Admission Control Policies for Surgery Patients

In China, day surgery has been promoted because its operation time and post-operative hospital stay are shorter than those of elective surgery. Day surgery can speed up the turnover of beds and operation rooms. Usually, the conditions of elective surgery patients are more complicated than those of day surgery patients. The development of the discipline, which means that the hospital has improved the skills of the doctors and the ability of doctors to cope with serious diseases and has increased the overall medical level of the hospital, requires surgeons to operate in some complicated elective surgeries. In the case of operating rooms and beds in short supply, there is a trade-off between the promotion of day surgery and the development of the discipline. Day surgery is relatively uncomplicated, but it requires more highly qualified surgeons. However, the development of the discipline requires surgeons to take on some complicated elective surgeris. Moreover, according to the notion of grading treatment, class-A tertiary hospitals are more suitable for patients with relatively complicated and serious conditions. In the emerging context of day surgery, highly qualified surgeons need to perform both day surgeries and elective surgeries. This paper studied how to control the admission of surgery patients. We take into account both day surgery promotion and discipline development in decision-making. A dynamic programming model was built for admission control, and a γ-adjust-threshold heuristic policy was proposed. We then compared the heuristic policy to three other policies through simulation. The results show that our heuristic policy outperforms the hospital's target policy.