Capacity Shortages in Healthcare: A Simulation Study of the Neonatal Care System

Abstract

Neonatal care in the Netherlands is under significant strain due to severe bed capacity and staffing shortages, particularly in the southwestern region, where 36% of hospitals have closed neonatal beds. The current neonatal care system, structured into three escalating levels of specialization—neonatal medium care, high care, and Neonatal Intensive Care Units (NICUs)—struggles to meet demand, resulting in high occupancy rates and frequent patient transfers. This study developed a discrete-event simulation model to analyze and address bed capacity shortages within these staffing limitations. The model, based on regional perinatal birth data, evaluated the impact of various interventions on bed occupancy and transfer rates across different care levels.

Key findings revealed that reducing the length of stay, adjusting admission rates, and altering patient pathways could alleviate capacity pressures. While individual interventions offered modest improvements, a combined strategy integrating multiple approaches significantly reduced occupancy rates and patient transfers. This research underscores the need for a multifaceted approach to address neonatal care challenges and highlights the potential of simulation modeling as a tool for informed decision-making in healthcare resource management. The study’s insights offer a pathway toward sustainable neonatal care despite ongoing constraints.