Scheduling admissions and reducing variability in bed demand

被引:47
作者
Bekker, Rene [1 ]
Koeleman, Paulien M. [2 ,3 ]
机构
[1] Vrije Univ Amsterdam, Dept Math, Amsterdam, Netherlands
[2] Vrije Univ Amsterdam, Woerden, Netherlands
[3] CC Zorgadviseurs, Woerden, Netherlands
关键词
Variability in bed demand; Admission scheduling; Capacity requirement; Queueing theory; Heavy-traffic approximation; Quadratic programming; ERLANG LOSS MODEL; TRAFFIC LIMIT-THEOREM; SERVICE SYSTEMS; QUEUES; APPROXIMATIONS; SENSITIVITY;
D O I
10.1007/s10729-011-9163-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy pattern. For the impact of variability on the required number of beds, we use a heavy-traffic limit theorem for the G/G/a queue yielding an intuitively appealing approximation in case the arrival process is not Poisson. Also, given a structural weekly admission pattern, we apply a time-dependent analysis to determine the mean offered load per day. This time-dependent analysis is combined with a Quadratic Programming model to determine the optimal number of elective admissions per day, such that an average desired daily occupancy is achieved. From the mathematical results, practical scenarios and guidelines are derived that can be used by hospital managers and support the method of quota scheduling. In practice, the results can be implemented by providing admission quota prescribing the target number of admissions for each patient group.
引用
收藏
页码:237 / 249
页数:13
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