Modeling and Analysis of Patient Transitions in Community Hospitals: A Systems Approach

Hyo Kyung Lee, Jingshan Li, Albert J. Musa, Philip A. Bain, Kenneth Nelson

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


A patient's stay at a hospital may encompass various departments or units. Since many critical and complex problems occur at the interfaces of healthcare delivery systems, safe and efficient transitions between the departments within a hospital has significant importance. This paper presents a Markov chain-based model to study patient transitions between emergency department, intensive or critical care unit, and hospital ward in small and medium-sized community hospitals. To make the analytical study tractable, an iteration method is introduced to approximate the system performance during transitions, including direct transferring probabilities without waiting, average patient occupancy in each department, and average patient length of stay. In addition, system properties, such as monotonicity and sensitivity, are analyzed. It is shown that such a method has a high accuracy in performance estimation and can be used to study and improve patient transitions in small or medium-sized hospitals.

Original languageEnglish
Article number7994648
Pages (from-to)686-699
Number of pages14
JournalIEEE Transactions on Systems, Man, and Cybernetics: Systems
Issue number2
Publication statusPublished - 2020 Feb
Externally publishedYes


  • Critical care unit (CCU)
  • Markov chain
  • emergency department (ED)
  • iteration procedure
  • patient transition
  • ward

ASJC Scopus subject areas

  • Software
  • Control and Systems Engineering
  • Human-Computer Interaction
  • Computer Science Applications
  • Electrical and Electronic Engineering


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