The optimum allocation of in-home supportive-type services in the multipurpose senior services program

Summary Allocative efficiency in community-based long-term care focuses on using purchased in-home supportive-type services to maximize the expected days of stay in the community of program clients. The paper discusses a DSS to assist case managers to best accomplish this objective. Exposition includes: the optimization principles; a demonstration that the requisite necessary and sufficient conditions of optimization hold; an implementation of the principles in a computational non-intensive algorithm based on a model of community-based long-term care in California that accounts for program priorities. The decision support system that informs case managers about best practice is demonstrated. The gains from its use are evaluated. A 15.4% increase in the community days stay attributable to program is expected from its use.