Abstract
Beds are key, scarce medical resources in hospitals. The bed occupancy rate (BOR) amongst different departments within large tertiary hospitals is very imbalanced, a situation which has led to problems between the supply of and the demand for bed resources. This study aims to balance the utilization of existing beds in a large tertiary hospital in China. We developed a data-driven hybrid three-stage framework incorporating data analysis, simulation, and mixed integer programming to minimize the gaps in BOR among different departments. The first stage is to calculate the length of stay (LOS) and BOR of each department and identify the departments that need to be allocated beds. In the second stage, we used a fitted arrival distribution and median LOS as the input to a generic simulation model. In the third stage, we built a mixed integer programming model using the results obtained in the first two stages to generate the optimal bed allocation strategy for different departments. The value of the objective function, Z, represents the severity of the imbalance in BOR. Our case study demonstrated the effectiveness of the proposed data-driven hybrid three-stage framework. The results show that Z decreases from 0.7344 to 0.0409 after re-allocation, which means that the internal imbalance has eased. Our framework provides hospital bed policy makers with a feasible solution for bed allocation.
Highlights
Is differential is apparent with respect to bed resources
We develop a data-driven hybrid three-stage framework incorporating data analysis, simulation, and mixed integer programming (MIP) to determine the optimal bed allocation strategy. e first stage is to select departments for allocation according to the relationship between the number of beds and the bed occupancy rate (BOR) and have this result approved by hospital management
Stage I: Data Preliminaries. e length of stay (LOS) of 28 departments can be calculated by function (1), and the BOR of the 28 departments can be calculated by function (2)
Summary
Hospital bed numbers have increased greatly in recent years, this increase cannot cope with the growth rate of admission demand in China. According to the report “Statistical Communique on the Development of China’s Health and Family Planning Program 2016” [2], the number of hospitalizations across the nation’s medical and health institutions was 227.28 million and the annual hospitalization rate was 16.5%. Ere were 7.410 million beds in medical institutions across the country. Amongst all of the medical institutions, China’s large tertiary hospitals, classed as Class III according to the classification standards (Appendix), are facing the most serious imbalance between admissions and bed resources (Table 1). Erefore, from the perspective of the sustainability of medical resources, the best option is to improve the utilization of bed resources 98.80 84.20 advantageous from the perspective of the public planner [3] and may even have some negative consequences, such as doctor and nurse work overloads, decreases in medical care quality, and aggravation of medical conflicts [4]. erefore, from the perspective of the sustainability of medical resources, the best option is to improve the utilization of bed resources
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