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Title of Journal: Ann Oper Res

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Abbravation: Annals of Operations Research

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Springer US

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DOI

10.1002/jcaf.20208

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1572-9338

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Timedependent analysis for refused admissions in 

Authors: R Bekker A M de Bruin
Publish Date: 2009/06/18
Volume: 178, Issue: 1, Pages: 45-65
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Abstract

For capacity planning issues in health care such as the allocation of hospital beds the admissions rate of patients is commonly assumed to be constant over time In addition to the purely random fluctuations there is also typically a predictable pattern in the number of arriving patients For example roughly 2/3 of the admitted patients at an Intensive Care Unit arrives during office hours Also most of the scheduled admissions occur during weekdays instead of during the weekendUsing approximations based on the infiniteserver queue we analyze an M t /H/s/s model to determine the impact of the timedependent arrival pattern on the required number of operational beds and fraction of refused admissions for clinical wards In particular the results show that the effect of the daily pattern is rather limited for clinical wards in contrast to the weekweekend pattern for which the difference in the fraction of refused admissions across the week is considerable We also show that an increased variability in length of stay distribution has a stabilizing effect on the timedependent required number of beds Finally we demonstrate a method to determine the required number of beds across the weekThis article is published under an open access license Please check the Copyright Information section for details of this license and what reuse is permitted If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and reuse information please contact the Rights and Permissions team

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