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BMJ Publishing Group, BMJ Open, 4(12), p. e056523, 2022

DOI: 10.1136/bmjopen-2021-056523

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Can we accurately forecast non-elective bed occupancy and admissions in the NHS? A time-series MSARIMA analysis of longitudinal data from an NHS Trust

Journal article published in 2022 by Emily Eyles ORCID, Maria Theresa Redaniel ORCID, Tim Jones ORCID, Marion Prat, Tim Keen
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

ObjectivesThe main objective of the study was to develop more accurate and precise short-term forecasting models for admissions and bed occupancy for an NHS Trust located in Bristol, England. Subforecasts for the medical and surgical specialties, and for different lengths of stay were realisedDesignAutoregressive integrated moving average models were specified on a training dataset of daily count data, then tested on a 6-week forecast horizon. Explanatory variables were included in the models: day of the week, holiday days, lagged temperature and precipitation.SettingA secondary care hospital in an NHS Trust in South West England.ParticipantsHospital admissions between September 2016 and March 2020, comprising 1291 days.Primary and secondary outcome measuresThe accuracy of the forecasts was assessed through standard measures, as well as compared with the actual data using accuracy thresholds of 10% and 20% of the mean number of admissions or occupied beds.ResultsThe overall Autoregressive Integrated Moving Average (ARIMA) admissions forecast was compared with the Trust’s forecast, and found to be more accurate, namely, being closer to the actual value 95.6% of the time. Furthermore, it was more precise than the Trust’s. The subforecasts, as well as those for bed occupancy, tended to be less accurate compared with the overall forecasts. All of the explanatory variables improved the forecasts.ConclusionsARIMA models can forecast non-elective admissions in an NHS Trust accurately on a 6-week horizon, which is an improvement on the current predictive modelling in the Trust. These models can be readily applied to other contexts, improving patient flow.