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Can home care for older people be improved?

Optimizing integrated planning of home care services through a decision support system

Jésica de Armas, Bruno Vieira and Helena Ramalhinho, Universitat Pompeu Fabra
Project selected in the Social Research Call 2019 (LCF/PR/SR19/52540014)

Over the last decades there has been a continuous increase in longevity worldwide and, whenever care for older people is needed, there is a higher preference for home care. Planning combined home health services (provided by nurses and doctors) and home social services (provided by social caregivers and cleaning staff) is a very difficult task for current home care organizations. The complexity of this task is a good reason to develop automated planning systems to obtain quality solutions. This article proposes a tool from operations research to optimize decisions in this area. Current care providers in Barcelona have helped in building and testing these models with real data. The results provide insights on parameters and the trade-off between the different indicators, such as costs and continuity of service. The proposed tool is available via a web-based decision support system that enables home care organizations to obtain efficient solutions in an intuitive, complete, and quick manner.
Key points
  • 1
       Operational research methods provide solutions to combined home health and social care planning with efficient indicators such as non-effective time, unscheduled services, or continuity of service. This means cost reduction and improvement in the quality of service for users and caregivers in home care organizations.
  • 2
       The developed tool makes it possible to test different options and evaluate the impact of some interventions and decisions.
  • 3
       The tool also makes it possible to specify dependencies between services, which should increase the quality of service for cases where the user requires both home health and social care.
  • 4
       Optimizing home care services involves a clear and direct benefit for older people and therefore for society at large.
Comparing solutions
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  • Non-effective working time: sum of travel time between homes and waiting time to start new jobs. The lower the value, the better.

  • Unscheduled services: after the home care planning for an area is created, some services may be unscheduled due to the limited available resources. Since they have to be served, this situation involves extra costs (caregivers from other areas, extra hours, etc.). The smaller the number of unscheduled services, the better.

  • Continuity of service: the average number of different caregivers who visit the user for the same type of service. Values around 1-2 are desirable.

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