Exploring financially sustainable initiatives to address out-of-area placements in psychiatric ICUs: a computer simulation study

Simon Moss, Christos Vasilakis, Richard Wood

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Transferring individuals for treatment outside their geographic area occurs when healthcare demand exceeds local supply. This can result in significant financial cost while impacting patient outcomes and experience.

Aims
The aim of this study was to assess initiatives to reduce psychiatric intensive care unit (PICU) out-of-area bed placements within a major healthcare system in South West England.

Methods
Discrete event computer simulation was used to model patient flow across the healthcare system’s three PICUs. A scenario analysis was performed to estimate the impact of management plans to decrease admissions and length of stay. The amount of capacity required to minimise total cost was also considered.

Results
Without increasing in-area capacity, mean out-of-area bed requirement can be reduced by 25.6% and 19.1% respectively through plausible initiatives to decrease admissions and length of stay. Reductions of 34.7% are possible if both initiatives are employed. Adjusting the in-area bed capacity can also lead to aggregate cost savings.

Conclusions
This study supports the likely effectiveness of particular initiatives in reducing out-of-area placements for high-acuity bedded psychiatric care. This study also demonstrates the value of computer simulation in an area that has seen little such attention to date.
Original languageEnglish
JournalJournal of Mental Health
Early online date29 Jun 2022
DOIs
Publication statusE-pub ahead of print - 29 Jun 2022

Keywords

  • Systems modelling
  • computer simulation
  • psychiatric intensive care

ASJC Scopus subject areas

  • Psychiatry and Mental health

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