Fig 1.
Organisation of intermediate care services in the English National Health Service (NHS).
Table 1.
Scenarios considered in this study, with baseline values are indicated by (*).
Fig 2.
Projections of demand for intermediate care Discharge to Assess (D2A) pathways P1-3, for each of the considered scenarios.
Fig 3.
Simulated results for total operating cost of D2A service and acute delays (indexed on baseline); mean D2A service occupancy, expressed as a percentage of total capacity; and mean number of acute beds ‘blocked’ (i.e. acute patients whose discharge is delayed due to insufficient D2A service capacity).
Simulations were performed over the period 14 May 2021 to 31 December 2021 for each of the three D2A pathways for a range of considered service capacities and scenarios (Table 1). Dashed vertical lines highlight the results corresponding to the cost-optimal capacity, as determined by the lowest total weekly cost.
Table 2.
Estimated cost-optimal capacities (daily maximum number of visits for P1; beds for P2 and P3) and corresponding summarised results for mean (95% CI) D2A service occupancy (expressed as a percentage of total capacity) and mean (95% CI) number of acute beds blocked.
Fig 4.
Box-whisker plots illustrating, for the cost-optimal D2A capacities, the median and interquartile range of D2A service occupancy (expressed as a proportion of total capacity) and number of acute beds blocked.