Stranded on emergency isle: Modeling competition for cardiac services using survival analysis

S. Levin, J. Han, D. Aronsky, C. Zhou, N. Hoot, L. Kelly, D. France

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Patients with cardiovascular disease (CVD) consume a large proportion of inpatient, procedural and emergency services within United States health care system. These patients are major contributors to the steadily increasing demand for health care services nationwide. Unfortunately, economic and legislative factors have resulted in concurrent reductions in hospital system capacity. The resulting imbalance has fallen directly on to the shoulders of emergency departments (ED) in the form of boarding. Boarding refers to the act of holding admitted patients in the ED until an inpatient bed becomes available. Boarding is a barrier to efficient throughput, a major contributor to ED overcrowding and a threat to patient safety. Patients with CVD often use the ED as an entry point to the hospital system. These patients frequently experience long boarding times as a result of hospital wide competition for inpatient resources. The objective of this study is to use survival analysis to determine how demand from competing cardiology admission sources affects access to ED patients requiring inpatient cardiac care. The model reflects bed management policies of the division of cardiology and demonstrates how variability in demand for cardiac services (i.e., surgical, catheterization, telemetry, intensive care) affects ED boarding time for cardiac patients.

Original languageEnglish (US)
Title of host publicationIEEM 2007
Subtitle of host publication2007 IEEE International Conference on Industrial Engineering and Engineering Management
Pages1772-1776
Number of pages5
DOIs
StatePublished - 2007
Externally publishedYes
Event2007 IEEE International Conference on Industrial Engineering and Engineering Management, IEEM 2007 - , Singapore
Duration: Dec 2 2007Dec 4 2007

Publication series

NameIEEM 2007: 2007 IEEE International Conference on Industrial Engineering and Engineering Management

Other

Other2007 IEEE International Conference on Industrial Engineering and Engineering Management, IEEM 2007
Country/TerritorySingapore
Period12/2/0712/4/07

Keywords

  • Cardiology
  • Cox hazard regression
  • Emergency department
  • Health care
  • Survival

ASJC Scopus subject areas

  • Strategy and Management
  • Industrial and Manufacturing Engineering

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