Modeling and Analysis of Patient Transitions in Community Hospitals: A Systems Approach
本文用马尔可夫链模型研究中小型社区医院内急诊、重症监护和普通病房之间的患者转诊，提出迭代方法估算转诊概率、平均住院人数和住院时长，帮助医院优化转诊流程。
A patient's stay at a hospital may encompass various departments or units. Since many critical and complex problems occur at the interfaces of healthcare delivery systems, safe and efficient transitions between the departments within a hospital has significant importance. This paper presents a Markov chain-based model to study patient transitions between emergency department, intensive or critical care unit, and hospital ward in small and medium-sized community hospitals. To make the analytical study tractable, an iteration method is introduced to approximate the system performance during transitions, including direct transferring probabilities without waiting, average patient occupancy in each department, and average patient length of stay. In addition, system properties, such as monotonicity and sensitivity, are analyzed. It is shown that such a method has a high accuracy in performance estimation and can be used to study and improve patient transitions in small or medium-sized hospitals.