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Queueing theoretic analysis of labor and delivery

Author

Listed:
  • Matthew Gombolay

    (Georgia Institute of Technology)

  • Toni Golen

    (Beth Israel Deaconess Medical Center)

  • Neel Shah

    (Beth Israel Deaconess Medical Center)

  • Julie Shah

    (Massachusetts Institute of Technology)

Abstract

Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts. First, we observe that the M/G/∞ model effectively predicts patient flow in an obstetrics department. This model captures the dynamics of labor and delivery where patients arrive randomly during the day, the duration of their stay is based on their individual acuity, and their labor progresses at some rate irrespective of whether they are given a bed. Second, using our queueing theoretic model, we show that reducing the rate of cesarean section – a current quality improvement goal in American obstetrics – may have important consequences with regard to the resource needs of a hospital. We also estimate the potential financial impact of these resource needs from the hospital perspective. Third, we report that application of our model to an analysis of potential patient coverage strategies supports the adoption of team-based care, in which attending physicians share responsibilities for patients.

Suggested Citation

  • Matthew Gombolay & Toni Golen & Neel Shah & Julie Shah, 2019. "Queueing theoretic analysis of labor and delivery," Health Care Management Science, Springer, vol. 22(1), pages 16-33, March.
    • Handle: RePEc:kap:hcarem:v:22:y:2019:i:1:d:10.1007_s10729-017-9418-2
    DOI: 10.1007/s10729-017-9418-2
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    References listed on IDEAS

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    1. Richard C. Larson, 1975. "Approximating the Performance of Urban Emergency Service Systems," Operations Research, INFORMS, vol. 23(5), pages 845-868, October.
    2. Randolph Hall & David Belson & Pavan Murali & Maged Dessouky, 2006. "Modeling Patient Flows Through the Healthcare System," International Series in Operations Research & Management Science, in: Randolph W. Hall (ed.), Patient Flow: Reducing Delay in Healthcare Delivery, chapter 0, pages 1-44, Springer.
    3. Ben-Tal, Aharon & Chung, Byung Do & Mandala, Supreet Reddy & Yao, Tao, 2011. "Robust optimization for emergency logistics planning: Risk mitigation in humanitarian relief supply chains," Transportation Research Part B: Methodological, Elsevier, vol. 45(8), pages 1177-1189, September.
    4. Taffel, S.M. & Placek, P.J. & Liss, T., 1987. "Trends in the United States cesarean section rate and reasons for the 1980-85 rise," American Journal of Public Health, American Public Health Association, vol. 77(8), pages 955-959.
    5. Galit B. Yom-Tov & Avishai Mandelbaum, 2014. "Erlang-R: A Time-Varying Queue with Reentrant Customers, in Support of Healthcare Staffing," Manufacturing & Service Operations Management, INFORMS, vol. 16(2), pages 283-299, May.
    6. Shlomo Halfin & Ward Whitt, 1981. "Heavy-Traffic Limits for Queues with Many Exponential Servers," Operations Research, INFORMS, vol. 29(3), pages 567-588, June.
    7. Yigal Gerchak & Diwakar Gupta & Mordechai Henig, 1996. "Reservation Planning for Elective Surgery Under Uncertain Demand for Emergency Surgery," Management Science, INFORMS, vol. 42(3), pages 321-334, March.
    8. Cameron, A Colin & Windmeijer, Frank A G, 1996. "R-Squared Measures for Count Data Regression Models with Applications to Health-Care Utilization," Journal of Business & Economic Statistics, American Statistical Association, vol. 14(2), pages 209-220, April.
    9. Colin Cameron, A. & Windmeijer, Frank A. G., 1997. "An R-squared measure of goodness of fit for some common nonlinear regression models," Journal of Econometrics, Elsevier, vol. 77(2), pages 329-342, April.
    10. Arnoud Bruin & A. Rossum & M. Visser & G. Koole, 2007. "Modeling the emergency cardiac in-patient flow: an application of queuing theory," Health Care Management Science, Springer, vol. 10(2), pages 125-137, June.
    11. Sem Borst & Avi Mandelbaum & Martin I. Reiman, 2004. "Dimensioning Large Call Centers," Operations Research, INFORMS, vol. 52(1), pages 17-34, February.
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    1. Melissa E. Cyr & Daryl Boucher & Ashley A. Holmes & James C. Benneyan, 2021. "Modelling policy interventions to improve patient access to rural dermatology care," Operations Management Research, Springer, vol. 14(3), pages 359-377, December.

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