EconPapers    
Economics at your fingertips  
 

Inpatient boarding in emergency departments: Impact on patient delays and system capacity

Raïsa Carmen, Inneke Van Nieuwenhuyse and Benny Van Houdt

European Journal of Operational Research, 2018, vol. 271, issue 3, 953-967

Abstract: This study seeks insights into the impact of inpatient boarding on emergency department (ED) congestion and capacity. To do so, we model the ED as a semi-open queueing network (SOQN) with limited resources (physicians and beds) and discontinuous patient service. We present a Markov-modulated fluid queue approach to efficiently calculate service levels, and show that boarding may cause the (expensive) physician resources to be starved, especially when the bed utilization is high. While the expected number of boarding patients has a primary impact on performance, we show that there is a secondary impact stemming from the expected boarding time and the boarding probability. Boarding reduction policies perform better if they focus on reducing expected boarding time instead of the decreasing probability of boarding. Our analysis and insights are applicable also to other SOQN settings where entities require more than one resource simultaneously (e.g., intensive care units, manufacturing systems, warehousing and transportation systems).

Keywords: OR in health services; Markov-modulated fluid queue; Emergency department; Inpatient boarding (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations Track citations by RSS feed

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0377221718305411
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:ejores:v:271:y:2018:i:3:p:953-967

Access Statistics for this article

European Journal of Operational Research is currently edited by Roman Slowinski, Jesus Artalejo, Jean-Charles. Billaut, Robert Dyson and Lorenzo Peccati

More articles in European Journal of Operational Research from Elsevier
Bibliographic data for series maintained by Dana Niculescu ().

 
Page updated 2018-11-10
Handle: RePEc:eee:ejores:v:271:y:2018:i:3:p:953-967