
Green LV, Kolesar PJ (1991) The pointwise stationary approximation for queues with nonstationary arrivals. Manag Sci 37(1):84–97
Green LV, Kolesar PJ, Svoronos A (1991) Some effects of nonstationarity on multiserver Markovian queuing systems. Oper Res 39(3):502–511
Ingolfsson A, Haque MA, Umnikov A (2002) Accounting for time-varying queueing effects in workforce scheduling. Eur J Oper Res 139(3):585–597
Jennings OB, Mandelbaum A, Massey WA, Whitt W (1996) Server staffing to meet time-varying demand. Manag Sci 42(10):1383–1394
Ingolfsson A, Akhmetshina E, Budge S, Li Y, Wu X (2007) A survey and experimental comparison of service level approximation methods for non-stationary M(t)/M/s(t) queueing systems. INFORMS J Comput 19(2):201–214
Gans N, Koole G, Mandelbaum A (2003) Telephone call centers: tutorial, review and research prospects. Manuf Serv Oper Manag 5(2):79–141
Green LV, Kolesar PJ, Whitt W (2007) Coping with time-varying demand when setting staffing requirements for a service system. Prod Oper Manag 16(1):13–39
Kwan SK, Davis MM, Greenwood AG (1988) A simulation model for determining variable worker requirements in a service operation with time-dependent customer demand. Queueing Syst 3:265–276
Whitt W (1991) The pointwise stationary approximation for Mt/Mt/s queues is asymptotically correct as the rates increase. Manag Sci 37(3):307–314
Atlason J, Epelman MA, Henderson SG (2008) Optimizing call center staffing using simulation and analytic center cutting-plane methods. ManagSci 54(2):295–309
Parlar M, Sharafali M (2008) Dynamic allocation of airline check-in counters: a queueing optimization approach. Manag Sci 54(8):1410–1424
De Vericourt F, Jennings O (2011) Nurse staffing in medical units: a queueing perspective. Oper Res 59:1320–1331
Yankovic N, Green LV (2011) Identifying good nursing levels: a queuing approach. Oper Res 59:942–955
Feldman Z, Mandelbaum A, Massey WA, Whitt W (2008) Staffing of time-varying queues to achieve time-stable performance. Manag Sci 54:324–338
Xie H, Chaussalet TJ, Millard PH (2006) A model-based approach to the analysis of patterns of length of stay in institutional long-term care. IEEE Trans Inf Technol Biomed 10(3):512–518
Miller RG (1981) Simultaneous statistical inference, 2nd edn. Springer, New York
Klein JP, Moeschberger ML (2003) Survival analysis, techniques for censored and truncated data, 2nd edn. Springer, New York
Fu MC (2002) Optimization for simulation: theory vs. practice. INFORMS J Comput 14(3):192–215
Tekin E, Sabuncuoglu I (2004) Simulation optimization: a comprehensive review on theory and applications. IIE Trans 36:1067–1081
Henderson SG, Nelson BL (2006) Handbooks in operations research and management science: simulation. Elsevier, Amsterdam
Hong LJ, Nelson BL (2009) A brief introduction to optimization via simulation. Winter Simulation Conference Proceedings, pp 75–85
Vancouver Island Health Authority (VIHA) (2009) http://www.viha.ca/NR/rdonlyres/B5AEA945-8240-47B7-8BC2-63D593924350/0/residential care admissions.pdf
Little JDC (1961) A proof of the queueing formula L = λW. Oper Res 9:383–387
Acknowledgments
We gratefully thank Steve Atkinson, Director of Operations Research, Vancouver Island Health Authority, Peter Kafka, Chief Executive Officer of the Louis Brier Home and Hospital for providing data and many helpful discussions. This research has been partially supported by NSERC grant RGPIN 5527.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Zhang, Y., Puterman, M.L. (2013). Analytical Long-Term Care Capacity Planning. In: Zaric, G. (eds) Operations Research and Health Care Policy. International Series in Operations Research & Management Science, vol 190. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6507-2_3
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6507-2_3
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6506-5
Online ISBN: 978-1-4614-6507-2
eBook Packages: Business and EconomicsBusiness and Management (R0)