Post-hospital intermediate care - Examining assumptions and systemic consequences of a health policy prescription

The provision of health and social care for an increasing elderly population is a challenge facing many societies. The financial and social problems associated with long-term institutional care and the use of beds in acute hospitals by patients who are medically stable and do not necessarily require expensive hospital care have gained particular attention. UK policy makers advocate the establishment of intermediate care services as a partial solution to both of these problems. In this presentation system dynamics is used to examine the logic behind these policies and bring into focus the crucial role of (frequently overlooked) assumptions about costs and outcomes of intermediate care for their sys temic consequences. This work shows how valuable and practically relevant insights can be gained from an analysis of the sensitivity of the behaviour of a relatively simple model to changes in underlying assumptions, even if the quality of the available da ta is poor.