Identifying the Bottleneck Unit: Impact of Congestion Spillover in Hospital Inpatient Unit Network

33 Pages Posted: 18 Sep 2020 Last revised: 4 Aug 2021

See all articles by Song-Hee Kim

Song-Hee Kim

Seoul National University - Business School

Fanyin Zheng

Columbia University - Columbia Business School

Joan Brown

University of Southern California - Keck School of Medicine

Date Written: August 3, 2021

Abstract

Because a hospital is an interconnected, interdependent network of care units, allocating resources--beds, nurses, and improvement initiatives--to one unit to reduce its congestion and improve its performance may have spillover effects on other units. As such, to identify the bottleneck unit and improve access to care, hospital administrators need to take into account potential effects of congestion spillover. We use detailed patient data from a hospital collected over five years to empirically examine whether and how much congestion propagates through the network of inpatient units and identify the bottleneck unit. Our estimation result suggests that the magnitude of the congestion spillover is substantial. For example, increasing one inpatient unit's utilization by 10 percentage points today can increase its neighboring inpatient unit's utilization by up to 5.71 percentage points tomorrow. Using counterfactual analyses, we estimate the effect of adding a bed to each unit. We find that adding a bed to the bottleneck unit can free up 3.75 beds in the hospital, which can be translated to 347.40 more hospital visits per year or a 3% increase in hospital throughput. This effect is about three times bigger in magnitude compared to what one can achieve by naively choosing which hospital unit to add a bed to. Hospitals and other manufacturing and service systems with complex interdependence across resources can use our empirical framework to examine the spillover effect of resources on performance metrics and leverage such understanding to effectively improve their operations.

Keywords: empirical operations management, network effect, bottleneck, congestion, healthcare, inpatient unit

Suggested Citation

Kim, Song-Hee and Zheng, Fanyin and Brown, Joan, Identifying the Bottleneck Unit: Impact of Congestion Spillover in Hospital Inpatient Unit Network (August 3, 2021). Available at SSRN: https://ssrn.com/abstract=3667970 or http://dx.doi.org/10.2139/ssrn.3667970

Song-Hee Kim (Contact Author)

Seoul National University - Business School ( email )

Seoul
Korea, Republic of (South Korea)

Fanyin Zheng

Columbia University - Columbia Business School ( email )

3022 Broadway
New York, NY 10027
United States

HOME PAGE: http://www.fanyinzheng.com

Joan Brown

University of Southern California - Keck School of Medicine ( email )

Los Angeles, CA 90089
United States

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