Modelling costs of bed occupancy and delayed discharge of post-stroke patients

Stroke is the major cause of disability in the UK, costing the economy £7 billion per annum. Prolonged length of stay (LOS) in hospital is considered to be an inefficient use of resources and is in part due to bed blocking. We present results of survival analyses utilising LOS and destination as outcome measures, based on data from the Belfast City Hospital. On the basis of these results we have created a number of groups, clustered by age, gender, diagnosis and destination. The groups were then used to form the basis of a simulation model, where each group is a patient pathway within the simulation. Various scenarios were explored focusing on the potential cost-efficiency gains should LOS, prior to discharge to a private nursing home (PNH) be reduced. We then consider a possible queue for patients awaiting discharge to a private nursing home with a focus on the financial gains should this queue be reduced.