title: Computer simulation of improvements in hospital length of stay for rehabilitation patients.
abstract: OBJECTIVE
  To estimate the potential improvement in acute and rehabilitation hospital length of stay for rehabilitation patients from hypothetical scenarios that address barriers to patient flow.
  
  
  METHODS
  Data about the duration of key processes for patients (n = 360) admitted to acute hospitals and subsequently transferred to inpatient rehabilitation in 2 wards in Melbourne, Australia were used to develop a computer simulation model.
  
  
  METHODS
  Simulated patients.
  
  
  METHODS
  A computer model of length of stay was developed, validation checks performed and alternate care pathways simulated.
  
  
  RESULTS
  Almost all scenarios resulted in significant changes in the length of stay compared with baseline. The effect size for the changes was typically small to medium. The duration of the rehabilitation discharge barriers showed significant changes in all hypothetical scenarios. The effect size was smaller when changes were made to a single barrier, but larger when multiple barriers were changed simultaneously.
  
  
  CONCLUSIONS
  Health system modelling can provide information regarding potential improvements in length of stay from addressing barriers to patient flow affecting rehabilitation patients. This can inform reforms to models of care and assist with cost benefit analyses.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, 3181 Melbourne, Australia. peter.new@southernhealth.org.au, p.new@cgmc.org.au, peter.new@monashhealth.org.
authors.forename: Peter W
authors.initials: PW
authors.lastname: New
authors.forename: Keith
authors.initials: K
authors.lastname: Stockman
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.forename: John H
authors.initials: JH
authors.lastname: Olver
authors.forename: Johannes U
authors.initials: JU
authors.lastname: Stoelwinder
mesh_terms: D001315:Australia; D003198:Computer Simulation; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research / Q000379:methods; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D017146:Models, Organizational; D010351:Patient Discharge; D012046:Rehabilitation / Q000458:organization & administration*