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Combining optimization with simulation to obtain credible models for intensive care units

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  • Fermín Mallor
  • Cristina Azcárate

Abstract

In this paper we develop a simulation model to study bed occupancy levels in an Intensive Care Unit (ICU). The main contributions of this study are: (1) A proposal for generalized regression models to fully capture the high variability of patients’ length of stay; (2) Proof that a simulation model that does not incorporate the management decisions by clinical staff cannot be considered valid; (3) The development of a mathematical model to represent these management decisions, and (4) A proposal for a method combining optimization with simulation to estimate the model parameters. This provides a valid simulation model that includes the physician management of an ICU. Validation is accomplished by comparing distribution patterns in daily bed occupancy records against simulated bed occupancy data. The methodology is tested using data provided by the Hospital of Navarre in Spain. Copyright Springer Science+Business Media, LLC 2014

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  • Fermín Mallor & Cristina Azcárate, 2014. "Combining optimization with simulation to obtain credible models for intensive care units," Annals of Operations Research, Springer, vol. 221(1), pages 255-271, October.
    • Handle: RePEc:spr:annopr:v:221:y:2014:i:1:p:255-271:10.1007/s10479-011-1035-8
    DOI: 10.1007/s10479-011-1035-8
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    Cited by:

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    2. Josephine Varney & Nigel Bean & Mark Mackay, 2019. "The self-regulating nature of occupancy in ICUs: stochastic homoeostasis," Health Care Management Science, Springer, vol. 22(4), pages 615-634, December.
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    5. Fermín Mallor & Cristina Azcárate & Julio Barado, 2015. "Optimal control of ICU patient discharge: from theory to implementation," Health Care Management Science, Springer, vol. 18(3), pages 234-250, September.
    6. Fermín Mallor & Cristina Azcárate & Julio Barado, 2016. "Control problems and management policies in health systems: application to intensive care units," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 62-89, June.
    7. Masoumeh Vali & Khodakaram Salimifard & Amir H. Gandomi & Thierry J. Chaussalet, 2022. "Care process optimization in a cardiovascular hospital: an integration of simulation–optimization and data mining," Annals of Operations Research, Springer, vol. 318(1), pages 685-712, November.
    8. Azcarate, Cristina & Esparza, Laida & Mallor, Fermin, 2020. "The problem of the last bed: Contextualization and a new simulation framework for analyzing physician decisions," Omega, Elsevier, vol. 96(C).

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