A systems model for burn care

The problem of projecting the number of tertiary service beds needed by a population is materially different for rare events than for medical events of more common occurrence. Demand for inpatient burn treatment services has been carefully measured in 57 countries in New York State. A survey provided data describing the rate of ocurrence, severity, and average length of stay for 5,791 hospitalized burn patients. Existing planning formulae which were designed for events of common occurrence were found to project conditions of overflow and underutilization incompletely when applied to regional burn units. Objective planning models designed specifically for intensive burn care were therefore developed. These models show that there is no number of intensive care burn beds which will provide both reasonably high occupancy and reasonable assurance of meeting the normally erratic demand of a small system. Conditions of overload and underutilization are inevitable and therefore planning efforts should be directed at minimizing these impacts. If all of the regional burn treatment facilities are regarded as components of a well-integrated statewide system, a much more effective efficient and economic service will result.