健康与医学信息学杂志

Strategies for Inpatient Bed Management

Abstract

Eva K. Lee, Zixing Wang, Andriy Shapoval

We consider the problem of partitioning clinical services in hospitals into groups with the goal of efficiently allocating existing inpatient beds. At the strategic level, there are two major possibilities: pooling versus focusing. Pooling the bed capacity allows one to achieve an overall high occupancy level for a fixed number of beds. On the other hand, focusing by dividing the capacity into groups with restricted access may offer increased efficiency and better resource utilization. We first derive a 2-stage approach to address the 3-fold problem: 1) how many groups of services to form; 2) how many beds to allocate to each group; and 3) how to partition services among the groups. Specifically, Stage 1 uses cluster analysis utilizing the similarity principle for possible advantages of economies of scale. Stage 2 then incorporates utility/ benefit functions to optimize the partitions and allocation of beds. To contrast the results, we combine the two stages into a single mixed integer nonlinear program. Three full-scale examples demonstrate the flexibility and diverse application of our framework with managerial insights for different utility optimization goals and queuing systems. The resulting modeling framework is not computationally sensitive to the number of beds, making it more practical for usage by any hospitals.