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A Data-Driven Hybrid Three-Stage Framework for Hospital Bed Allocation: A Case Study in a Large Tertiary Hospital in China

机译:基于数据驱动的混合三阶段病床分配框架:以中国一家大型三级医院为例

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摘要

Beds are key, scarce medical resources in hospitals. The bed occupancy rate (BOR) amongst different departments within large tertiary hospitals is very imbalanced, a situation which has led to problems between the supply of and the demand for bed resources. This study aims to balance the utilization of existing beds in a large tertiary hospital in China. We developed a data-driven hybrid three-stage framework incorporating data analysis, simulation, and mixed integer programming to minimize the gaps in BOR among different departments. The first stage is to calculate the length of stay (LOS) and BOR of each department and identify the departments that need to be allocated beds. In the second stage, we used a fitted arrival distribution and median LOS as the input to a generic simulation model. In the third stage, we built a mixed integer programming model using the results obtained in the first two stages to generate the optimal bed allocation strategy for different departments. The value of the objective function, Z, represents the severity of the imbalance in BOR. Our case study demonstrated the effectiveness of the proposed data-driven hybrid three-stage framework. The results show that Z decreases from 0.7344 to 0.0409 after re-allocation, which means that the internal imbalance has eased. Our framework provides hospital bed policy makers with a feasible solution for bed allocation.
机译:床是医院中关键的稀缺医疗资源。大型三级医院内不同部门之间的床位占用率非常不平衡,这种情况导致床位资源的供求之间存在问题。这项研究旨在平衡中国一家大型三级医院现有病床的利用率。我们开发了一个数据驱动的混合三阶段框架,该框架结合了数据分析,模拟和混合整数编程,以最大程度地减少不同部门之间的BOR差距。第一阶段是计算每个部门的住院时间(BOR)和BOR,并确定需要分配床位的部门。在第二阶段,我们使用拟合的到达分布和中位数LOS作为通用仿真模型的输入。在第三阶段,我们使用前两个阶段获得的结果构建了一个混合整数规划模型,以生成针对不同部门的最优床位分配策略。目标函数Z的值表示BOR失衡的严重程度。我们的案例研究证明了所提出的数据驱动型混合三阶段框架的有效性。结果表明,重新分配后Z从0.7344降低到0.0409,这意味着内部失衡得到缓解。我们的框架为医院病床决策者提供了可行的病床分配解决方案。

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