Testing integrated care service models for patients with complex care needs using simulation modelling

Description:
The Long Term Conditions Year of Care Commissioning Programme supports commissioners and service providers within the English NHS to improve outcomes for patients with complex care needs through the redesign of commissioning mechanisms and care models to deliver person-centred coordinated care.

How to cite:

White J, Day J, Cordeaux C, Matthews B. Testing integrated care service models for patients with complex care needs using simulation modelling / Probando modelos integrados de servicios de atención con pacientes con complejos cuidados de atencion usando modelos de simulación. International Journal of Integrated Care. 2015;15(8). Available at: http://www.ijic.org/articles/abstract/2396/

The programme promotes three connected principles. Multimorbidity (more than one long-term condition) is common, and individuals with multimorbidity are likely to benefit from integrated care. An integrated payment approach (capitated budget) parallel to the integrated service model is likely to incentivise service integration and cost efficiency. Patients are likely to benefit most if they are involved in planning their care, understanding the care they receive (through a shared care record) and are able to support their own care.

The programme develops national tools and resources to help healthcare organisations achieve national policy objectives. One of these is a simulation model that allows care organisations to test the cost efficiency and staff resource shifts of new care models. Using the simulation model, we compared a ‘typical’ local service model with a planned new model, where more investment in community, mental health and GP practice services supports patients to avoid acute emergency services. 10% of the population (those with the highest risk population segmentation scores) were tested.

The simulation model used historical whole population activity, cost and staff resource data from acute, community, mental health and GP practice services for the whole population (718,289 individuals). Distributions of activity and cost, and set rates for patient access to services and staff resources were incorporated into the model. The model includes rates for intake to and movement

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