An automated model for forecasting non-elective hospital bed demand in the entire English National Health System: retrospective process assessment study (Preprint)

2020 ◽  
Author(s):  
Kanan Shah ◽  
Akarsh Sharma ◽  
Chris Moulton ◽  
Simon Swift ◽  
Clifford Mann ◽  
...  
Keyword(s):  
National Health ◽  
Mean Squared Error ◽  
Winter Season ◽  
National Health System ◽  
Forecast Accuracy ◽  
Occupancy Models ◽  
Bed Occupancy ◽  
Median Error ◽  
Hospital Bed ◽  
Forecasting Techniques

BACKGROUND From 2006/2007 to 2017/2018, there was a 26% increase in emergency department (ED) attendances and 32% increase in total admissions in the National Health Service in England (NHS). Growing demand puts severe strain on hospitals, resulting in bed, nursing, clinical and equipment shortages. Nevertheless, scheduling issues can still result in significant under-utilization of beds. It is imperative to optimize the allocation of existing healthcare resources, including hospital beds. More accurate and reliable long-term hospital bed occupancy rate prediction would help managers plan ahead for their population’s hospital requirements, ultimately resulting in greater efficiencies and better patient care. OBJECTIVE This study aimed to compare widely used automated time series forecasting techniques to predict short-term daily non-elective bed occupancy at all trusts in the NHS. METHODS Bed occupancy models that accounted for patterns in occupancy were created for each trust in the NHS. Daily non-elective midnight trust occupancy data from April 2011 to March 2017 for 121 NHS trusts were utilized to generate these models. Forecasts were generated using the three most widely used automated forecasting techniques: Exponential Smoothing (ES); Seasonal Autoregressive Integrated Moving Average (SARIMA); Trigonometric, Box-Cox transform, ARMA errors, Trend and Seasonal components (TBATS). The NHS Modernization Agency’s recommended forecasting method prior to 2020, was also replicated. A comparative analysis of forecast accuracy was conducted by comparing forecasted daily non-elective occupancy with actual non-elective occupancy in the out-of-sample dataset for each week forecasted. Percentage root mean squared error (RMSE) was reported. RESULTS The accuracy of the models varied based on the season during which occupancy was forecasted. For the summer season, percent RMSE values for each model remained relatively stable across six forecasted weeks. However, only the TBATS model (median error 2.45% for six weeks) outperformed the NHS Modernization Agency’s recommended method (median error 2.63% for six weeks). In contrast, during the winter season, percent RMSE values increased as we forecasted further into the future. ES generated the most accurate forecasts (median error 4.91% over four weeks), but all models outperformed the NHS Modernization Agency’s recommended method prior to 2020 (median 8.5% error over four weeks). CONCLUSIONS It is possible to create automated models, similar to those recently published by the NHS, that can be used at a hospital level for a large, national healthcare system in order to predict non-elective bed admissions and thus schedule elective procedures. CLINICALTRIAL N/A

Novel indicator for the assessment of hospital bed occupancy

2011 ◽  
Vol 152 (20) ◽  
pp. 797-801 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Patient Needs ◽  
Bed Occupancy ◽  
The Past ◽  
Hospital Beds ◽  
Hospital Bed ◽  
Bed Capacity ◽  
Statistical Indicators

In the past decades the bed occupancy of hospitals in Hungary has been calculated from the average of in-patient days and the number of beds during a given period of time. This is the only measure being currently looked at when evaluating the performance of hospitals and changing their bed capacity. The author outlines how limited is the use of this indicator and what other statistical indicators may characterize the occupancy of hospital beds. Since adjustment of capacity to patient needs becomes increasingly important, it is essential to find indicator(s) that can be easily applied in practice and can assist medical personal and funders who do not work with statistics. Author recommends the use of daily bed occupancy as a base for all these statistical indicators. Orv. Hetil., 2011, 152, 797–801.

scholarly journals Cardiovascular diseases burden in Italy, 1990–2017: the Global Burden of Disease Study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Fornari ◽  
P A Cortesi ◽  
F Madotto ◽  
S Conti ◽  
G Crotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
National Health ◽  
Population Aging ◽  
National Health System ◽  
Total Mortality ◽  
Premature Death ◽  
Global Burden ◽  
High Systolic Blood Pressure ◽  
Life Years

Abstract Background Cardiovascular diseases (CVDs) are still the leading cause of mortality, morbidity and disability in Europe. Consequently, an exhaustive estimation of CVDs burden and cardiovascular risk factors impact is crucial for healthcare planning and resource allocation. In Italy, data on CVDs burden are sparse. This study aims to assess the global Italian CVDs burden and to analyze time changes from 1990 to 2017 within the country and in comparison to other European states. Methods We used data from the 2017 Global Burden of Diseases (GBD) study to estimate CVDs prevalence, mortality and disability-adjusted life-years (DALYs) in Italy from 1990 to 2017. We also analyzed burden attributable to CVDs-related risk factors. Finally, Italian estimations were compared to those of the other 28 European Union countries. Results CVDs were still the first cause of death (34.8% of total mortality) in Italy in 2017. A significant decrease in CVDs burden was observed since 1990: age-standardized prevalence (-12.7%), mortality rate (-53.75%), and DALYs rate (-55.54%) all decreased. Similar patterns were observed also in the majority of European countries. Despite these trends, all-ages CVDs prevalent cases increased from 5.75 million to 7.49 million. More than 80% of CVDs burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high LDL cholesterol, and impaired kidney function. Conclusions Data showed a decline in cardiovascular mortality and DALYs, which reflects the success in terms of reducing disability, premature death and early incidence of CVDs. However, the burden of CVDs is still high, as population aging and the increased prevalent cases require more access to care and generate more years lived with disability, which in turn leads to higher costs for the National Health Service and society. More efficient prevention strategies at community and individual level are needed. Key messages Despite decreasing trends in CVDs mortality and DALYs, the burden of CVDs is still high in Italy. A joined approach of the National Health System stakeholders is needed to keep reducing the CVDs burden.

Does the ageing population correctly predict the need for medical beds?: Part one: fundamental principles

2021 ◽  
Vol 27 (8) ◽  
pp. 1-10
Author(s):  
Rodney P Jones
Keyword(s):  
World War Ii ◽  
Capacity Planning ◽  
Baby Boom ◽  
National Average ◽  
Ageing Population ◽  
Bed Occupancy ◽  
World War ◽  
Funding Formula ◽  
Hospital Bed ◽  
The World

The World War II baby boom, coupled with increasing life expectancy, will lead to increasing numbers of deaths for the next 40 years. The last year of life represents a large proportion (55%) of lifetime hospital bed occupancy. This is called the nearness to death effect. However, the nearness to death effect has not been factored into NHS capacity planning, which largely relies on age-based forecasting, often called the ageing population. In certain locations, deaths are predicted to rise far more rapidly than the national average of 1% per annual growth. These locations are highly susceptible to capacity pressures emanating from the nearness to death effect, which is not compatible with recent policies that aim to build smaller hospitals. This article is the first of a two-part series discussing these trends in deaths and bed demand, as well as the likely impact on NHS capacity and the implications for the NHS funding formula.

scholarly journals IMPACT OF HEALTH INFORMATION SYSTEMS ON HOSPITAL BED OCCUPANCY RATES IN FRENCH HOSPITALS: RESULTS FROM THE E-SI (PREPS-SIPS) STUDY

2016 ◽  
Vol 19 (3) ◽  
pp. A273
Author(s):  
L. Perrier ◽  
M. Plantier ◽  
T. Durand ◽  
N. Caquot ◽  
C. Amaz ◽  
...  
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Health Information Systems ◽  
Bed Occupancy ◽  
Hospital Bed ◽  
Occupancy Rates ◽  
Bed Occupancy Rates

Experience in applying the effectiveness audit methodology in order to save budget funds for the purchase of medicines in the UK

2020 ◽  
pp. 82-87
Author(s):  
S. S. Budarin ◽  
N. V. Yurgel
Keyword(s):  
United Kingdom ◽  
Health System ◽  
National Health ◽  
Sharp Increase ◽  
National Health System ◽  
Pharmaceutical Market ◽  
National Audit ◽  
Drug Pricing ◽  
The United Kingdom ◽  
The Uk

The article examines the experience of the national audit office of the United Kingdom in conducting an audit of the effectiveness of budget funds aimed at providing medicines to English citizens. The reasons for the sharp increase in budget expenditures for providing the population with reproduced medicines in 2017—2018 are described in detail.The article analyzes the shortcomings of the system of regulation of drug pricing procedures and the resulting risks to the budget of the national health system in United Kingdom.It is concluded that the effectiveness audit has allowed us to identify not only the reasons for significant overspending of the NHS budget to provide the population with medicines, but also to assess the actions of organizations authorized by the UK Government to address issues of regulation of the pharmaceutical market.

I limiti del tempo in un tempo di limiti

2009 ◽  
pp. 55-62
Author(s):  
Fabrizio Rizzi
Keyword(s):  
Health System ◽  
Key Words ◽  
Community Service ◽  
National Health ◽  
National Health System ◽  
Short Term ◽  
Intellectual Honesty ◽  
Life Itself ◽  
Environmental Limits

- This article recounts the doubts and fears of an experienced analyst who is now an apprentice acrobat. He is forced to keep himself tiredly balanced between psychological and physical limits imposed by age, restrictions introduced by the National Health System and categories of patients who have precedence over others. He cannot receive all of the patients who ask for him and even those who he does receive will have to be discharged in the short term. Explaining to them, with intellectual honesty, that the community service has rules that limit his wishes as well. What can this be if not acrobatics? In the end it means combining the contradictory but perhaps also the most real aspects of life itself. [KEY WORDS: desires, personal and environmental limits, truth of the therapist]

Safety and feasibility of a nurse-led ambulatory abdominal paracentesis service.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 63-63
Author(s):  
Kim Hua Lee
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Average Length ◽  
Symptom Relief ◽  
Bleeding Complications ◽  
Inpatient Setting ◽  
Bed Occupancy ◽  
Abdominal Drain ◽  
Hospital Bed ◽  
Abdominal Paracentesis

63 Background: Ascites is a common complication of cancer. Symptomatic ascites contributes to cancer-related morbidity and is distressing for patients (pts). Therapeutic abdominal paracentesis (TAP) provides symptom relief but requires specialized procedural knowledge and is usually performed in the inpatient setting with several days of hospitalization. Additionally, high hospital bed occupancy during the COVID-19 pandemic prevented timely admission for TAP. An Advanced Practice Nurse (APN)-led ambulatory TAP service was introduced at our center, with the aim of improving access to TAP and reducing hospital bed occupancy. Methods: A multidisciplinary team developed workflows and safety guidelines for TAP to enable right-siting of pts in a cancer day care unit. Pts were scheduled for radiologically guided insertion of abdominal drains in the morning before 10am to allow adequate time for drainage. Pre-procedure clinical examination and safety checks were performed by APNs in the day unit. Following the procedure, abdominal fluid was drained with concurrent administration of 20% IV albumin. Drains were removed by the APN and pts were examined before discharge on the same day. Data for all cancer pts requiring TAP in the day unit and hospital from 1 Jan to 30 Nov 2020 were extracted from the electronic medical record system. The primary outcome was length-of-stay (LOS). The primary safety outcome was adverse events in the day unit. Continuous data were compared using the t-test. Data analysis was done in SPSS version 22. Results: The number of TAPs performed in the day unit and general ward requiring hospitalization were 102 and 133, respectively. There was a significant reduction in average LOS with TAPs performed in the day unit vs. hospitalization (1.48 vs. 5.82 days, p<0.001) (Table). The mean difference was 4.34 (95% confidence interval 3.33 - 5.34) days saved per pt, or a saving of 443 inpatient bed days. The TAP day unit service encountered 10 adverse events (AEs) requiring admission to the ward for continued drainage. AEs were borderline baseline blood pressure, pt frailty and inability to care for an indwelling catheter. There were no infective or bleeding complications. The majority of TAPs (86.8%) were performed in one day, with the remainder over 2-days with the abdominal drain left in-situ and reattendance at the day unit the next day for further drainage. Differences in average length-of-stay with TAP in the hospital vs. day unit. Conclusions: An APN-led ambulatory abdominal paracentesis service is a safe alternative to inpatient paracentesis. Optimal utilization of a day unit enabled reduced LOS for pts with advanced cancer. This reduction in LOS was critical during a pandemic where bed demand was high. This was possible from advanced scheduling and control over the day unit capacity.[Table: see text]

Sign in / Sign up

Export Citation Format

Share Document