Understanding the Nature of the Random Fluctuations of the Hospital Daily Census: An Important Health Planning Tool

Abstract

This investigation analyzes some social and economic criteria relevant to health planners who need to determine how many hospital beds are required in an area to meet a specified service requirement. Choices of different bed requirements as goals are shown to affect some of these criteria in opposite directions, resulting in a decision-making process which involves choices of trade-offs. The usefulness of probability distributions of the daily census and various waiting factors in making informed decisions under these circumstances is discussed, and some distributions which have been proposed by different investigators are described. A distribution developed by the writer for this purpose is presented and its use demonstrated. Some important inadequacies of the present Hill-Burton bed allocation formula are analyzed, and an alternative approach is suggested. Aspects of the planning process, other than determining the number of beds required to meet a predetermined service level, are touched upon in order to indicate the place which the use of probability distributions of the census and related variables occupies in the more comprehensive planning picture.