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- 228 - 25. Duran, Lilia, "Desarrollo de una Metodologia para Establecer Prioridades de Atencion en el Sector Salud." Internal working paper, Centro Universitario de Tecnologia Educacional para la Salud (CEUTES) , June, 1981.25. 26. LaSalle, Gerald, "Nuevos Modelos en la Formacion Profesional del Personal de la Salud," Universidad de Sherbrooke, Educacion Medica y Salud, 4, 4, 1970. 27. Maddison, D.C. "What's Wrong with Medical Education?" Medical Education. 1978, 12, pp. 97-102. 28. Rexed, Bror, "The Role of Medical Education in Planning. The Development of a National Health Care System," Journal of Medical Education, Vol. 49, January 1974. 29. Duran, Lilia, "Una Aplicacion de la Tecnica de Analisis de Tareas a Partir de un Modelo de Servicio en el Area de la Salud y su Derivacion en Objetivos Generals de Carrera." Technical Report. Centro Latinoamericano de Tecnologia Educacional para la Salud (CLATES), 1979. 30. Duran, Lilia y Torres, A., "Planificacion Familiar: Una Aplicacion de la Tecnica de Analisis de Tareas." Technical Report. Centro Latinoamericano de Tecnologia Educacional para la Salud (CLATES), 1979. 31. Duran, Lilia, "Algunas Sugerencias de Apoyo al Catalogo Nacional de Ocupaciones en el Area de Planeamiento Curricular." Documento Presentado a la Direccion General de Planeacion de la S.E.P. (Secretary of Public Education) Marzo, 1980. 32. Duran, Lilia, "Technology Development for a Quantitative and Qualitative Definition of Human Resourcres in the Health Field." Research proposal submitted to the National Council of Science and Technology, June, 1979.
- 229 - METHODS Parameters Affecting Hospital Occupancy and Implications for Facility Sizing By Walton M. Hancock, David B. Magerlein, Robert H. Siorer, and lames B. Martin Simulation is used to investigate the effects on hospital occupancy of the number of beds in the facility, the percentage of patients who are emergencies, the percentage of elective patienta who are acheduled, and the average lengths of stay of emergency and elective patients. A practical method is presented for estimating the optimum suze of a short-term hospital on the basis of expected demand, and use of the resulta in planning is discussed. To operate at minimum cost it is imperative that a hospital not contain more beds than necessary to meet demand. The nontrivial costs of building, stafflag, and maintaining unused beds are unnecessary and are ultimately bdrne by the health care consumer. The variable cost of staffing and maintaining a hospital bed was found to be $10,130 per year in one study [1] and $16,201 per year in another [2], and the fixed cost of building a bed has been quoted as $50,000 [3]. Thus, considerable savings are possible by eliminating beds in an overbedded Hospital (saving variable costs) and by preventing the construction of unneeded beds (saving both fixed and variable costs). A simulation-based analysis of the effects of several parameters on hospital occupancy is presented. The parameters investigated are number of beds in the facility, percentage of patients who are emergencies, percentage of elective patients whose admission date is set in advance (scheduled patients), and mean lengths of stay of emergency and elective patients. A practical method is developed for predicting the correct size of hospital facilities, given the expected demand. Current planning methods such as the Hill-Burton formula, the Poisson assumption, and that of Shonick [4] are shown to be inappropriate ThiJ study was supported by PHS grant no. HS00228 from ¿he National Center for HIalth Services Rescarch (DHEW) and by the W.K. Kellogg Foundation through the Greater Detroit Arca Hospital Council, Inc. Addrdeu communications and requests for reprints to Walton M. Hancock, HEALTH ProCessor of Induswlrial and Operations Engineering and Hospital Administration, SERVICES Program and Bureau of Hospital Administration, University oJ Michigan School of RESEARCH Public Health, 1420 Washington Heights, Ann Arbor, MI 48109. David P. Mager. ARC. A'I cin is a graduate student and Robert H. Storr is an undergraduate student, both in industrial and operations engineering; and ]ames B. Martin is assistant professor of hospital adminisuration. All of the authors are at the University of Michigan. 0017-9124/78/03027614/$02.00/0 ( 1978 Hospital Research and Educational Trust
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- ii - liancock, W., D. Magerlein y
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FOREWORD These last years, PAHO wit
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Workshop .- Education in Operationa
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-3. The format of the workshop was
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-5- 2. Programs for bringing togeth
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II. R.commendations -7- A series of
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-9- there are technically trained i
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-11- and selected individuals who h
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-13- 6. In order to improve the qua
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-15- cnve!opment will typically be
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-17- 16. All participants sbould pr
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A. Short Courses -19- Short courses
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-21- 4. Presentation of a case to b
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Topic Introduction to Systems Analy
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-25- 12. Elementary Statistics ior
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-27- 8. Applications of data proces
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-29- problems. The graduate should
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-31- Lblo-w. Also given is that typ
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- 33 -' -Case Mix Definition by Dia
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- 35 - Acknowledgment The authors w
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ML ICAL CAE1 Februurl 1980, Vol. XV
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X;' VIII, No. 2. Suippllce,t - 39 -
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- 41 - dMLDICAL C.ARE '.Fcbrtanj 19
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\'nKV 111,I No. 2, IIIJ·,ri - 43 -
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Vol. XVIII, No. 2, Supplenent - 45
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?Vol. XVIII. No. 2. Sttilluleareilt
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.'yo. XVIII. No. 2, Supplentcsit Si
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.V'oL XVIII. No. 2. Stpphlidary dia
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Vol..'XVlII, No. 2, Supplement - 55
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- 57 - MEDICAL CARE Febiuary 1980,
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- 59 - .SlDiCL ( :AL.. FcbnartlrJ p
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Vol. XVIII, No. 2, Suppletiment - 6
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- 65 - £.¡EDCAL CARE ebrNuarV 1;9
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Vol. XVIII, No. 2, Sn",,phl- steal
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VoL XVIII. No. 2, Supplemnlent - 69
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'XVII. No. 2. Supplement - 71 - P)i
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;.'. 'Vol. XVIII. No. 2. Siupplemen
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,VoL XVIII, No. 2, Supplement Major
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.. Vol. XVIII, No. 2. Supl|lemcent
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i,..X VIII. No. 2. Supplemeiint - 8
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T XVIII. No. 2. S.pphlts"t .i¿jor
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·. ¥XVIII. No. 2 Supplement )i, "
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- 87 - 'i1. XVIII. No. -. Supplemne
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Vl. \'ll. No. 2. Sntiít'ult.uit M.
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- 91 - R. FRIRICHIS AND J. PRAWDA W
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- 93 - 414 R. FRRKICkIS AND J. PRAW
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- 95 - R. F'RERICItS'AND J. PRAWDA
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- 97 - R. F'RRICHS AND J. PRAWDA wh
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- 99 - 420 R. MFRIlC}IS AND J. PRAW
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V - 101 - McUCi. (:Au AWuu IMI. VoL
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GREENLAND ET AL - 103 - the case (p
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CREENLAND iT AL - 105 - TABLE 2. Fi
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GREENLAND ET AL. 3. Cornfleld J, Ha
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160 I indicates the flow of patient
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162 CONGESTION POINTS ANU CONTROL.A
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164 c 8o Table 4. The cffect of cha
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166 B. LEV etal. significant differ
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MEREDITH - 117 - ciety. However. ch
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I MEREDITH - 119 - varying oulcome
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MEDICAL CARE ,arch 1981, Vol. XIX,
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%,I. XIX, No. 3 iclnts. It should d
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n'ol. XIX, No. 3 - 125 - tailed exa
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1 Vol. XIX. No. 3 - 127 - tant for
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Vi. .XIX, No. 3 - 129 - tom' s reco
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- 131 - A \ ,,1. XIX, No. 3 PEHFOHR
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V Xl. IX, No. 3 - 133 - PERFORMANCE
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- 135 - The fourth requirement is l
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- 137 - Systems and Procedures of P
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- 139 - 2. ldentify problemn areas
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c 1 '-a
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u. o a.- 1 W. LZi - 143 - c c S C.
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- 145 - Thc cu rrent appointmren t-
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- 147 - A pure block appointment sy
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- 149 - ihe future. It was discover
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- 151 -
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- 153 - Figui.'¢ VII. Patient Arri
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- 155 - sonnel working in positions
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- 157 - 17. Keep the time span of t
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- 159 - TABLE I: Pnmary DesklConsul
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.Recomme;tded systenz - 161 - .;any
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- 163 - system, there is nr'. :vste
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- 165 - - A major problem with such
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- 167 - T1c Iteole of Olieraionls R
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- 169 - Larry J. Shumc- Harvey Wolf
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- 171 - '- ionoal Heolth Ploanning
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- 173 - Regional Health Planning ar
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- 175 - Regio.,oi Health Planning w
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Page 185 and 186: A^CJonoal neonah ronning 21. 1'. F.
Page 187 and 188: - .,1 - Programming, Budgeting, and
Page 189 and 190: - 183 - the health care industí ,
Page 191 and 192: - 185 - was apparently no scarcity.
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Page 205 and 206: Budgeting Attitudes - 199 - The pla
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Page 211 and 212: - 205 - DESIGN OF ALTERNATIVE PROVI
Page 213 and 214: - 207 - 1. A change in the immigrat
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Page 217 and 218: - 211 - dimensional graph to illust
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Page 225 and 226: IC1 o -a - i - w im W..i C -J M. -
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Page 229 and 230: TABLE 3 TASK ANALYSIS OF MALNUTRITI
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Page 239 and 240: - 233 - HANCOCK Table 1. Parameters
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Page 249 and 250: #12 Estinating the Need for Additio
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Page 253 and 254: . 1' - - IIINDLE Algorithmn for Det
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Page 263 and 264: - 257 - HIiDLZ 26. Ado, An . ad L.
Page 265 and 266: - 259 - REISMIAN, DEAN, ESOOBUE, AG
Page 267 and 268: - 261 - REISMAN, DEAN, ESOGBUE, AGG
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Page 275 and 276: - 269 - William J. Abernothy and Jo
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- 279 - William J. Aberncthy and Jo
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- 281 - 642 William J. Abernathy an
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Decmand in Mintu és/Day Numnlber o
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Disposal System 326 IIstlic I,',i,
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i Trays 334 Colorful pattenis anid
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tiie, gency L:ghting 347 ,i',., .:.
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- 296 - REVEI.LE we believe to be t
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- 293 R£VELLE is apparent in light
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- 295 - REVEt.EI. ET AL. poSJcd pro
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- 297 - RM.VELLE EL AL. of faciliti
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REVELLE ET AL. HALTOI SERVICUS RESE
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REVELLE ET Al.. - 301 - Fig. 4. Ano
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- 303 - REVet. ¡T AL Act of 1973.
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- 305 - REVELLE possible within ilh
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- 307 - RLVELI.E 29- Khumawala. a.
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- 309 - assuring thal the maxinmum
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-311 - the implemented strategy he
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- 313 - analytical approximalions w
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- 315 - rcquired Ior shipping and o
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- 317 - Controlling ¡he system The
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- 319 - The light pen techniques ar
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- 321 - shipnients have to be on ro
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- 323 THE CREATER NEIW' YORK BLOOD
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_,~ .- - 3. 2- - TABLE 1. PATIENT C
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TABLE 3. MEDICAL INTENSIVE CARE UNI
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Nursing Stalf Level (i of nurss/day
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Table 1. Factors ¡i denad for medi
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e forecast. This section descijbcs
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ei, paid to these standards in cond
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O Emphasis u.on the explicit enumer
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*1 1 21 1 «i 1 1 1 1 - 331, -- For
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Therc are ihreec basic prcessecs fi
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- 343 - Forecasting Hcalth Care Ser
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#20 Jaime 1B. Henrs Rtxlnc. I.. Ro:
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- 347 - I v,'N ti.K 1tHm.pi.l !, t1
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Ra.fo.renem.. aid %.hs '. - 31!9 -
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; / larman u empirical research has
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I Klarman - >3 - benefits that for
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I Klaman Ctitena for Inchmion - 355
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IClarman - 37 - The prevailing tend
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1 Klarman Intargibl Benefits - .5 -
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Kllarman - 361 - thi prospects of r
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- 363 - Thua, it did not consider w
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I Klannan - 365 - again if the new
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Klarman - 367 - At the other pole,
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- 369 - seem worth exploring. Howev
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iKlarman - 371 - in the use of serv
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Kmnnan - 373 - REFERENCES 1. Havema
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- 375 - 59. Valr y, W. S. One eonoi
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- 377 - i aSll a _ . b, CuaMu L. L,
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WAHRNER ANI) I|UTTr)N The puroses I
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WARNER AND HUTfON - 381 - observers
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.AHNF:R AND IIl'TIoN - 383 - rare I
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WARNER AND HUTTrU., TABLE 1. Trenda
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W'AHNER AND IHUTTON - 387 - treatme
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AAHNER AND HU'TON - 389 - Several d
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WARNER AND HUTTON pal orientations
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w'ARNER AND UL'TTOit'u ' . N Engl I
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I,,qr *ir 'ilu.,i XV. Seplteri¡br
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In.lumin- i',)i.eIu XV. Seph.irhb'r
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In#unrvlVolutn XV. September 1978 h
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Problemas identificados - 401 - Dur
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Programas educativos 3 - 403 - 1. S
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- 405 - maestrfa, donde se supone q
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- 407 - presentación formal de inf
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- 409 - * Curso para ingenieros ind
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- 411 - ¢ 16. Hancock, W., D. Mage
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- 413 - 2. Barrenechea, J. J. La se
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- 415 - Curwso (8 a 16 horas) para
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- 417 - 4. Necesidades de los admin
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MOISES ARTEAGA DR. DAVID GOMEZ COVA
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