An objective method for bed capacity planning in a hospital department - a comparison with target ratio methods.
OBJECTIVE
To propose an objective approach in order to determine the number of beds required for a hospital department by considering how recruitment fluctuates over time. To compare this approach with classical bed capacity planning techniques.


METHODS
A simulated data-based evaluation of the impact that the variability in hospital department activity produces upon the performance of methods used for determining the number of beds required. The evaluation criteria included productive efficiency measured by the bed occupancy rate, accessibility measured by the transfer rate of patients due to lack of available beds and a proxy of clinical effectiveness, by the proportion of days during which there is no possibility for unscheduled admission.


RESULTS
When the variability of the number of daily patients increases, the Target Occupancy Rate favors productive efficiency at the expense of accessibility and proxy clinical effectiveness. On the contrary, when the variability of the department activity is marginal, the Target Activity Rate penalizes the proxy of clinical effectiveness, and the Target Occupancy Rate underoptimizes productive efficiency. The method we propose led to a superior performance in terms of accessibility and proxy of clinical effectiveness at the expense of productive efficiency. Such a situation is suitable for intensive care units. In the case of other departments, a weighting procedure should be used to improve productive efficiency.


CONCLUSIONS
This approach could be considered as the first step of a family of methods for quantitative healthcare planning.
Nguyen
J M
JM
PIMESP, CHU Nantes, rue Saint Jacques, 44093 Nantes Cedex 1, France. jmnguyen@chu-nantes.fr
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D000465:Algorithms; D017598:Efficiency, Organizational; D006739:Hospital Administration; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D010343:Patient Admission; D014481:United States