Applying simple dynamic modelling for decision support in planning regional health care

In contrast to more simple methods, our dynamic model takes advantage of two assumptions that were checked with the high quality data from the collective nursing homes of the health care region of The Hague. First, the indication period, time spent in the nursing home added to the time spent waiting, is constant. Second, the number of people that fail to be admitted (renege) changes proportionally to the time they spend on the waiting list. As a consequence, the model can be dynamic in order to provide estimates of how long it takes for the waiting list and the average waiting time to stabilise after a sudden change in important parameters. This description of dynamic behaviour, together with projections of average waiting time and the length of the waiting list, provides a powerful aid for examining the consequences of different scenarios and discussing them in advance. Data from the health care region of The Hague are presented and the consequences of two scenarios are calculated. Suggestions are made for applying a similar technique to other types of long-cycle waiting lists in regional health care.