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      Optimizing Hospital Bed Capacity and Resource Allocation Using Inflow and Outflow Indices for Effective Healthcare Management

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          Abstract

          This study analyzes hospital bed capacity and resource allocation using inflow and outflow indices to identify disparities in bed utilization. The COVID-19 pandemic highlighted the need for effective healthcare management, particularly in the allocation of specialized beds such as those in intensive care units (ICU). Despite a high bed-to-population ratio, South Korea faces regional disparities in bed distribution, especially in Seoul, which accounts for 12.4% of the nation’s hospital beds. Hospital beds were categorized based on the Medical Service Act, and the Relevance Index (RI) and Commitment Index (CI) were used to assess patient flow in 2019 across different bed types and functions. Data from the “Statistical Yearbook on the Usage of Medical Service by Region” provided insights into utilization patterns in tertiary referral hospitals, general hospitals, hospitals, and long-term care facilities. The analysis revealed high RIs for tertiary referral hospitals, indicating strong patient retention and minimal outflow, whereas lower RIs for long-term care hospitals suggested underutilization. Regional analysis within Seoul found a concentration of tertiary referral hospitals in the Southeast and a shortage of ICU beds in the Northwest and Southwest regions. The Inflow and Outflow Index confirmed significant patient inflow into tertiary referral hospitals, with some areas experiencing higher outflows, particularly for long-term care beds. These findings underscore the need for strategic hospital bed capacity management, prioritizing essential beds in underserved regions. Future research should incorporate more recent data and employ direct patient flow analysis to optimize resource allocation, addressing evolving healthcare demands, such as an aging population and new infectious diseases. This study offers valuable insights for regional health policy, aiming to enhance functional hospital bed management and improve overall healthcare resource utilization.

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          Most cited references23

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          Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea

          Moran Ki (2020)
          In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.
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            Dynamics of bed use in accommodating emergency admissions: stochastic simulation model

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              Primary Care Patients’ Preference for Hospitals over Clinics in Korea

              Korea is in a unique condition to observe whether patients, when equal access to the levels of health care facilities is guaranteed by the support of the national health insurance, choose the appropriate levels of health care facilities. This study was performed to investigate the primary care patients’ preference for hospitals over clinics under no restriction for their choice. We used the 2011 National Inpatient Sample database of the Health Insurance Review and Assessment Service in Korea. A primary care patient was defined as a patient who visited as an outpatient in health care facilities with one of the 52 minor conditions defined by the Korean government. We found that approximately 15% of outpatient visits of the patients who were eligible for primary care in Korea happened in hospitals. In terms of cost, the outpatient visits in hospitals accounted for about 29% of total cost of outpatient visits. This arbitrary access to hospitals can lead to an inefficient use of health care resources. In order to ensure that health care facilities are stratified in terms of access as well as size and function, interventions to distribute patients to the appropriate level of care are required.
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                Author and article information

                Journal
                Inquiry
                Inquiry
                INQ
                spinq
                Inquiry: A Journal of Medical Care Organization, Provision and Financing
                SAGE Publications (Sage CA: Los Angeles, CA )
                0046-9580
                1945-7243
                30 November 2024
                Jan-Dec 2024
                : 61
                : 00469580241304244
                Affiliations
                [1 ]Kyung Hee University, Seoul, Republic of Korea
                Author notes
                [*]In-Hwan Oh, Department of Preventive Medicine, College of Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea. Email: parenchyme@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-6798-6917
                Article
                10.1177_00469580241304244
                10.1177/00469580241304244
                11607773
                39614715
                f90a8509-b9a4-4820-895f-922c4268cf7a
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 2 July 2024
                : 25 October 2024
                : 12 November 2024
                Funding
                Funded by: national research foundation of korea, FundRef https://doi.org/10.13039/501100003725;
                Award ID: No. 2023R1A2C1005966
                Categories
                Original Research
                Custom metadata
                January-December 2024
                ts1

                hospital bed capacity,resource allocation,relevance index (ri),commitment index (ci),healthcare management

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