An iterative estimation and validation procedure for specification of semi-Markov models with application to hospital patient flow.
This article presents a methodology to identify and specify a continuous time semi-Markov model of population flow within a network of service facilities. An iterative procedure of state space definition, population disaggregation, and parameter estimation leads to the specification of a model which satisfies the underlying semi-Markov assumptions. We also present a test of the impact of occupancy upon realizations of population flows. The procedure is applied to data describing the movement of obstetric patients in a large university teaching hospital. We use the model to predict length-of-stay distributions. Finally, we compare these results with those that would have been obtained without the procedure, and show the modified model to be superior.
D000704:Analysis of Variance; D001509:Bed Occupancy; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D007902:Length of Stay; D008390:Markov Chains; D008962:Models, Theoretical; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D011383:Progressive Patient Care