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Abstract

French

A chronic care hospital in London, Ontario, was faced with the question of whether to continue to admit applicants on a first-come, first-served basis, or to implement a needs-based admission criterion. To provide information relevant to this decision, a simple computer modelling technique was used to model the waiting list under both policies. Analysis of the results indicated substantial variability in the need for care demonstrated by waiting list applicants, and individual placement priority under the two schemes. Descriptions of individuals affected by the proposed change in policy provided additional information. The information provided by the waiting list analysis contributed to the decision-making process about waiting list policy. The method used is applicable to waiting list management decisions in other institutions.

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It should be noted that this is a pessimistic, though reasonable, estimate of time to placement. At the time of the waiting list study, the individual waiting for the longest time had been on the list for 5 years. If each person on the waiting list were to require placement at Parkwood, the waiting period would be as indicated. In reality, the hospital experiences attrition from the waiting list for many reasons, such as death, placement at other institutions and the choice of deferred placement. However, it is difficult to predict the future effect of these factors on the waiting list population, and thus hard to give an estimate of waiting time that takes these factors into account.

Hoffmaster

and Wolf

. Allocation and Rationing of Resources in Long-term and Chronic Care. London, Ont, Westminster Institute for Ethics and Human Values, 1993.

A Decision-Making Aid for Long-Term Care Waiting List Policies: Modelling First-Come,First-Served vs. Needs-Based Criteria

Abstract

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