Modeling the emergency cardiac in-patient flow: an application of queuing theory

• Published in: Health care management science Vol. 10; no. 2; pp. 125 - 137
• Main Authors: de Bruin, Arnoud M, van Rossum, A C, Visser, M C, Koole, G M
• Format: Journal Article
• Language: English
• Published: Netherlands Springer 01-06-2007; Springer Nature B.V
• Series: Health Care Management Science
• Subjects: Admissions policies; Bed Occupancy - statistics & numerical data; Bed Occupancy - utilization; Bottlenecks; Capacity management; Cardiovascular disease; Coronary Care Units - supply & distribution; Data analysis; Emergency medical care; Emergency patient flow; Emergency Service, Hospital - organization & administration; Health facilities; Heart; Heart Diseases; Hospitals; Humans; Intensive care; Length of Stay; Occupancy rate; Patient admissions; Patients; Queuing theory; Studies; Systems Theory; Time Factors
• ISSN: 1386-9620; 1572-9389
• DOI: 10.1007/s10729-007-9009-8

This study investigates the bottlenecks in the emergency care chain of cardiac in-patient flow. The primary goal is to determine the optimal bed allocation over the care chain given a maximum number of refused admissions. Another objective is to provide deeper insight in the relation between natural variation in arrivals and length of stay and occupancy rates. The strong focus on raising occupancy rates of hospital management is unrealistic and counterproductive. Economies of scale cannot be neglected. An important result is that refused admissions at the First Cardiac Aid (FCA) are primarily caused by unavailability of beds downstream the care chain. Both variability in LOS and fluctuations in arrivals result in large workload variations. Techniques from operations research were successfully used to describe the complexity and dynamics of emergency in-patient flow.