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The impact of specialization of hospitals on patient access to care; a queuing analysis with an application to a neurological hospital

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  • Saied Samiedaluie

    (University of Alberta)

  • Vedat Verter

    (McGill University)

Abstract

We study the impact of specialization on the operational efficiency of a multi-hospital system. The mixed outcomes of recently increasing hospital mergers and system re-configuration initiatives have raised the importance of studying such organizational changes from all the relevant perspectives. We consider two configuration scenarios for a multi-hospital system. The first scenario assumes that all the hospitals in the system are general, which implies they can provide care to all types of patients. In the alternative configuration, we specialize each hospital in certain level of care, which means they serve only specific types of patients. By considering an extensive number of possible settings for a multi-hospital system, we characterize the situations in which one scenario outperforms the other in terms of extending access of patients to care. Our results show that whenever the percent of patients with shorter length of stay in the system increases, specialization of healthcare services can maximize the accessibility of care. Also, if the patient load is balanced between all hospitals in the system, it seems more likely that all hospitals benefit from specialization. We conclude that the strategic decision of designing a multi-hospital system requires careful consideration of patient mix among arrivals, relative length of stay of patients, and distribution of patient load between hospitals.

Suggested Citation

  • Saied Samiedaluie & Vedat Verter, 2019. "The impact of specialization of hospitals on patient access to care; a queuing analysis with an application to a neurological hospital," Health Care Management Science, Springer, vol. 22(4), pages 709-726, December.
    • Handle: RePEc:kap:hcarem:v:22:y:2019:i:4:d:10.1007_s10729-018-9453-7
    DOI: 10.1007/s10729-018-9453-7
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    1. Avishai Mandelbaum & Martin I. Reiman, 1998. "On Pooling in Queueing Networks," Management Science, INFORMS, vol. 44(7), pages 971-981, July.
    2. Yves Dallery & Yannick Frein, 1993. "On Decomposition Methods for Tandem Queueing Networks with Blocking," Operations Research, INFORMS, vol. 41(2), pages 386-399, April.
    3. Gordon C. Hunt, 1956. "Sequential Arrays of Waiting Lines," Operations Research, INFORMS, vol. 4(6), pages 674-683, December.
    4. van Dijk, Nico & van der Sluis, Erik, 2009. "Pooling is not the answer," European Journal of Operational Research, Elsevier, vol. 197(1), pages 415-421, August.
    5. Benjaafar, Saifallah, 1995. "Performance bounds for the effectiveness of pooling in multi-processing systems," European Journal of Operational Research, Elsevier, vol. 87(2), pages 375-388, December.
    6. E. El‐Darzi & C. Vasilakis & T. Chaussalet & P.H. Millard, 1998. "A simulation modelling approach to evaluating length of stay, occupancy, emptiness and bed blocking in a hospital geriatric department," Health Care Management Science, Springer, vol. 1(2), pages 143-149, October.
    7. Stanley B. Gershwin, 1987. "An Efficient Decomposition Method for the Approximate Evaluation of Tandem Queues with Finite Storage Space and Blocking," Operations Research, INFORMS, vol. 35(2), pages 291-305, April.
    8. Alexandre Brandwajn & Yung-Li Lily Jow, 1988. "An Approximation Method for Tandem Queues with Blocking," Operations Research, INFORMS, vol. 36(1), pages 73-83, February.
    9. H.S. Lee & A. Bouhchouch & Y. Dallery & Y. Frein, 1998. "Performance evaluation of open queueing networks with arbitrary configuration and finite buffers," Annals of Operations Research, Springer, vol. 79(0), pages 181-206, January.
    10. Vikram Tiwari & H. Heese, 2009. "Specialization and competition in healthcare delivery networks," Health Care Management Science, Springer, vol. 12(3), pages 306-324, September.
    11. Frederick S. Hillier & Ronald W. Boling, 1967. "Finite Queues in Series with Exponential or Erlang Service Times—A Numerical Approach," Operations Research, INFORMS, vol. 15(2), pages 286-303, April.
    12. Elliott N. Weiss & John O. McClain, 1987. "Administrative Days in Acute Care Facilities: A Queueing-Analytic Approach," Operations Research, INFORMS, vol. 35(1), pages 35-44, February.
    13. Yutaka Takahashi & Hideo Miyahara & Toshiharu Hasegawa, 1980. "An Approximation Method for Open Restricted Queueing Networks," Operations Research, INFORMS, vol. 28(3-part-i), pages 594-602, June.
    14. I.N. Kamal Abadi & Nicholas G. Hall & Chelliah Sriskandarajah, 2000. "Minimizing Cycle Time in a Blocking Flowshop," Operations Research, INFORMS, vol. 48(1), pages 177-180, February.
    15. Elliott N. Weiss & Morris A. Cohen & John C. Hershey, 1982. "An Iterative Estimation and Validation Procedure for Specification of Semi-Markov Models with Application to Hospital Patient Flow," Operations Research, INFORMS, vol. 30(6), pages 1082-1104, December.
    16. Hyo-Seong Lee & Stephen M. Pollock, 1990. "Approximation Analysis of Open Acyclic Exponential Queueing Networks with Blocking," Operations Research, INFORMS, vol. 38(6), pages 1123-1134, December.
    17. John C. Hershey & Elliott N. Weiss & Morris A. Cohen, 1981. "A Stochastic Service Network Model with Application to Hospital Facilities," Operations Research, INFORMS, vol. 29(1), pages 1-22, February.
    18. Paul Joustra & Erik Sluis & Nico Dijk, 2010. "To pool or not to pool in hospitals: a theoretical and practical comparison for a radiotherapy outpatient department," Annals of Operations Research, Springer, vol. 178(1), pages 77-89, July.
    19. Bar{i}c{s} Ata & Jan A. Van Mieghem, 2009. "The Value of Partial Resource Pooling: Should a Service Network Be Integrated or Product-Focused?," Management Science, INFORMS, vol. 55(1), pages 115-131, January.
    20. Thomas J. Best & Burhaneddin Sandıkçı & Donald D. Eisenstein & David O. Meltzer, 2015. "Managing Hospital Inpatient Bed Capacity Through Partitioning Care into Focused Wings," Manufacturing & Service Operations Management, INFORMS, vol. 17(2), pages 157-176, May.
    21. Mahar, Stephen & Bretthauer, Kurt M. & Salzarulo, Peter A., 2011. "Locating specialized service capacity in a multi-hospital network," European Journal of Operational Research, Elsevier, vol. 212(3), pages 596-605, August.
    22. John A. Buzacott, 1996. "Commonalities in Reengineered Business Processes: Models and Issues," Management Science, INFORMS, vol. 42(5), pages 768-782, May.
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