Redondo Eduardo, Nicoletta Vittorio, Bélanger Valérie, Garcia-Sabater José P, Landa Paolo, Maheut Julien, Marin-Garcia Juan A, Ruiz Angel
Faculty of Business Administration, Université Laval, Quebec (Quebec), G1K 7P4, Canada.
Interuniversity Research Center on Enterprise Networks, Logistics and Transportation (CIRRELT), Canada.
Healthc Anal (N Y). 2023 Nov;3:100197. doi: 10.1016/j.health.2023.100197. Epub 2023 May 26.
COVID-19 pandemic has sent millions of people to hospitals worldwide, exhausting on many occasions the capacity of healthcare systems to provide care patients required to survive. Although several epidemiological research works have contributed a variety of models and approaches to anticipate the pandemic spread, very few have tried to translate the output of these models into hospital service requirements, particularly in terms of bed occupancy, a key question for hospital managers. This paper proposes a tool for predicting the current and future occupancy associated with COVID-19 patients of a hospital to help managers make informed decisions to maximize the availability of hospitalization and intensive care unit (ICU) beds and ensure adequate access to services for confirmed COVID-19 patients. The proposed tool uses a discrete event simulation approach that uses archetypes (i.e., empirical models of trajectories) extracted from empirical analysis of actual patient trajectories. Archetypes can be fitted to trajectories observed in different regions or to the particularities of current and forthcoming variants using a rather small amount of data. Numerical experiments on realistic instances demonstrate the accuracy of the tool's predictions and illustrate how it can support managers in their daily decisions concerning the system's capacity and ensure patients the access the resources they require.
新冠疫情已致使全球数百万人入院治疗,许多时候医疗系统已无力为患者提供维持生命所需的护理。尽管多项流行病学研究工作提出了各种模型和方法来预测疫情传播,但很少有人尝试将这些模型的结果转化为医院服务需求,尤其是床位占用方面,这是医院管理者面临的一个关键问题。本文提出了一种工具,用于预测医院新冠患者当前和未来的床位占用情况,以帮助管理者做出明智决策,最大限度地提高住院床位和重症监护病房(ICU)床位的可用性,并确保确诊新冠患者能够充分获得服务。所提出的工具采用离散事件模拟方法,该方法使用从实际患者轨迹的实证分析中提取的原型(即轨迹的实证模型)。使用相当少量的数据,原型就可以拟合在不同地区观察到的轨迹或当前及即将出现的病毒变种的特点。在实际案例上的数值实验证明了该工具预测的准确性,并说明了它如何在系统容量的日常决策中支持管理者,并确保患者能够获得所需资源。