Health care management science
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Health Care Manag Sci · Oct 1998
A simulation modelling approach to evaluating length of stay, occupancy, emptiness and bed blocking in a hospital geriatric department.
The flow of patients through geriatric hospitals has been previously described in terms of acute (short-stay), rehabilitation (medium-stay), and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model using BOMPS (Bed Occupancy Modelling and Planning System). In this a patient is initially admitted to acute care. The majority of the patients are discharged within a few days into their own homes or through death. ⋯ The average length of stay in the acute compartment is artificially high if some would-be long-term patients are kept waiting in the short-stay compartment until beds become available in long-stay (residential and nursing homes). In this paper we consider the problem as a queueing system to assess the effect of blockage on the flow of patients in geriatric departments. What-if analysis is used to allow a greater understanding of bed requirements and effective utilisation of resources.
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"Bed crisis" is a buzz word of the 90's in the National Health Services (NHS). Medical emergency admissions keep rising and hospital resources remain limited. Faced with such a dilemma, many hospitals have endeavoured to improve their service efficiencies in order to meet the challenge. This paper describes a real-life hospital process re-engineering project in which computer simulation and optimisation models were applied to provide decision making support in determining the size of the proposed medical assessment unit and the allocation of the available medical beds to minimise hospital bed overflows.