case mix and acute care system design
Acute care departments frequently report queuing of arriving patients due to department overcrowding. The cause for this overcrowding is often sought in insufficient capacity levels. However, the omnipresent variability in acute demand and service times may also play an active role. Especially, not managing this variability well in terms of capacity allocation may affect the overcrowding more than the matter of capacity volume. For example, allocating available beds such that a bed is not available for a new patient of specialty x while specialty y has overcapacity. Previous research has proved that pooling capacity into a large(r) department can decrease the likelihood of patients waiting by increasing the availability of capacity. This paper describes a comparison of two cases that wanted to pool their acute care beds into an acute care department. A case mix analysis and simulation experiments were carried out, focused on the relations between acute patient flows, case mix and the size of a bed pool. The results of the comparative case study endorse to the assumption that pooling acute beds benefits acute care delivery systems with room for substantial process improvement.
case mix acute care system design variability computer simulation