Cooperative solutions for challenges in neonatal care: A case study of the region of Utrecht

This research aims to demonstrate the effect of cooperative solutions to tackle neonatal care capacity challenges. Two earlier articles that proposed analytical models for resource planning and optimisation form the inspiration of this research. We employ a model that distinguishes three patient types (TPTM). So far, the TPTM was applied in two policies in intensive care wards: a virtual MC (VMC) policy by Litvak et al. (2008) and a threshold policy by Chan et al. (2018). We propose novel numerical approach for the VMC policy. In a case study from the city of Utrecht we showed that for two hospitals using the CTMC approach results in a joint decline of 132 lesser refusals per year at the costs of 78 more overbed-days per year, while maintaining proper occupancy levels of 85 %. Extending to four hospitals with the DES, we observe a joint decline of 49 beds at the costs of 24 more overbed-days. We also propose a numerical approach and a greedy optimisation method to optimise threshold reservation settings in the threshold policy. We demonstrate that the model results in a collective decline of 45 refusals per year and 35 overbed-days per year, for 4 neonatal care locations involved.