Managing the overflow of intensive care patients

Many hospitals in the Netherlands are confronted with capacity problems at their intensive care units (ICUs) resulting in cancelling operations, overloading the staff with extra patients, or rejecting emergency patients. In practice, the last option is a common choice because for legal reasons, as w...

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Bibliographic Details
Published in:European journal of operational research 2008-03, Vol.185 (3), p.998-1010
Main Authors: Litvak, Nelly, van Rijsbergen, Marleen, Boucherie, Richard J., van Houdenhoven, Mark
Format: Article
Language:English
Subjects:
Emergency medical care
Equivalent random method
Hospitals
Indigent care
Intensive care
Intensive care units
Mathematical models
Operations research
OR in health services
Overflow models
Studies
Trauma centers
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Summary:Many hospitals in the Netherlands are confronted with capacity problems at their intensive care units (ICUs) resulting in cancelling operations, overloading the staff with extra patients, or rejecting emergency patients. In practice, the last option is a common choice because for legal reasons, as well as for hospital logistics, rejecting emergency patients has minimal consequences for the hospital. As a result, emergency patients occasionally have to be transported to hospitals far away. In this work, we propose a cooperative solution for the ICU capacity problem. In our model, several hospitals in a region jointly reserve a small number of beds for regional emergency patients. We present a mathematical method for computing the number of regional beds for any given acceptance rate. The analytic approach is inspired by overflow models in telecommunication systems with multiple streams of telephone calls. Simulation studies show that our model is quite accurate. We conclude that cooperation between hospitals helps to achieve a high acceptance level with a smaller number of beds resulting in improved service for all patients.
ISSN:0377-2217
1872-6860
DOI:10.1016/j.ejor.2006.08.021