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Application of Portfolio Theory to Healthcare Capacity Management

Author

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  • Carina Fagefors

    (Department of Pediatric Anesthesiology, Intensive Care and Neonatology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
    Technology Management and Economics, Chalmers University of Technology, 412 96 Gothenburg, Sweden)

  • Björn Lantz

    (Technology Management and Economics, Chalmers University of Technology, 412 96 Gothenburg, Sweden
    Department of Engineering Science, University West, 461 86 Trollhättan, Sweden)

Abstract

Healthcare systems worldwide are faced with continuously increasing demand for care, while simultaneously experiencing insufficient capacity and unacceptably long patient waiting times. To improve healthcare access and availability, it is thus necessary to improve capacity utilization and increase the efficiency of existing resource usage. For this, variations in healthcare systems must be managed judiciously, and one solution is to apply a capacity pooling approach. A capacity pool is a general, collaborative capacity that can be allocated to parts of the system where the existing workload and demand for capacity are unusually high. In this study, we investigate how basic mean-variance methodology from portfolio theory can be applied as a capacity pooling approach to healthcare systems. A numerical example based on fictitious data is used to illustrate the theoretical value of using a portfolio approach in a capacity pooling context. The example shows that there are opportunities to use capacity more efficiently and increase service levels, given the same capacity, and that a mean-variance analysis could be performed to theoretically dimension the most efficient pooling organization. The study concludes with a discussion regarding the practical usefulness of this methodology in the healthcare context.

Suggested Citation

  • Carina Fagefors & Björn Lantz, 2021. "Application of Portfolio Theory to Healthcare Capacity Management," IJERPH, MDPI, vol. 18(2), pages 1-9, January.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:2:p:659-:d:480184
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    References listed on IDEAS

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    1. Brusco, MJ & Showalter, MJ, 1993. "Constrained nurse staffing analysis," Omega, Elsevier, vol. 21(2), pages 175-186, March.
    2. Bloom, Joan R. & Alexander, Jeffrey A. & Nuchols, Beverly A., 1997. "Nurse staffing patterns and hospital efficiency in the United States," Social Science & Medicine, Elsevier, vol. 44(2), pages 147-155, January.
    3. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    4. Scala, Antonio & Facchini, Angelo & Perna, Umberto & Basosi, Riccardo, 2019. "Portfolio analysis and geographical allocation of renewable sources: A stochastic approach," Energy Policy, Elsevier, vol. 125(C), pages 154-159.
    5. Kyle Cattani & Glen M. Schmidt, 2005. "The Pooling Principle," INFORMS Transactions on Education, INFORMS, vol. 5(2), pages 17-24, January.
    6. Pradeep Kumar & Sasadhar Bera & Tanusree Dutta & Shibashish Chakraborty, 2018. "Auxiliary Flexibility in Healthcare Delivery System: An Integrative Framework and Implications," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 19(2), pages 173-186, June.
    7. Akter, Sonia & Kompas, Tom & Ward, Michael B., 2015. "Application of portfolio theory to asset-based biosecurity decision analysis," Ecological Economics, Elsevier, vol. 117(C), pages 73-85.
    8. Sebastiano, Antonio & Belvedere, Valeria & Grando, Alberto & Giangreco, Antonio, 2017. "The effect of capacity management strategies on employees' well-being: A quantitative investigation into the long-term healthcare industry," European Management Journal, Elsevier, vol. 35(4), pages 563-573.
    9. Ludwig Kuntz & Roman Mennicken & Stefan Scholtes, 2015. "Stress on the Ward: Evidence of Safety Tipping Points in Hospitals," Management Science, INFORMS, vol. 61(4), pages 754-771, April.
    10. Costa, Oswaldo L.V. & de Oliveira Ribeiro, Celma & Rego, Erik Eduardo & Stern, Julio Michael & Parente, Virginia & Kileber, Solange, 2017. "Robust portfolio optimization for electricity planning: An application based on the Brazilian electricity mix," Energy Economics, Elsevier, vol. 64(C), pages 158-169.
    11. Bar{i}c{s} Ata & Jan A. Van Mieghem, 2009. "The Value of Partial Resource Pooling: Should a Service Network Be Integrated or Product-Focused?," Management Science, INFORMS, vol. 55(1), pages 115-131, January.
    12. Bar-Lev, Dan & Katz, Steven, 1976. "A Portfolio Approach to Fossil Fuel Procurement in the Electric Utility Industry," Journal of Finance, American Finance Association, vol. 31(3), pages 933-947, June.
    13. Delarue, Erik & De Jonghe, Cedric & Belmans, Ronnie & D'haeseleer, William, 2011. "Applying portfolio theory to the electricity sector: Energy versus power," Energy Economics, Elsevier, vol. 33(1), pages 12-23, January.
    14. Barnes, Belinda & Giannini, Fiona & Arthur, Anthony & Walker, James, 2019. "Optimal allocation of limited resources to biosecurity surveillance using a portfolio theory methodology," Ecological Economics, Elsevier, vol. 161(C), pages 153-162.
    15. Kortbeek, N. & Braaksma, A. & Burger, C.A.J. & Bakker, P.J.M. & Boucherie, R.J., 2015. "Flexible nurse staffing based on hourly bed census predictions," International Journal of Production Economics, Elsevier, vol. 161(C), pages 167-180.
    16. Mahar, Stephen & Bretthauer, Kurt M. & Salzarulo, Peter A., 2011. "Locating specialized service capacity in a multi-hospital network," European Journal of Operational Research, Elsevier, vol. 212(3), pages 596-605, August.
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