Simulating the impact of preventive strategies for older persons' emergency care demands on health care utilisation, Amsterdam as Dutch use case.
Background Preventive strategies aim to reduce older adults' emergency department (ED) visits and related adverse health outcomes, but their impact on healthcare system utilisation remains unclear. This can be investigated using system dynamics modelling, which uses data to explore effects and test...
| Publicado en: | Age & Ageing Vol. 55; no. 6; pp. 1 - 11 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jun2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195099712&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195099712 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jun2026 vid: 55 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195099712 10.1093/ageing/afag162 ppf: 1 ppct: 10 formats: tig: atl: Simulating the impact of preventive strategies for older persons' emergency care demands on health care utilisation, Amsterdam as Dutch use case. aug: au: Smeekes, Oscar S Boer, Tim R de Willems, Hanna C Mei, Rob D van der Buurman, Bianca M affil: Amsterdam UMC location University of Amsterdam, Internal Medicine, section of Geriatric Medicine, Meibergdreef 9, Amsterdam, Netherlands Centrum Wiskunde & Informatica-Stochastics, Science Park 123, Amsterdam, Netherlands Amsterdam UMC location University of Amsterdam, Internal Medicine, section of Geriatric Medicine, Meibergdreef 9, Amsterdam, NetherlandsAmsterdam UMC location Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam Public Health Research Institute, De Boelelaan 117, Amsterdam, Netherlands su: Home care services Patients Hospital care Hospital admission & discharge Primary health care Emergency medical services Emergency medicine Nursing care facilities Analysis of variance Critical care medicine Medical care use Independent living T-test (Statistics) Research funding Emergency room visits Descriptive statistics Chi-squared test Simulation methods in education Subacute care sug: subj: Home care services Patients Hospital care Hospital admission & discharge Primary health care Emergency medical services Emergency medicine Nursing care facilities Analysis of variance Critical care medicine Emergency and Other Relief Services Municipal police services Home Health Care Services Offices of All Other Miscellaneous Health Practitioners Offices of all other health practitioners Services for the Elderly and Persons with Disabilities Community care facilities for the elderly Nursing Care Facilities (Skilled Nursing Facilities) Medical care use Independent living T-test (Statistics) Research funding Emergency room visits Descriptive statistics Chi-squared test Simulation methods in education Subacute care keyword: acute aged and chronic care copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency department visits emergency service emergency treatment health care use home care services hospital hospitalization https://dx.doi.org/10.1093/ageing/afag162 inLanguage:en intermediate intermediate care nursing homes older adult prevention preventive strategies publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42258337/ system dynamics modelling acute aged and chronic care copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency department visits emergency service emergency treatment health care use home care services hospital hospitalization https://dx.doi.org/10.1093/ageing/afag162 inLanguage:en intermediate intermediate care nursing homes older adult prevention preventive strategies publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42258337/ system dynamics modelling ab: Background Preventive strategies aim to reduce older adults' emergency department (ED) visits and related adverse health outcomes, but their impact on healthcare system utilisation remains unclear. This can be investigated using system dynamics modelling, which uses data to explore effects and test strategies across populations. Aim In this study, we simulated and studied how preventive measures affect acute hospitalisations, intermediate care, home care, and nursing home admissions among community-dwelling older adults after an ED visit. Methods We developed a system dynamics simulation model tracing older adults from ED visit to hospitalisation, intermediate care, discharge home (with or without care), nursing home admission, or death within 30 days. Simulated strategies included proactive care, geriatric emergency medicine, and hospital-at-home. Data from Amsterdam residents aged ≥65 who visited the ED in 2019 were used. Patients were categorised by home care status. Results 31,049 patient journeys were used in the modelling. Of the simulated strategies, hospital-at-home demonstrated the largest potential reductions in institutionalised care use after ED visits in the total cohort: acute hospitalisations (−10.2%), intermediate care (−16.7%), nursing home care (−10.7%). Furthermore, it showed a reduction in personal home care (−1.8%), and limited increases in household help (+2%) and nursing home care at home (+1.5%). Conclusion Of the simulated strategies, hospital-at-home reduced healthcare use post-ED most effectively, causing the greatest decrease in institutional care without requiring a meaningful increase in home care services during one year of follow-up.These findings can guide policymakers, insurers, and institutions in choosing effective preventive strategies for regional populations. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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