Forecasting emergency department arrivals using INGARCH models

BACKGROUND: Forecasting patient arrivals to hospital emergency departments is critical to dealing with surges and to efficient planning, management and functioning of hospital emerency departments. OBJECTIVE: We explore whether past mean values and past observations are useful to forecast daily patient arrivals in an Emergency Department. MATERIAL AND METHODS: We examine whether an integer-valued generalized autoregressive conditional heteroscedastic (INGARCH) model can yield a better conditional distribution fit and forecast of patient arrivals by using past arrival information and taking into account the dynamics of the volatility of arrivals. RESULTS: We document that INGARCH models improve both in-sample and out-of-sample forecasts, particularly in the lower and upper quantiles of the distribution of arrivals. CONCLUSION: Our results suggest that INGARCH modelling is a useful model for short-term and tactical emergency department planning, e.g., to assign rotas or locate staff for unexpected surges in patient arrivals.