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Article: Allocation of Intensive Care Unit Beds in Periods of High Demand
Title | Allocation of Intensive Care Unit Beds in Periods of High Demand |
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Authors | |
Keywords | Health care operations Dynamic control Markov decision processes |
Issue Date | 2020 |
Publisher | INFORMS. The Journal's web site is located at http://or.pubs.informs.org |
Citation | Operations Research, 2020, v. 68 n. 2, p. 591-608 How to Cite? |
Abstract | The objective of this paper is to use mathematical modeling and analysis to develop insights into and policies for making bed allocation decisions in an Intensive Care Unit (ICU) of a hospital during periods when the patient demand is high. We first develop a stylized mathematical model in which patients' health conditions change over time according to a Markov chain. In this model, each patient is in one of two possible health stages, one representing the critical and the other representing the highly critical health stage. The ICU has limited bed availability and therefore when a patient arrives and no beds are available, a decision needs to be made as to whether the patient should be admitted to the ICU and if so which patient in the ICU should be transferred to the general ward. With the objective of minimizing the long-run average mortality rate, we provide analytical characterizations of the optimal policy under certain conditions. Then, based on these analytical results, we propose heuristic methods, which can be used under assumptions that are more general than what is assumed for the mathematical model. Finally, we demonstrate that the proposed heuristic methods work well by a simulation study, which relaxes some of the restrictive assumptions of the mathematical model by considering a more complex transition structure for patient health and allowing for patients to be possibly queued for admission to the ICU and readmitted from the general ward after they are discharged. |
Persistent Identifier | http://hdl.handle.net/10722/276159 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 2.848 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Ouyang, H | - |
dc.contributor.author | Argon, NT | - |
dc.contributor.author | Ziya, S | - |
dc.date.accessioned | 2019-09-10T02:57:09Z | - |
dc.date.available | 2019-09-10T02:57:09Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Operations Research, 2020, v. 68 n. 2, p. 591-608 | - |
dc.identifier.issn | 0030-364X | - |
dc.identifier.uri | http://hdl.handle.net/10722/276159 | - |
dc.description.abstract | The objective of this paper is to use mathematical modeling and analysis to develop insights into and policies for making bed allocation decisions in an Intensive Care Unit (ICU) of a hospital during periods when the patient demand is high. We first develop a stylized mathematical model in which patients' health conditions change over time according to a Markov chain. In this model, each patient is in one of two possible health stages, one representing the critical and the other representing the highly critical health stage. The ICU has limited bed availability and therefore when a patient arrives and no beds are available, a decision needs to be made as to whether the patient should be admitted to the ICU and if so which patient in the ICU should be transferred to the general ward. With the objective of minimizing the long-run average mortality rate, we provide analytical characterizations of the optimal policy under certain conditions. Then, based on these analytical results, we propose heuristic methods, which can be used under assumptions that are more general than what is assumed for the mathematical model. Finally, we demonstrate that the proposed heuristic methods work well by a simulation study, which relaxes some of the restrictive assumptions of the mathematical model by considering a more complex transition structure for patient health and allowing for patients to be possibly queued for admission to the ICU and readmitted from the general ward after they are discharged. | - |
dc.language | eng | - |
dc.publisher | INFORMS. The Journal's web site is located at http://or.pubs.informs.org | - |
dc.relation.ispartof | Operations Research | - |
dc.subject | Health care operations | - |
dc.subject | Dynamic control | - |
dc.subject | Markov decision processes | - |
dc.title | Allocation of Intensive Care Unit Beds in Periods of High Demand | - |
dc.type | Article | - |
dc.identifier.email | Ouyang, H: oyhy@hku.hk | - |
dc.identifier.authority | Ouyang, H=rp02271 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1287/opre.2019.1876 | - |
dc.identifier.scopus | eid_2-s2.0-85088044300 | - |
dc.identifier.hkuros | 304369 | - |
dc.identifier.volume | 68 | - |
dc.identifier.isi | WOS:000521730200016 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0030-364X | - |