Strategic Hospital Runs

Hospital runs are of primary concern in a pandemic and are especially devastating when nonsevere patients crowd out severe ones. We study a rushing game among patients for a given infection pattern and find that hospital crowding out can result from strategic behaviors. Even if immediate treatment is unnecessary, nonsevere patients may nonetheless seek treatment to obtain future priority of treatment in case their condition deteriorates. With SIR (susceptible-infectious-removed) dynamics, runs start long before the capacity is insufficient for severe patients because expecting a run later can trigger earlier runs. The strategic behaviors can even make hospital runs self-fulfilling and make hospital crowding out nonmonotonic in the capacity. However, rushing is not the only problem. Inefficient waiting may also happen as individuals ignore the social cost of future overload. While many health systems prevent hospital crowding out by excluding nonsevere patients, this policy is generally inefficient. We discuss alternative policies.