A simple graphical decision aid for the placement of elderly people in long-term care

This paper describes the construction of a graphical decision tool to aid placement decisions of a multidisciplinary review panel for admissions to long-term care in a London borough in the UK. First we construct a prediction model of placement decisions based on an applicant's attributes. Using data from the London borough, a composite model comprising syndromic decision rules followed by a two-stage hierarchical logistic regression model is proposed. The model proved to be robust in differentiating cases needing residential home care and nursing home care. Placement outcomes generated by the model are then represented graphically on a triangle plot. This approach could potentially be used as a decision support tool by managers of long-term care for continuous monitoring and assessment of the appropriateness of placements with respect to residents' needs.