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An Improved Stochastic Model for Occupancy-Related Random Variables in General-Acute Hospitals

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  • William Shonick

    (University of California, Los Angeles, California)

  • James R. Jackson

    (University of California, Los Angeles, California)

Abstract

This paper presents an improved stochastic model for the behavior of the daily census and associated waiting variables in general-acute hospitals. The development and form of the distributions derived follow the general approach of a previous paper by Shonick [ J. Amer. Statist. Assoc. 65, 1474–1500 (1970)], but greater flexibility is provided for the health-services planner by increasing the number of decision choices available for achieving given outcomes. This increased flexibility is attained via a generalization of the queuing discipline, permitting admissions of elective patients to be suspended when the number of occupied beds reaches a predetermined level (which may be less than the total bed complement). For any emergency-elective mix of the demand for hospitalization, this model permits the computation of many measures of operating efficiency, including expected overfill rate, percentage occupancy, waiting-list length, and loss of emergency patients. A variant of the model permits computation of the expected number of patient days that will be served in “nonapproved” facilities when emergencies arriving during “full” periods are accommodated therein, rather than turned away.

Suggested Citation

  • William Shonick & James R. Jackson, 1973. "An Improved Stochastic Model for Occupancy-Related Random Variables in General-Acute Hospitals," Operations Research, INFORMS, vol. 21(4), pages 952-965, August.
    • Handle: RePEc:inm:oropre:v:21:y:1973:i:4:p:952-965
    DOI: 10.1287/opre.21.4.952
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    Cited by:

    1. Iannoni, Ana Paula & Chiyoshi, Fernando & Morabito, Reinaldo, 2015. "A spatially distributed queuing model considering dispatching policies with server reservation," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 75(C), pages 49-66.
    2. Papier, Felix & Thonemann, Ulrich W., 2011. "Capacity rationing in rental systems with two customer classes and batch arrivals," Omega, Elsevier, vol. 39(1), pages 73-85, January.
    3. Pazour, Jennifer A. & Roy, Debjit, 2012. "Minimizing Customer Waiting Costs for Rental Vehicle Providers using Threshold Reservation Policies," IIMA Working Papers WP2012-12-05, Indian Institute of Management Ahmedabad, Research and Publication Department.
    4. Jones, Bruce L., 1995. "A stochastic population model for high demand CCRCs," Insurance: Mathematics and Economics, Elsevier, vol. 16(1), pages 69-77, April.
    5. Li, L. X. & Benton, W. C., 1996. "Performance measurement criteria in health care organizations: Review and future research directions," European Journal of Operational Research, Elsevier, vol. 93(3), pages 449-468, September.

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