Health and Social Care Modelling GroupUniversity of Westminster, London

Interpretation of outputs

Outline

Following the sequence of FLoSC reportsLoS – General InfoLoS – Summary InfoLoS – Fitted ResultsCost – General InfoCost – Forecast ResultLoS – Technical Info

FLoSC: Report - LoS – General Info

First FLoSC summarises the data, after some basic cleansing

FLoSC deletes records of patients moving from NC to RC

Report: Length-of-stay Analysis

This analysis was carried out on 2008-04-10 at 18:30:18

General informationnumber of records 2144period covered between 2003-04-20 and 2007-09-07

Data cleaning and data processingnumber of record(s) deleted due to missing (or unknown) value 5---- due to missing (type of care) 1---- due to missing (end reason) 1---- due to missing (los) 2---- due to missing (plos) 1data subset criterion gender = both ; type of care = bothnumber of record(s) deleted due to movement from NC to RC 2number of record(s) in the working dataset 2137

FLoSC provides a summary frequency table

FLoSC: Report - LoS – Summary Info (1)

Summary statistics on length of staycount mean stdev Q1 median Q3 skewness

All RC residents 1149 800.6 788.7 230 552 1100 1.799All NC residents 988 616.7 775.8 102 323.5 827.5 2.433All female residents in RC 867 793.8 791 230 549 1078 1.902All male residents in RC 282 821.5 782.4 229.2 575.5 1237 1.466All female residents in NC 753 642.2 796.7 109 345 883 2.396All male residents in NC 235 534.7 699.7 79 283 728 2.5All residents with missing gender in RC 0 NA NA NAAll residents with missing gender in NC 0 NA NA NA

FLoSC: Report - LoS – Summary Info (2)

FLoSC provides summary statistics on length-of-stay (mean, standard deviation, etc), stratified by type of care and by gender

■ Histograms (should) confirm the “exponential” shape of the LoS distribution• The time labels are actually interval mid-points

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LOS in nursing care

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FLoSC: Report - LoS – Summary Info (3)

Summary on the movement of residentstotal number of residents present on 2003-04-20 636---- in RC 382---- in NC 254number of admissions to RC during the period 767number of residents died in RC during the period 628number of residents transferred to NC during the period 137number of residents still living in RC at the end of the period 384number of direct admissions to NC during the period 597number of residents still living in NC at the end of the period (including those transferred from RC) 259number of residents died in NC at the end of the period (including those transferred from RC) 729number of residents died in NC at the end of the period (among those transferred from RC) 93number of residents still living in NC at the end of the period (among those transferred from RC) 44

FLoSC: Report - LoS – Summary Info (4)

■ The table at the bottom summarises the movement of residents

RC NC

discharge

FLoSC: Report - LoS – Fitted Results (1)

Model fitted results

Model structureRC 1 stateNC 2 states

model selection mode: automatic

Residents' movements and patterns of LOS

804 days

112 days

805 days

17.9%

82.1%

55.6%

44.4%

• More homogeneous group in RC than in NC

• High mortality in the first few months in NC

• Once past the early phase in NC, residents “behave” like in RC

FLoSC: Report - LoS – Fitted Results (2)

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Survival curve for residential care

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• Very good fit to data

• Exponential shape

FLoSC: Report - LoS – Fitted Results (3)

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Survival curve for nursing care

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• Very good fit to data• “Exponential” shape• Much sharper early decline

captured by the mixture of two exponentials

Report: Cost Forecast - Summary Information

This analysis was carried out on 2008-04-10 at 18:34:43

Summary information on known commitmentnumber of residents in system on 2007-09-07 643data subset criterion gender = both ; type of care = bothnumber of residents in working dataset 643--- in RC 384--- in NC 259

Frequency table (by gender)RC NC Total

female 284 205 489male 100 54 154total 384 259 643

FLoSC: Report - Cost – General Info (1)

First FLoSC summarises the number of residents in the care system (RC and NC) on the last date of the data availability period (7 Sep 2007)

FLoSC: Report - Cost – General Info (2)

Summary statistics on length of staycount mean stdev Q1 median Q3 skewness

All RC residents 384 822.3 776.3 248 565.5 1158 1.779All NC residents 259 807.7 862 165.5 506 1153.5 1.755All female residents in RC 284 803.3 732.5 269.2 573 1124 1.866All male residents in RC 100 876.4 890.9 221 556.5 1319.2 1.517All female residents in NC 205 879.6 902.3 215 550 1221 1.642All male residents in NC 54 534.7 622.2 92.5 342 723.8 1.991All residents with missing gender in RC 0 NA NA NAAll residents with missing gender in NC 0 NA NA NA

FLoSC provides other LoS statistics on those in care at the last date of the data availability period

First FLoSC summarises your cost input data

FLoSC: Report – Cost – Forecast Result (1)

Report: Cost Forecast - Forecasted Costs Due to Known Commitment

Forecasting period: from 2007-09-07 to 2009-04-01 year(s)Forecasting interval: quarterly

Weekly cost of careFinancial year RC NC2007/08 400 5002008/09 450 600

Costs amount to nearly £7.5m to the end of the current financial year (1 Apr 2008), and almost £11m for the following financial year

Predict cost of known commitments quarterly Known commitment: residents already in system

FLoSC: Report – Cost – Forecast Result (2)

Projected total cost of current commitmentFinancial period Total costpresent to 2007-10-01 9554182007-10-01 to 2008-01-01 34027162008-01-01 to 2008-04-01 30090812008-04-01 to 2008-07-01 31327842008-07-01 to 2008-10-01 28481492008-10-01 to 2009-01-01 25620022009-01-01 to 2009-04-01 2257927

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Estimated cost

Costs are also broken down by type of careBreak-down of the projected total cost by type of careFinancial period RC NCpresent to 2007-10-01 518869 4365482007-10-01 to 2008-01-01 1851909 15508072008-01-01 to 2008-04-01 1635303 13737782008-04-01 to 2008-07-01 1643427 14893572008-07-01 to 2008-10-01 1483310 13648382008-10-01 to 2009-01-01 1323406 12385962009-01-01 to 2009-04-01 1156463 1101463

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Estimated cost by type of care

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FLoSC: Report – Cost – Forecast Result (3)

FLoSC: Report - LoS – Technical Info

Residents' movements and patterns of LOS

804 days

112 days

805 days

17.9%

82.1%

55.6%

44.4%

These are the parameters used to derive information on residents’ movements and costs forecasts

Model fitted results (details)

Fitted model parametersparameter estimate s.e. cil ciuq_{12} 0.000223 0.00002 0.000188 0.000263q_{23} 0.00496 0.00124 0.003037 0.008099q_{14} 0.001021 0.00004 0.000944 0.001104q_{24} 0.003963 0.00037 0.003302 0.004755q_{34} 0.001243 0.00008 0.001091 0.001415

Fitted survivor functionRC exp(-0.00124*x)NC 0.354*exp(-0.00892*x) + 0.646*exp(-0.00124*x)

Fitted transfer probability from RC to NCtransfer probability 0.179

THANK YOU

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