Abstract

http://ssrn.com/abstract=2062518
 
 

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ICU Admission Control: An Empirical Study of Capacity Allocation and Its Implication on Patient Outcomes


Song-Hee Kim


Columbia University

Carri Chan


Columbia University - Columbia Business School

Marcelo Olivares


Columbia University - Columbia Business School - Decision Risk and Operations; University of Chile - Departamento de Ingenieria Industrial

Gabriel J. Escobar


Kaiser Permanente

April 23, 2014

Columbia Business School Research Paper No. 12/34

Abstract:     
This work examines the admission process to hospitals' Intensive Care Units (ICUs), which currently lacks well-defined admission criteria. A major challenge that has impeded the progress of developing ICU admission standards is that the impact of ICU admission on patient outcomes has not been well quantified, making it difficult to evaluate the performance of candidate admission strategies. Using a large patient-level dataset of over 190,000 hospitalizations across 15 hospitals, we first quantify the cost of denied ICU admission for a number of patient outcomes. We make methodological contributions in this context, improving upon previously developed instrumental variable approaches. Using the estimates from our econometric analysis, we provide a framework to evaluate the performance of various admission strategies. By simulating a hospital with 21 ICU beds, we then show that we could save about 1.9 million dollars per year by using our optimal objective policy--and hence can be used as a standard-- designed to reduce readmissions and hospital length-of-stay. We also discuss the role of physicians' discretion on the performance of alternative admission strategies.

Number of Pages in PDF File: 34

Keywords: service operations, healthcare operations management, empirical research, dynamic programming, capacity allocation, admission control, occupancy level, quality of service

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Date posted: May 19, 2012 ; Last revised: April 25, 2014

Suggested Citation

Kim, Song-Hee and Chan, Carri and Olivares, Marcelo and Escobar, Gabriel J., ICU Admission Control: An Empirical Study of Capacity Allocation and Its Implication on Patient Outcomes (April 23, 2014). Columbia Business School Research Paper No. 12/34. Available at SSRN: http://ssrn.com/abstract=2062518 or http://dx.doi.org/10.2139/ssrn.2062518

Contact Information

Song-Hee Kim (Contact Author)
Columbia University ( email )
3022 Broadway
New York, NY 10027
United States
Carri Chan
Columbia University - Columbia Business School ( email )
3022 Broadway
New York, NY 10027
United States
Marcelo Olivares
Columbia University - Columbia Business School - Decision Risk and Operations ( email )
3022 Broadway
Uris Hall, #417
New York, NY 10027
United States
HOME PAGE: http://www.columbia.edu/~mo2338/index.htm

University of Chile - Departamento de Ingenieria Industrial ( email )
Republica 701 Santiago
Chile
Gabriel J. Escobar
Kaiser Permanente ( email )
CA
United States
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