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An Iterative Estimation and Validation Procedure for Specification of Semi-Markov Models with Application to Hospital Patient Flow

Author

Listed:
  • Elliott N. Weiss

    (Cornell University, Ithaca, New York)

  • Morris A. Cohen

    (University of Pennsylvania, Philadelphia, Pennsylvania)

  • John C. Hershey

    (University of Pennsylvania, Philadelphia, Pennsylvania)

Abstract

This article presents a methodology to identify and specify a continuous time semi-Markov model of population flow within a network of service facilities. An iterative procedure of state space definition, population disaggregation, and parameter estimation leads to the specification of a model which satisfies the underlying semi-Markov assumptions. We also present a test of the impact of occupancy upon realizations of population flows. The procedure is applied to data describing the movements of obstetric patients in a large university teaching hospital. We use the model to predict length-of-stay distributions. Finally, we compare these results with those that would have been obtained without the procedure, and show the modified model to be superior.

Suggested Citation

  • Elliott N. Weiss & Morris A. Cohen & John C. Hershey, 1982. "An Iterative Estimation and Validation Procedure for Specification of Semi-Markov Models with Application to Hospital Patient Flow," Operations Research, INFORMS, vol. 30(6), pages 1082-1104, December.
    • Handle: RePEc:inm:oropre:v:30:y:1982:i:6:p:1082-1104
    DOI: 10.1287/opre.30.6.1082
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    Citations

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    Cited by:

    1. Muge Capan & Julie S. Ivy & James R. Wilson & Jeanne M. Huddleston, 2017. "A stochastic model of acute-care decisions based on patient and provider heterogeneity," Health Care Management Science, Springer, vol. 20(2), pages 187-206, June.
    2. Hideaki Takagi & Yuta Kanai & Kazuo Misue, 2017. "Queueing network model for obstetric patient flow in a hospital," Health Care Management Science, Springer, vol. 20(3), pages 433-451, September.
    3. Jacqueline Griffin & Shuangjun Xia & Siyang Peng & Pinar Keskinocak, 2012. "Improving patient flow in an obstetric unit," Health Care Management Science, Springer, vol. 15(1), pages 1-14, March.
    4. Côté, Murray J. & Stein, William E., 2000. "An Erlang-based stochastic model for patient flow," Omega, Elsevier, vol. 28(3), pages 347-359, June.
    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.
    6. Samuel Davis & Nasser Fard, 2020. "Theoretical bounds and approximation of the probability mass function of future hospital bed demand," Health Care Management Science, Springer, vol. 23(1), pages 20-33, March.
    7. Saied Samiedaluie & Vedat Verter, 2019. "The impact of specialization of hospitals on patient access to care; a queuing analysis with an application to a neurological hospital," Health Care Management Science, Springer, vol. 22(4), pages 709-726, December.
    8. Yuta Kanai & Hideaki Takagi, 2021. "Markov chain analysis for the neonatal inpatient flow in a hospital," Health Care Management Science, Springer, vol. 24(1), pages 92-116, March.

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