A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times
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- 作者：Shanshan Qiu (1)
Ratna Babu Chinnam (1)
Alper Murat (1)
Bassam Batarse (2)
Hakimuddin Neemuchwala (3)
Will Jordan (3)
1. Industrial & Systems Engineering Department ; Wayne State University ; Detroit ; MI ; 48202 ; USA
2. John D. Dingell VA Medical Center ; Detroit ; MI ; USA
3. VA-CASE ; Detroit ; MI ; USA - 关键词：Bed reservation ; Triage ; Admission prediction ; Length of stay ; Patient boarding
- 刊名：Health Care Management Science
- 出版年：2015
- 出版时间：March 2015
- 年：2015
- 卷：18
- 期：1
- 页码：67-85
- 全文大小：989 KB
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- 刊物主题：Economics
Operation Research and Decision Theory
Health Administration
Health Informatics and Administration
Management
Econometrics
Business - 出版者：Springer Netherlands
- ISSN：1572-9389
文摘
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.