Improving the forecasting of hospital services: A comparison between projections and actual utilization of hospital services
Improving the forecasting of hospital services: A comparison between projections and actual utilization of hospital services
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DOI：
10.1016/j.healthpol.2018.05.010
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发表时间：
2018-07-01
期刊：
影响因子：
3.3
通讯作者：
Van de Voorde, Carine
中科院分区：
文献类型：
--
作者：
Bouckaert, Nicolas;Van den Heede, Koen;Van de Voorde, Carine
目的：为了比较预测和观察到的医院住院病人使用在Belgium，并从中吸取教训，comparison.Methods：在2005年，预测医院服务的使用产生到2015年，根据人口变化，替代住院到日托，和，平均住院时间（LOS）的演变。预测的准确性进行了评估，通过比较预测和观察到的人口规模，入院和住院天数，平均LOS和百分比变化的情况mix.Results：人口增长被低估。总体而言，住院的基线预测与观察到的数字非常接近，但潜在的病例组合存在重要差异。在住院和日间护理之间进行替代的情况下，入院人数被低估了15%-40%。天数预计将增加在每种情况下，而观察到的下降趋势，主要是由于平均LOS下降速度比project.Conclusion：医院容量规划的证据知情决策的一个重要组成部分。预测结果得益于精心设计的方法：预测组的选择、估计模型、选择标准和结果的敏感性分析。为了科普医院运作的动态和不断变化的环境，定期更新以纳入新数据并重新评估估计趋势应成为预测框架的一个组成部分。(C)2018爱思唯尔B. V.保留所有权利。
Objectives: To compare projected and observed hospital inpatient use in Belgium and to draw lessons from that comparison.Methods: In 2005, projections for hospital service use were generated up to 2015, based on demographic change, substitution from inpatient to day care, and, the evolution of the average length of stay (LOS). The accuracy of the forecasts was assessed by comparing projected and observed population size, admissions and inpatient days, average LOS and percentage change in case mix.Results: The demographic growth was underestimated. Overall, the baseline projection for hospital admissions was remarkably close to the observed figures but the underlying case mix diverged importantly. With substitution between inpatient and day care, the number of admissions was underestimated by 15%-40%. The number of days was projected to increase in every scenario, whereas a decreasing trend was observed mainly due to the faster decline in average LOS than projected.Conclusion: Hospital capacity planning is an important component of evidence informed policymaking. Projection results benefit from a well-designed methodology: choice of forecast groups, estimation models, selection criteria, and a sensitivity analysis of the results. To cope with the dynamic and continuously evolving context in which hospitals operate, regular updates to incorporate new data and to reassess estimated trends should be an integral part of the projection framework. (C) 2018 Elsevier B.V. All rights reserved.