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Forecasting models of emergency department crowding.
Acad Emerg Med. 2009 Apr; 16(4):301-8.AE

Abstract

OBJECTIVES

The authors investigated whether models using time series methods can generate accurate short-term forecasts of emergency department (ED) bed occupancy, using traditional historical averages models as comparison.

METHODS

From July 2005 through June 2006, retrospective hourly ED bed occupancy values were collected from three tertiary care hospitals. Three models of ED bed occupancy were developed for each site: 1) hourly historical average, 2) seasonal autoregressive integrated moving average (ARIMA), and 3) sinusoidal with an autoregression (AR)-structured error term. Goodness of fits were compared using log likelihood and Akaike's Information Criterion (AIC). The accuracies of 4- and 12-hour forecasts were evaluated by comparing model forecasts to actual observed bed occupancy with root mean square (RMS) error. Sensitivity of prediction errors to model training time was evaluated, as well.

RESULTS

The seasonal ARIMA outperformed the historical average in complexity adjusted goodness of fit (AIC). Both AR-based models had significantly better forecast accuracy for the 4- and the 12-hour forecasts of ED bed occupancy (analysis of variance [ANOVA] p < 0.01), compared to the historical average. The AR-based models did not differ significantly from each other in their performance. Model prediction errors did not show appreciable sensitivity to model training times greater than 7 days.

CONCLUSIONS

Both a sinusoidal model with AR-structured error term and a seasonal ARIMA model were found to robustly forecast ED bed occupancy 4 and 12 hours in advance at three different EDs, without needing data input beyond bed occupancy in the preceding hours.

Authors+Show Affiliations

Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA. lschweig@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19210488

Citation

Schweigler, Lisa M., et al. "Forecasting Models of Emergency Department Crowding." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 16, no. 4, 2009, pp. 301-8.
Schweigler LM, Desmond JS, McCarthy ML, et al. Forecasting models of emergency department crowding. Acad Emerg Med. 2009;16(4):301-8.
Schweigler, L. M., Desmond, J. S., McCarthy, M. L., Bukowski, K. J., Ionides, E. L., & Younger, J. G. (2009). Forecasting models of emergency department crowding. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 16(4), 301-8. https://doi.org/10.1111/j.1553-2712.2009.00356.x
Schweigler LM, et al. Forecasting Models of Emergency Department Crowding. Acad Emerg Med. 2009;16(4):301-8. PubMed PMID: 19210488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Forecasting models of emergency department crowding. AU - Schweigler,Lisa M, AU - Desmond,Jeffrey S, AU - McCarthy,Melissa L, AU - Bukowski,Kyle J, AU - Ionides,Edward L, AU - Younger,John G, Y1 - 2009/02/04/ PY - 2009/2/13/entrez PY - 2009/2/13/pubmed PY - 2009/10/15/medline SP - 301 EP - 8 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 16 IS - 4 N2 - OBJECTIVES: The authors investigated whether models using time series methods can generate accurate short-term forecasts of emergency department (ED) bed occupancy, using traditional historical averages models as comparison. METHODS: From July 2005 through June 2006, retrospective hourly ED bed occupancy values were collected from three tertiary care hospitals. Three models of ED bed occupancy were developed for each site: 1) hourly historical average, 2) seasonal autoregressive integrated moving average (ARIMA), and 3) sinusoidal with an autoregression (AR)-structured error term. Goodness of fits were compared using log likelihood and Akaike's Information Criterion (AIC). The accuracies of 4- and 12-hour forecasts were evaluated by comparing model forecasts to actual observed bed occupancy with root mean square (RMS) error. Sensitivity of prediction errors to model training time was evaluated, as well. RESULTS: The seasonal ARIMA outperformed the historical average in complexity adjusted goodness of fit (AIC). Both AR-based models had significantly better forecast accuracy for the 4- and the 12-hour forecasts of ED bed occupancy (analysis of variance [ANOVA] p < 0.01), compared to the historical average. The AR-based models did not differ significantly from each other in their performance. Model prediction errors did not show appreciable sensitivity to model training times greater than 7 days. CONCLUSIONS: Both a sinusoidal model with AR-structured error term and a seasonal ARIMA model were found to robustly forecast ED bed occupancy 4 and 12 hours in advance at three different EDs, without needing data input beyond bed occupancy in the preceding hours. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/19210488/Forecasting_models_of_emergency_department_crowding_ L2 - https://doi.org/10.1111/j.1553-2712.2009.00356.x DB - PRIME DP - Unbound Medicine ER -