Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr;48(2 Pt 2):735-52.
doi: 10.1111/1475-6773.12041. Epub 2013 Feb 10.

Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009

Sabina Braithwaite  1 , Bernard Friedman, Ryan Mutter, Michael Handrigan
Affiliations

Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009

Sabina Braithwaite et al. Health Serv Res. 2013 Apr.

Abstract

Objective: Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately and postponing elective admissions (a "passive" supply response).

Methods: Epidemiologic assumptions were combined with assumptions from other literature (e.g., staff absenteeism, profitability by payer class), Census data on age groups by region, and baseline hospital utilization data. Hospital discharge records were available from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Hospital bed capacity and staffing were measured with the American Hospital Association's (AHA) Annual Survey.

Results: Nationwide, in a scenario of relatively severe epidemiologic assumptions, we estimated aggregate net income of $119 million for about 1 million additional influenza-related admissions, and a net loss of $37 million for 52,000 postponed elective admissions.

Implications: Aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary. The analysis identified needs for better information of several types to improve simulations of hospital behavior and impacts during demand surges.

PubMed Disclaimer

References

    1. Barr HL, Macfarlane JT, Macgregor O, Foxwell R, Buswell V, Lim WS. “Ethical Planning for an Influenza Pandemic”. Clinical Medicine. 2008;8(1):49–52. - PMC - PubMed
    1. Beutels P, Edmunds W, Smith R. “Partially Wrong? Partial Equilibrium and the Economic Analysis of Public Health Emergencies of International Concern”. Health Economics. 2008;17:1317–22. - PubMed
    1. Cohen SB, Hudson JL. 2009. “Supporting Healthcare Policy Initiatives through Modeling and Microsimulation Efforts: Issues of Data Capacity and Statistical Quality,” Agency for Healthcare Research and Quality, Working Paper No. 09002 [accessed on January 11, 2013]. Available at http://meps.ahrq.gov/mepsweb/data_files/publications/workingpapers/wp_09....
    1. Elmendorf DW. 2011. “CBO's Analysis of the Major Health Care Legislation Enacted in March 2010,” testimony before the Subcommittee on Health, Committee on Energy and Commerce, U.S. House of Representatives [accessed on March 13, 2011]. Available at http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/121xx/doc12119/0....
    1. Feldstein M, Friedman B, Luft H. “Distributional Aspects of National Health Insurance Benefits and Finance”. National Tax Journal. 1972;25(4):497–510.

MeSH terms