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A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times

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Listed:
  • Shanshan Qiu
  • Ratna Chinnam
  • Alper Murat
  • Bassam Batarse
  • Hakimuddin Neemuchwala
  • Will Jordan

Abstract

Emergency departments (ED) in hospitals are experiencing severe crowding and prolonged patient waiting times. A significant contributing factor is boarding delays where admitted patients are held in ED (occupying critical resources) until an inpatient bed is identified and readied in the admit wards. Recent research has suggested that if the hospital admissions of ED patients can be predicted during triage or soon after, then bed requests and preparations can be triggered early on to reduce patient boarding time. We propose a cost sensitive bed reservation policy that recommends optimal bed reservation times for patients. The policy relies on a classifier that estimates the probability that the ED patient will be admitted using the patient information collected and readily available at triage or right after. The policy is cost sensitive in that it accounts for costs associated with patient admission prediction misclassification as well as costs associated with incorrectly selecting the reservation time. Results from testing the proposed bed reservation policy using data from a VA Medical Center are very promising and suggest significant cost saving opportunities and reduced patient boarding times. Copyright Springer Science+Business Media New York 2015

Suggested Citation

  • Shanshan Qiu & Ratna Chinnam & Alper Murat & Bassam Batarse & Hakimuddin Neemuchwala & Will Jordan, 2015. "A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times," Health Care Management Science, Springer, vol. 18(1), pages 67-85, March.
  • Handle: RePEc:kap:hcarem:v:18:y:2015:i:1:p:67-85
    DOI: 10.1007/s10729-014-9283-1
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    References listed on IDEAS

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    Cited by:

    1. Lee, Seung-Yup & Chinnam, Ratna Babu & Dalkiran, Evrim & Krupp, Seth & Nauss, Michael, 2021. "Proactive coordination of inpatient bed management to reduce emergency department patient boarding," International Journal of Production Economics, Elsevier, vol. 231(C).
    2. José Carlos Ferrão & Mónica Duarte Oliveira & Daniel Gartner & Filipe Janela & Henrique M. G. Martins, 2021. "Leveraging electronic health record data to inform hospital resource management," Health Care Management Science, Springer, vol. 24(4), pages 716-741, December.
    3. Seung-Yup Lee & Ratna Babu Chinnam & Evrim Dalkiran & Seth Krupp & Michael Nauss, 2020. "Prediction of emergency department patient disposition decision for proactive resource allocation for admission," Health Care Management Science, Springer, vol. 23(3), pages 339-359, September.
    4. Yin-Chi Chan & Eric W. M. Wong & Gavin Joynt & Paul Lai & Moshe Zukerman, 2018. "Overflow models for the admission of intensive care patients," Health Care Management Science, Springer, vol. 21(4), pages 554-572, December.

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