Applying Operations Research to the Inpatient Stroke Rehabilitation System

Abstract

The Canadian best practice guidelines recommend stroke patients receive a minimum three hours of therapy per day in inpatient rehabilitation. However, few patients receive this because cost is considered a barrier. The purpose of the study was to develop a linear programming model to assess the tradeoff of cost and guideline achievement. The objective function was to minimize the cost of inpatient rehabilitation. Decision variables included the cost of therapy and length of stay. Constraints included hours of therapy and the relationship between the amount of therapy and length of stay. The optimal solution showed minimal cost when patients received 3 hours of therapy per day. This results in a 24.3-day length of stay, costing $18,253.55 per patient. The Canadian average length of stay in rehabilitation and therapy cost an additional $1,470.13, compared with the optimal solution from the model. This demonstrates that more therapy may result in cost savings.