A survey of OR/MS models on care planning for frail and elderly patients

Context

With an ageing population, there is an increased demand on public health services and on long-term-care facilities. It is not uncommon for frail and elderly patients to spend longer in hospital or require more support within the community, often due to multi-morbidities. Many health services are faced with the complex problem as to how to administer the best care for the frail and elderly whilst best managing limited health resources.

Objective

This paper focuses on the literature concerning frail and elderly patient pathways within both hospital and community care settings with the use of Operations Research and Management Science (OR/MS) methods. To cover a wide range of specialities, the following additional subject areas have been included: Geriatrics and Gerontology, Health Policy and Services, Industrial Engineering, and Medical Informatics, to synthesise the work on modelling the application of care for frail and elderly patients. This review paper also analyses trends in the research literature and identifies gaps for future study.

Methods

A set of criteria has been established in which a systematic search was performed against to identify literature from 2000 to 2020. In total 62 publications were identified as applicable and were categorised methodologically and analysed. Common features of the papers including hospital setting, research aims and planning decisions have been identified and discussed.

Results

The results from the analysis reveal that this field of study is increasing with over 47% of papers having been published since 2015. The main findings suggest three areas of future research. Firstly, focus should be on modelling pathways holistically, with collaboration from both hospitals and community care settings. Secondly, work should be conducted on patient outcomes of these modelled pathways to highlight the increase in quality of care. Thirdly, there is potential for a wider variety of OR/MS methods to be utilised across the whole pathway. These three areas will reduce pressure on health services which are currently facing rising demands with limited resources.