Simulation of a hospital's surgical suite and critical care area
WSC '92 Proceedings of the 24th conference on Winter simulation
Multi-hospital validation of critical care simulation model
WSC '93 Proceedings of the 25th conference on Winter simulation
Information distortion in a supply chain: the bullwhip effect
Management Science - Special issue on frontier research in manufacturing and logistics
Journal of Medical Systems
Development and validation of a large scale ICU simulation model with blocking
Proceedings of the Winter Simulation Conference
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Health care capacity decisions are often based on average performance metrics such as utilization. However, such decisions can be misleading, as a large portion of the costs in service operations is due to the inability to provide service due to congestion. This paper will review sources of variation that affect inpatient care capacity and develop a series of models of patient flow in a health care facility. We demonstrate that even in settings where the patient population and services provided are fixed, models that do not account for natural variations in the arrival rate and correlation in patient lengths of stay in sequential units will show the same utilization, but underestimate congestion and the resulting costs. Therefore, we argue that utilization is an inappropriate measure for validating models and congestion metrics such as blocking and diversions should be used instead.