Optimization of hospital ward resources with patient relocation using Markov chain modeling

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Abstract

Overcrowding of hospital wards is a well-known and often revisited problem in the literature, yet it appears in many different variations. In this study, we present a mathematical model to solve the problem of ensuring sufficient beds to hospital wards by re-distributing beds that are already available to the hospital. Patient flow is modeled using a homogeneous continuous-time Markov chain and optimization is conducted using a local search heuristic. Our model accounts for patient relocation, which has not been done analytically in literature with similar scope. The study objective is to ensure that patient occupancy is reflected by our Markov chain model, and that a local optimum can be derived within a reasonable runtime.Using a Danish hospital as our case study, the Markov chain model is statistically found to reflect occupancy of hospital beds by patients as a function of how hospital beds are distributed. Furthermore, our heuristic is found to efficiently derive the optimal solution. Applying our model to the hospital case, we found that relocation of daily arrivals can be reduced by 11.7% by re-distributing beds that are already available to the hospital.
Original languageEnglish
JournalEuropean Journal of Operational Research
Volume260
Issue number1
Pages (from-to)1152-1163
ISSN0377-2217
DOIs
Publication statusPublished - 2017

Keywords

  • Stochastic optimizations
  • OR in health services
  • Heuristics
  • Markov chain
  • Queueing

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