Creating a pathway through the dementia crisis
Did you know that if dementia care were a country, it would be the world’s 18th largest economy? According to the 2011 World Alzheimer Report the worldwide costs of dementia (US$604 billion in 2010) amount to more than 1% of global GDP.
This really drives home the impact of the implementation of best practice in health and social care and to support planning of dementia services, and the importance of early diagnosis.
With higher incidences of dementia amongst an ageing population there is a need for health services to reliably predict the numbers of dementia patients likely to enter the care system at some point.
That’s why when the opportunity presented itself to work with NHS in the UK to develop a simulation model, we jumped on board.
The simulation model I’m talking about combines dementia prevalence forecasting, and disease progression modeling with a range of care pathway scenario models.
According to 2011 World Alzheimer Report the primary purpose of early diagnosis is timely access to information, advice, and support and access to a pathway of effective intervention and care from the time of diagnosis to end of life care.
It’s simply not enough to predict the expected number of people with dementia, planners need to understand when their care needs may change, and test the potential impact of interventions.
What’s great about simulation is that it allows users to understand the impact of passing time on the planning process. This is crucial in a condition like dementia where patients may need increasing care as their condition gets worse; a process which takes place over 10 years or so.
The simulation model takes population projections by age and gender, and age-banded prevalence for seven types of dementia to create an annual modeled population which is used to simulate patients entering the model each year.
Each patient into the simulation is given a set of characteristics:
- condition type,
- progression time,
- diagnosis and
- life expectancy
These characteristics administer how patients with dementia move through the simulation, progressing through different phases of the disease over time and taking into account death from all causes.
At each stage of the disease the simulation is able to model the types of services and treatments patients are likely to receive and therefore enables health and social care planners to answer questions about demand changes, earlier diagnosis of dementia, the implementation of new services, and costs to different parts of the care system.
I think it’s plain to see how simulation has a positive impact on planning future service needs for dementia care, but it’s also important to understand the financial cost of dementia. The global estimate last year was at US$604 billion per year!
This article by Christine Stomes states that there is an urgent need to develop cost-effective packages of medical and social care including evidence-based prevention strategies that meet the needs of people with dementia and their caregivers across the course of the illness.
By investing in cost-effective approaches like simulation there can be adequate preparation for the future, and preventative care options that can improve the lives of people with dementia, as well as lowering costs.
“This simulation has really helped us to understand the impact of increasing numbers of people living with dementia over time, and how we need plan to make sure we have the right services in place at the right time in the future” Peter Fryers, Public Health Consultant, NHS Worcestershire
Also, it’s not just dementia care that simulation can be used to model, but other long term conditions where patients and service users are living with a condition that needs to be managed over time.
Do you have any examples of simulation being used to manage long term healthcare pathways? If so, we’d like to hear from you!