Managing the overflow of intensive care patients

Nelli Litvak, Marleen van Rijsbergen, Richard J. Boucherie, Mark van Houdenhoven

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106 Citations (Scopus)
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Many hospitals in the Netherlands are confronted with capacity problems at their intensive care units (ICUs) resulting in cancelling operations, overloading the staff with extra patients, or rejecting emergency patients. In practice, the last option is a common choice because for legal reasons, as well as for hospital logistics, rejecting emergency patients has minimal consequences for the hospital. As a result, emergency patients occasionally have to be transported to hospitals far away. In this work, we propose a cooperative solution for the ICU capacity problem. In our model, several hospitals in a region jointly reserve a small number of beds for regional emergency patients. We present a mathematical method for computing the number of regional beds for any given acceptance rate. The analytic approach is inspired by overflow models in telecommunication systems with multiple streams of telephone calls. Simulation studies show that our model is quite accurate. We conclude that cooperation between hospitals helps to achieve a high acceptance level with a smaller number of beds resulting in improved service for all patients.
Original languageEnglish
Pages (from-to)998-1010
Number of pages13
JournalEuropean journal of operational research
Issue number3
Publication statusPublished - Mar 2008


  • MSC-90B22
  • OR in health services
  • Intensive care units
  • Overflow models
  • Equivalent random method


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