The current elderly care system in the Netherlands doesn’t work as well as it could. Older people sometimes experience great difficulty in obtaining prompt, adequate and appropriate care when they need it. Ahti is working with Amsterdam UMC (AMC site), the CWI (National Research Institute for Mathematics and Computer Science), VU Amsterdam and SIGRA to address this problem. The Dolce Vita project is shedding light on issues affecting elderly care. The project involves the development of an innovative data model that clarifies the structures and inefficiencies in the current elderly care system. It is also capable of generating what-if scenarios that predict the effects of short-term decisions, long-term policy changes and investments in the system.
Problems in the acute elderly care system
Following the recent, large-scale political-financial overhaul of the healthcare system in 2015, which brought elderly care under responsibility of the municipalities, older people are experiencing greater difficulty in obtaining prompt, adequate and appropriate care when they need it. Temporary care is not always available, for example. Moreover, hospital emergency departments are becoming systemically overloaded by elderly people who do not need to be there: many elderly people end up in hospital simply because they can no longer manage at home, when they have no real emergency care need. Furthermore, 20% of elderly patients discharged from emergency departments are back within 30 days; another 20% even die in the same time frame. Consequently, the admission of elderly people to emergency departments immediately leads to an increase in the demand for care from all providers in the system, and to a corresponding increase in cost. It is also the case that many elderly people are not able to return home straight after discharge from hospital. They are too vulnerable to be at home, but not unwell enough to stay in hospital, causing capacity problems for emergency departments and nursing wards.
The problems arise from a mismatch in the current complex system of acute elderly care, at a higher administrative and organisational level. The system is characterised by a multitude of care providers and three financial-political instruments. According to research by SIGRA in 2017, the mismatch has multiple causes:
- Problems occur mostly at interfaces between care providers. For example, where patients are transferred between GP care and nursing home care, or between emergency care and at-home care.
- Supply of and demand for resources within the various care settings are not well matched, due to a lack of quantitative insight.
- There is insufficient coordination and planning at the system level.
Making the current elderly care system more transparent
Dolce Vita stands for ‘Data-driven Optimisation for a Vital Elderly Care System’. Ahti is working with Amsterdam UMC (AMC site), the CWI, VU Amsterdam and SIGRA to tackle the problems described above and facilitate the development of an integrated approach to planning at the macro level. We are developing an innovative data model to help achieve this. The model has two functions. First, it sheds light on the structures and inefficiencies in the current acute elderly care system. Second, it can generate what-if scenarios. That allows the healthcare sector as a whole to make collective predictions in the context of the acute elderly care system regarding the consequences of:
- Short-term decisions (capacity plans, patient preferences, etc.)
- Long-term policy changes (investments and innovations, etc.)
Through this project, we aim to improve transparency in the elderly care system and support system-wide optimisation. Our goal is for every vulnerable elderly person to receive the care they need in the right place at the right time, leading to appropriate outcomes at affordable cost.
Status of the Dolce Vita project
The project has received a grant from the Netherlands Organisation for Scientific Research (NWO).
- Amsterdam UMC – AMC site
- CWI (National Research Institute for Mathematics and Computer Science)
- VU (VU Amsterdam)
- City of Amsterdam
More information or do you have a question? Please contact Rosan van Zoest (Project Leader)