Modeling the Movement of Coronary Patients within a Hospital by Semi-Markov Processes

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Abstract
This paper studies the use of a collection of semi-Markov processes (referred to as paths) to describe the movement of coronary patients within a hospital. Two earlier papers by the same author [Health Serv. Res. 7, 191–208 (1972) and IEEE Trans, on Systems, Man, and Cybernetics SMC-3, 327–336 (1973)] define the state of a patient by a specific set of care requirements dictated by his “state of health;” this paper considers a state definition based solely on the care unit in which the patient resides. This new state definition is simpler to administer, especially when patients of different diagnoses are included in the model. The paper uses field data to estimate the parameters of the underlying processes and evaluate the adequacy of using such a model. Procedures involving simple matrix operations are introduced to obtain length-of-stay and patient-day statistics in each care unit as well as in the hospital. An approach for reconstructing the original arrival distribution based on admission data is also presented with application.

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