A demand and capacity model for home-based intermediate care: optimizing the ‘step down’ pathway

Alison Harper, Martin Pitt, Manon De Prez, Zehra Onen Dumlu, Christos Vasilakis, Richard Wood, Paul Forte

Research output: Contribution to conferencePaperpeer-review

2 Citations (SciVal)


Step-down intermediate care provides a bridge between acute hospital admission and return to normal function. The purpose is to enable patients to leave hospital as soon as medically fit, avoiding costs of delayed discharge and consequent risks to patients’ health and wellbeing. Determining optimum capacity for resource planning of intermediate care requires balancing the costs to both acute hospital and community care providers. Too much community capacity results in underutilized resources and poor economic efficiency, while too little risks excessive hospital discharge delays. Application of discrete-time simulation shows that total costs across the acute-community interface can be minimized by identifying optimal community capacity in terms of the number of patients that can be concurrently accommodated. To our knowledge, this is the first simulation study to model the patient pathway from hospital discharge through to provision of home visits. The model supports short-term resource planning in a major English healthcare system.
Original languageEnglish
Publication statusPublished - 12 Dec 2021
EventWinter Simulation Conference 2021: Simulation for a Smart World: From Smart Devices to Smart Cities - JW Marriott Desert Ridge, Arizona, USA United States
Duration: 12 Dec 202115 Dec 2021


ConferenceWinter Simulation Conference 2021
Abbreviated titleWSC 2021
Country/TerritoryUSA United States
Internet address


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