PMID- 14613624
OWN - NLM
STAT- MEDLINE
DCOM- 20040105
LR  - 20191210
IS  - 0951-4848 (Print)
IS  - 0951-4848 (Linking)
VI  - 16
IP  - 4
DP  - 2003 Nov
TI  - Cyclic fluctuations in hospital bed occupancy in Roma (Italy): supply or demand 
      driven?
PG  - 268-75
AB  - The objective of this study was to assess hospital bed occupancy both by planned 
      and unplanned cases, and to assess how supply and demand affect bed occupancy. 
      Data was obtained from the Lazio Hospital Information System (HIS) dataset on all 
      hospital discharges from July 1998 to June 2001. Using Diagnosis Related Groups 
      (DRG) as the reason for hospital stay, admissions were classified into four 
      categories: 'planned stay', 'presumed planned stay', 'presumed unplanned stay', 
      and 'unplanned stay'. Time series analysis of daily bed occupancy by category of 
      stay was performed. Generalized Additive Models (GAMs) were used to asses the 
      effect of weekdays and holidays on bed occupancy. Fluctuations in daily occupancy 
      were observed in all categories of stay-in general, bed occupancy decreased over 
      weekends, on national holidays, and during the major holiday season of August. In 
      comparison with unplanned stays, the largest fluctuations were observed for 
      planned stays while presumed planned and unplanned stays showed lesser 
      fluctuations. It is possible to distinguish planned and unplanned hospital stays 
      by using DRG grouping. Cyclic rigidities in the supply of services rather than 
      the availability of beds or demand for beds seem to dictate hospital use in Roma 
      so that restrictions in services hamper any reallocation of beds for 'planned 
      stay' when demand for 'unplanned stay' beds declines.
FAU - Fusco, D
AU  - Fusco D
AD  - Department of Epidemiology, Local Health Authority RME, Roma, Italy.
FAU - Saitto, C
AU  - Saitto C
FAU - Arca, M
AU  - Arca M
FAU - Ancona, C
AU  - Ancona C
FAU - Perucci, C A
AU  - Perucci CA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Health Serv Manage Res
JT  - Health services management research
JID - 8811549
MH  - Bed Occupancy/*statistics & numerical data/trends
MH  - Diagnosis-Related Groups/*classification
MH  - Health Services Needs and Demand/statistics & numerical data/*trends
MH  - Health Services Research
MH  - *Hospital Planning
MH  - Hospitals/*statistics & numerical data
MH  - Humans
MH  - Italy/epidemiology
MH  - Length of Stay/statistics & numerical data
MH  - Patient Admission/statistics & numerical data
MH  - Patient Discharge/statistics & numerical data
MH  - Process Assessment, Health Care
MH  - Time and Motion Studies
EDAT- 2003/11/14 05:00
MHDA- 2004/01/06 05:00
CRDT- 2003/11/14 05:00
PHST- 2003/11/14 05:00 [pubmed]
PHST- 2004/01/06 05:00 [medline]
PHST- 2003/11/14 05:00 [entrez]
AID - 10.1258/095148403322488964 [doi]
PST - ppublish
SO  - Health Serv Manage Res. 2003 Nov;16(4):268-75. doi: 10.1258/095148403322488964.