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Optimizing Patient Placement in Normal Care Units: An Instrumental Causal Forest Approach Minimizing Mortality

Johannes Cordier

arXiv 3 Jan 2026 · Econometrics

arXiv:2601.01149 · PDF · DOI · OpenAlex · Extracted main text

Abstract

Normal care units (NCU) placement affects health outcomes. NCUs in a hospital have different specialisations. There are patients that can potentially stay in multiple different NCUs. On a given day the NCUs are on different utilisation levels, which also affects health outcomes. Our approach uses instrumental variable causal forests, with emergency admission as an instrument, to estimate how the effect of NCU placement varies across patients and utilisation levels. The results show a clear trade-off between specialisation and utilization. Based on these findings, we design a minimax regret placement policy, using frequentist, Balke-Pearl and Manski bounds, that lowers mortality without capacity expansion. The policy reallocates patients according to their individualized average treatment effects, showing that data-driven patient placement can improve outcomes by using existing resources more efficiently.

Citation extraction

53
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appendix boundary found by appendix_titled_section at “Appendix” · 96% of the source is main text. Read the extracted text to check this.

Most heavily cited references

The works this paper leans on most, across its whole bibliography — not restricted to papers in our corpus. Ranked by composite intensity, which combines how often a work is mentioned, how many sections mention it, and how much of that falls in the main text rather than the appendix.

ReferenceIntensityMentionsSectionsMain text
1Athey, Susan and Imbens, Guido W (2019) Machine learning methods that economists should know about0.92843100%
2Wager, Stefan and Athey, Susan (2018) Estimation and inference of heterogeneous treatment effects using random forests0.87482100%
3Athey, S. and Imbens, G. W (2016) Recursive Partitioning for Heterogeneous Causal Effects0.73732100%
4Balke, Alexander and Pearl, Judea (1997) Bounds on treatment effects from studies with imperfect compliance0.73732100%
5Manski, Charles F (1990) Nonparametric bounds on treatment effects0.73732100%
6Rubin, Donald B (1974) Estimating causal effects of treatments in randomized and nonrandomized studies.0.73732100%
7Breiman, Leo (2001) Random forests0.58531100%
8Boyle, Justin and Zeitz, Kathryn and Hoffman, Richard and Khanna, Sa… (2013) Probability of severe adverse events as a function of hospital occupancy0.51121100%
9Wise, Jacqui (2015) Cutting medical bed occupancy is linked to reduced patient mortality in UK hospital, study shows0.51121100%
10Abir, Mahshid and Goldstick, Jason and Malsberger, Rosalie and Bauho… (2020) The association between hospital occupancy and mortality among Medicare patients0.51121100%

Showing the top 10 of 53 scored citations.