Nursing care demand prediction based on a decomposed semi-markov population model

The semi-markovian population model introduced by Kao for the planning of progressive care hospitals is adapted to the prediction of nursing care demand at the level of a care unit in a general hospital. Assuming a feedback admission policy which refills the unit as soon as discharges occur, it is shown that the care unit can be decomposed into B independent subsystems corresponding to each of the B beds in the unit.For each bed the semi-Markov model permits the computation of the expected care demand and its variance for each of the seven forthcoming days. The model permits also the prediction of admissions of new patients. A prediction formula can thus be obtained where the expected care demand is expressed as a linear function of the expected number of admissions in the forthcoming days.Finally this methodology is illustrated on real data obtained in the gynaecology department of the Montreal Jewish General Hospital.