A discrete event simulation model for the admission of patients to a home care rehabilitation service

The admission of new patients to Home Care (HC) services is a relevant problem, which requires managing waiting lists while respecting a maximum admissible period between patient’s request and service beginning. In the literature, this problem is only marginally addressed when compared to other HC management issues, e.g., visit scheduling and patient assignment to personnel. The goal of our work is to develop a discrete event simulation framework for analysing admission policies and waiting list management strategies in HC services. In this paper, we propose and test a first model for the admission of patients to a HC rehabilitation service, where the care service must start within a fixed period from the acute event. We refer to the specific case of a provider operating according to the regulation of the health system of Milan, Italy, which is however general enough to derive general considerations. Results show the effectiveness of the methodology for this application, its versatility, and a quantitative evaluation of some directions of improvement in the system.