Admission Control Policies for Surgery Patients

Area of Science:

• Health Services Research
• Operations Research
• Hospital Management

Background:

• Day surgery offers shorter stays and faster turnover but may conflict with developing surgical expertise in complex cases.
• Hospitals face a trade-off between increasing day surgery volume and enabling surgeons to perform complex elective surgeries for discipline advancement.
• Resource constraints (operating rooms, beds) necessitate strategic patient admission control.

Purpose of the Study:

• To develop a model for controlling surgical patient admissions.
• To balance the competing goals of promoting day surgery and fostering surgical discipline development.
• To propose and evaluate a novel admission control policy.

Main Methods:

• A dynamic programming model was formulated for patient admission control.
• A gamma-adjust-threshold heuristic policy was developed and proposed.
• The heuristic policy was compared against three other policies via simulation.

Main Results:

• The proposed heuristic policy demonstrated superior performance compared to the hospital's target policy.
• The study provides insights into optimizing patient flow in surgical settings.
• The model effectively integrates day surgery promotion with surgical discipline growth.

Conclusions:

• The heuristic policy offers an effective strategy for managing surgical patient admissions.
• Balancing day surgery and complex elective surgeries is crucial for hospital efficiency and medical advancement.
• Dynamic programming provides a robust framework for addressing complex healthcare operational challenges.