Nosokinetics (Service care delivering modelling) is a term used to describe the science/subject of measuring and modelling the process of care in health and social care systems.
- Objectivity to decisions
- Consequences of decisions
- Identifying what is important
- Performance & monitoring measures
- Explaining what went wrong
- Measurable parameters must exist
- Usually include political and social stability
- War, earthquake or that unexpected epidemic
- Can often use data that is routinely collected
- Assumption examination can allow what if scenario planning
- Can allow for regular or repeating in time events such as seasonal influenza, effect of weekends and public holidays
- Can allow for demography changes
- Assume you do not know precisely what will happen in advance, but past experience and reasonable population size allow assumption of randomness that underlies many real-world phenomena
- Allows a range of estimates
- More useful when you want a background level of guaranteed service
- More complicated so less likely to appeal to decision makers
- Returns a most likely estimate
Is easier to grasp but is far more likely to lead to chaos if used in prediction
Health and social care decisions based on deterministic modelling have created major system crises in most such systems
- Creating assessment panels or other rationing (queuing) steps such as waiting lists for inpatient investigations in patients who are already inpatients.
- Decreasing social service funding while increasing health funding leading to game playing by the underfunded service
- Examples include:
- Health and social care decisions based on deterministic modelling have created major system crises in most such systems
Will tend to have to use phase-type (PH) distributions such as length of stay in an institution
- State transitions need the mathematical concept of the (finite-state) continuous-time Markov chain (CTMC) which is rendered vis vector arithmetic.
Coxian distributions, a subtype of phase-type distributions are useful in healthcare modelling
- Care home residents classically have a two state coxian distribution to their length of stay, because a subgroup rapidly die (or move on to more dependent institutional care) as they have a subacute unstable medical condition while the other subgroup have a chronic and only slowly progressive condition.
- General phase-type (PH) distributions would be better for modelling patient flow around a hospital since the processes in the emergency department, theatres and wards are so different with the potential for readmissions and indeed use of complex numbers to =best fit the observed distrution of length of stay.
- Nosokinetics Group web site
- NHS institute modelling and simulation tools
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