Improving the Hospital Quality of Care during Winter Periods by Optimizing Budget Allocation Between Rotavirus Vaccination and Bed Expansion

Dort, Thibaut; Schecroun, Nadia; Standaert, Baudouin

All calculations are conducted using MATLAB R2016a (The MathWorks, Inc., Natick, MA, USA), except for the one-way sensitivity analysis on data inputs which is done in MS Excel (Microsoft Corporation, Redmond, WA, USA). Figure 1 presents the QoC-isocurves for three improvement rates in hospital QoC-score (i.e., QoC ¼ ? 30, ? 50, and ? 70%), with a higher improvement in hospital QoC- In the subsequent analysis the target improvement in hospital QoC-score is 50%, presented as the dashed QoCisocurve of Fig. 1 . Using the aforementioned data and the baseline parameter values, Fig. 2 shows the solution of the budget optimization model described by Eq. 4. To reach a 50% improvement in hospital QoC-score the minimum budget between rotavirus vaccination and rotavirus gastroenteritis (RVGE) treatment covers a combination of 63.51% vaccine coverage (V) and 39.36% extra hospital beds (H) (? 13 extra beds) during the winter peak. This combination represents a total annual budget of €1,051,564. V (a) and H (b) are assumed to contribute equally (50-50%) to the QoC-score improvement and, subsequently, to the minimum budget as well. In other words, the same amount of money is spent on vaccination and bed expansion. However, Fig. 2 shows that the budget curve increases faster with more H than with a higher V. Therefore, vaccination could be the most efficient option to achieve the target QoC-score improvement: an increase in H costs more than an increase in V for the same improvement in QoC-scores.