A decision-making aid for long-term care waiting list policies: modelling first-come, first-served vs. needs-based criteria.

A chronic care hospital in London, Ontario, was faced with the question of whether to continue to admit applicants on a first-come, first-served basis, or to implement a needs-based admission criterion To provide information relevant to this decision, a simple computer modelling technique was used to model the waiting list under both policies. Analysis of the results indicated substantial variability in the need for care demonstrated by waiting list applicants, and individual placement priority under the two schemes. Descriptions of individuals affected by the proposed change in policy provided additional information. The information provided by the waiting list analysis contributed to the decision-making process about waiting list policy. The method used is applicable to waiting list management decisions in other institutions.