Socio-Econ. Plan. Sci. Vol. IO, pp. 7-15. Pergamon Press 1916.

Printed in Great Britain

SIMULATION OF A BLOOD-INVENTORY-BANK SYSTEM

IN A HOSPITAL

PREM VRAT and A. B. KHAN?

Indian Institute of Technology. Hauz Khas, New Delhi-l 10029 India

(Received 25 March 1975; revised 28 &ly 1975)

Abstract-A blood-bank inventory system has been analysed viewing it as an inventory-bank system where the
demand forecasting forms a part of the inventory model. A simulation model incorporating the “desired-beginning-
inventory-level” policy has been used for the analysis of system-performance. Optimal inventory policy-guidelines
have been suggested for a hospital blood-bank using blood shortage and blood out-dating as the two important
components of the measure of effectiveness. Numerical results have been given.

INTRODUCTION they arise, without increasing the blood expiration on

The desire for healthy living as a result of improved
socio-economic and allied conditions, has tended to
increase the demand on the health services systems. The
hospital systems plays an important role in catering to the
needs of community by providing medical care to the sick
and injured. The need for health care in the community is
virtually unlimited and matching of services with the need
calls for a careful analysis and systematic planning. Blood
bank systems are an important link of the entire
health-care systems and the investigations reported in this
work are aimed at rationalizing the procurement. storage
and issue of blood inventories in the blood bank of a
hospital.
Essentially, blood banks are facilities which procure,
store, process and dispense blood to ensure an adequate
supply of blood for transfusion to the hospital patients.
The inventory problem connected with the blood bank is a
chalIenging problem because of certain special charac-
teristics of the problem and system components.
SPECIFIC ATTRIBUTES OF THE BLOOD
INVENTORY PROBLEM
1. Whole-blood is a perishable commodity. Current
medical practice avoids using whole blood for infusion if
it has been stocked for more than 21 days. This may be
termed as the legal life of blood.
2. Cost of non-availability of the blood, if required is
quite difficult as one hestiates to assign costs to loss of
human life or sufferings caused by postponement of
surgery. Hence cost is not an acceptable criterion of
performance.
3. Available supply is a function of public generosity.
Nearly all blood needs are met through voluntary
donations. Since it is difficult to uniformly motivate
volunteer donars, periods of short supply may be quite
common.
4. A large number of staff involved in the collection and
distribution functions offer challenging control and
motivation problems.
5. The supply of the blood is to be matched with the
type of blood group of the patients requiring it.
6. The demand and supply of the blood is quite random
in nature.
The major inventory problem is to maintain an
adequate supply of blood to meet the needs as soon as
shelf unduly.
The blood bank of a major govemment hospital in
New Delhi was chosen for the study reported in this
paper. The inputs and outputs of the blood bank are
shown in the Fig. 1. The Red-cross, other blood-banks,
random and paid donars supply the blood to the bank
which is received and kept in the unassigned blood cold
storage. The blood units are issued either to the patients
of the hospital or supplied to other hospitals (if it can be
spared) on request. Units beyond 21 days in age are
discarded. The stock from unassigned refrigerator is
shifted to assigned refrigerator where it is stocked after
cross matching with the blood of the receiving patients. In
the assigned refrigerator the blood is kept till the end of
the working day (midnight). If not required by then, it is
cross-matched again and issued to the patient who first
requisitions it.
There are 4 basic types of blood groups, viz. A, B, AB
and 0. They are further sub-divided on the basis of
Rhesus Factor as Rh positive and Rh negative. The
issuing policy is that a patient should get the blood
according to his or her own group. If not available, the
other blood groups can be given on the recommendation
of the treating doctor according to the relationships shown
in Fig. 2. The arrows in this figure point to the groups to
which transfusion is possible after proper cross-matching
is carried out. The female patients with Rh negative can
not be infused with Rh positive blood because of
formation of antibodies.
The present policy is that one of the relatives of the
patient requiring transfusion must donate blood at least
once. The collection of blood is about 250cm’ to which
Other hospitals
Out doted blood

*Present address: C.A.M.S., Cuttack-753007, India. Fig. 1. Hospital blood-inventory-bank system.

SEPS WI.. IO NO. I-B

8 PREM VRAT
50 cm3 of preservatives are added. This 300 cm3 of blood
and preservatives is known as a unit of blood. In case of
shortage either the bank requests other hospitals to help
or tries to collect it from paid donors. Usually difficulties
in Rh negative blood are encountered as it is rare in India.
At present no rational inventory policy is being
followed and every systematic record of collections and
issues are not maintained for scientific planning of blood
inventory. Shortages are quite frequent and the requests
to other hospitals and Red-cross are frequently turned
down. Hence an effort was made in this study to analyse
the inventory system and to formulate rational inventory
policies keeping in mind the uncertainty of the system
exhibited by the variability of demand and supply.
LITTLE SURVEY
In the literature on the analysis of system under
investigation, attempts have been made to justify the rule
of thumb to provide adequate service on one hand and
analysis of highly simplified models of blood bank on the
other. Rockwell et al. [l] have used the fixed lot size and
fixed cycle time inventory policies and analysed effects of
ordering policies on probability of stock-out and
expiration. Elston and Pickrel[Z] have simulated the
system to determine the ordering and usage policies of the
blood bank, assigning only specific transfusions using
FIFO policy. Jennings[3] has stressed that inventory
policy should be examined mainly on the basis of the
effects on shortages and expirations. The model de-
veloped by him has considered shortages and expirations
as the main criteria of effectiveness and has demon-
strated the effect of inventory level on shortages and
out-dating (expiration) with the help of operating charac-
teristic curves. Hurlburt and Jones [4] Silver and Silver [5]
and Sathianatham[6] have also analysed the blood bank
inventory systems. The simulation model developed and
used in this paper aims at investigating the effects of
different inventory levels on the shortages and out-dating
with the help of inventory-bank model concept originated
by Naddor [7].
PROBLEM OVULATION
The basic purpose of analysing the inventory system
was to develop procedures leading to stability in order
schedules and to eliminate extreme fluctuations in
inventory while reducing the risk of shortage and
expiration on the shelf. The inventory policies have been
evaluated with respect to the following parameters:
(i) average inventory level
(ii) average age of blood at the time of infusion
(iii) average number of units short and expired.
SYSTEM COMPONENTS,
VARIABLES AM, PARAMETERS
The entities (components) of the system were:
1. Inputs to the blood bank.
2. Output demands for blood by the physicians.
3. Emergency orders to sources outside the system for
raising the inventory to meet emergency demands.
4. Demand from outside agencies requesting for blood.
The variables associated with the system under study
are:
(a) Size of input to the bank (external, non-
controllable).
(b) Size of demand for blood (external, non
controllable).
and A. B. KHAN
0 -A
,_)
AB
B
Fig. 2. Possiblealternativebloodgroupfor transfusion.
(c) Inventory level (Independent, non-controllable,
external).
(d) Order-size from outsize agencies (dependent, con-
trollably, internal).
The parameters governing the behaviour of the system
are:
1. Probability distribution of input or collection.
2. Probability distribution of output or issues.
3. Level of inventory.
Average age of blood for infusion varies according to
the input and output conditions. Some delay due to
grouping, serological tests and holding the blood in
storage to kill the germs and bacteria always puts a lower
bound on the average age of the blood. Similarly,
mismatching between the time and level of collection and
infusion results in shortages and expirations.
ASSUMPTIONS
The following assumptions have been made for
developing a simulation model for the inventory-bank
system.
1. The data collected over 365 days to compute input
and output distributions truely represent the stable
distributions of the universe in the statistical sense.
2. The request for blood from any outside agency is
not met unless there is any unit which is about to expire due
to storage.
3. The reviewing period of inventory status has been
taken to be 24 hr.
4. When fresh blood is demanded, the collected blood
is immediately sent to the physician. It is excluded from
inventory considerations.
5. For raising the inventory level, the blood can be
obtained fresh through Red-Cross Control Blood Bank or
paid donors can be used for bleeding.
6. Only type-specific group infusions are permitted.
7. Demands not met on any day is given top priority for
consideration on the subsequent day. (This is often true in
case of surgery but not for emergency demands.)
COLLECTION OF DATA
The probability distributions of input (collections) and
output (issues) are relevant for designing the simulation
experiments. The data were collected for more than 365
days to obtain the frequency distribution to the input and
output for each type of blood, for a specified Rh factor.
The blood groups are coded as A, B, AB and 0 each group
further sub-dividing for -ve and +ve Rh factors, thus
making 8 distinct kinds of blood groups.
Tables 1 and 2 give the cumulative probability
distribution for the collections and issues respectively for
A and AB blood groups with Rh + ve. Similar data were
obtained for the other blood groups.
 Simulation of a blood-inventory-bank system in a hospital 9

Table 1. Cumulative probability of collections of blood of various groups and Rh factors

Blood Cumulative prob. for number of units per day

Group 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14

ARh+ 0.06 0.144 0.266 0.394 0.560 0.667 0.761 0.864 0.914 0.948 0.967 0,979 0.986 0.993 1.000
AB Rht 0.255 0.585 0.781 0.903 0.969 0.988 l+OO

Table 2. Cumulative probability of issue of blood of various groups and Rh factors

Blood
Group 0 1 2 3 4 5 6 7 8 9 10 11 12 13

ARh+ 0,046 0,150 0,273 0.454 0.605 0,721 0.807 0.838 0.874 0,960 0,971 0,987 0.995 1~000
AbRh+ 0.268 0,580 0,775 0.920 0.952 0,984 0.996 0.998 1.000

SIMULATION MODEL FOR BLOOD-INVENTORY-BANK

Another important aspect of the computer-simulation
The model used in the analysis of the blood bank is of the inventory-bank system was to initialize the
similar to the “Inventory-bank” model as proposed by conditions for starting the simulation experiment. The
Naddor [8]. The inventory status and replenishment following starting initial conditions have been assumed in
decisions are reviewed every “t” units of time. The value the simulation model:
of “t” in this study has been taken to be 24 hr. Thus the
blood inventory is reviewed daily. The amount re- a=6
plenished at time i raises the available inventory Ai to a S,=S for i=a-M+l,...... a-l
bank Bi. No returns are permitted. The quantity Pi
P,= S for i = a -L,. .. a - 1
ordered for replenishment is defined by
qa-, = (N-L - 1)s
Pi = max (B, - A,, 0). R,m, = s

The notations used in the model are same as used by
Naddor[8] and hence are not included here. The
important parameters that completely define the inven-
tory policy are N, the number of days in a bank, and M,
the number of days immediately preceding ith day. Here
the forecast of the demand is a part of the inventory
system itself. The expected inventory per day (I,),
expected shortages per day (1J expected units re-
plenished per day (I,) and expected units expired on the
shelf per day (L) are dependent controllable parameters
and are functions of the controllable parameters N and M.
The lead-time in this study has been assumed to be
constant and taken to be 3 days as evidenced by the
records available.
Most expressions for II, Iz, I,, I, and the total system
costs are same as derived by Naddor[8] and hence are
omitted in this paper. Simulation approach has been
adopted in this paper in order to find the relationship of
decision variable N and the dependent controllable
parameters II, I>, I,, Id. As shown by Naddor [8], the value
of M does not have a significant effect on the variables,
hence M was fixed and assumed to be M = 3 in the
present study, thus leaving N to be the only decision
variables in the inventory-bank system. Simulation
approach was used for estimating the relevant inventory
parameters outlined above as a function of N. One of the
important aspects of the computer-simulation model
developed were generating the random events pertaining
to the collections of the blood and issues of the blood, the
latter being synonymous to the generation of random
demand. This has been accomplished by making use of
the Monte Carto sampling technique where the cumula-
tive distributions for various blood groups shown in
Tables 1 and 2 have been used for generating the random
events. Computer subroutines were developed for the
generation of random events as shown in the Appendix
giving the computer listing.
The rest of the logic in the simulation model makes use of
the expressions developed by Naddor[8] for the computa-
tion of the dependent parameters I,, 1*, 1, and L. The
system was simulated for various values of the decision
variable N ranging from 1 to 7 days for various blood
groups and Rh factors.
Figure 3 shows the flow diagram of the computer-model
developed for simulating the blood-inventory-bank sys-
tem. The first part of the flow diagram concerns with the
setting up of the initial conditions for starting the
simulation experiment. The computer listing of the
simulation model of the blood-inventory-bank is shown in
the Appendix. The program has a master segment
supported by various sub-routines which are linked up
with the main program according to the logic shown in
Fig. 3.
The computer simulation model developed provided the
relationship of the decision variable N with the average
blood inventory, average age of the blood, percentage
shortages and % blood expirations on the shelf. The curve
relating the % expirations (or blood outdating) with the %
shortages has been termed as the operating characteristic
curve of the inventory system which can give a very
meaningful insight into the operation of the inventory
bank system and help in making the optimal decision
regarding the value of N, since the blood shortage and
blood-outdating are the two important components of the
measure of the effectiveness of the blood-inventory-bank
system.
ANALYSIS OF RESULTS
Table 3 gives the result obtained by simulation of the
blood bank inventory system for various values of N.
Some important observations may be summarised as
follows:
1. For A group with Rh + ve, the average inventory in
the system increases with increase in N. The system is
10 ‘REM VRAT and A. R. KHAN

2. For A, Rh -ve, there is no minimum value of %

shortages and expirations. Same is true for B, and 0 groups
with Rh -ve as can be readily seen by the operating
characteristic curves of Fig. 4.
3. For B, Rh t ve, the system is quite sensitive between
N = 3 to N = 5 and at N = 4, it gives the minimum
shortages as well as expirations. With average age of
blood as 6 days and average inventory level at 3823 units.
IS (DISBAR
4. For AB, Rh + ve, values of N between 4 to 5 will be
quite reasonable from the point of view of shortages as
well as expirations.
5. AB, Rh - ve is not found to be consistent. Since Ab,
Rh - ve is very rare among the AB donors, the collections
were meagre and hence the data collected were probably
insu~cieRt.
6. For 0, Rh + ve, the average inventory tends to rise
rapidly with increase in N and the favourable range of N
is between 3 to 7 days, The optima1 policy is at N = 4
which has no shortages or expirations and the average
inventory will be 26.68 units, with the average age of
blood as 6 days.
CONCLUSIONS
On the basis of the simulation results, it can be seen that
for blood group A, Rh fve, the best policy will be at
N = 4 and this will minimize the percentage shortages as
110 ~I~-IQA~I-II+IR1I-B~
I well as percentage expirations. Similarly, the optimal
policy for other blood groups were obtained. In this
analysis, it was presumed that the cost of expiration and
cost of shortages are two important considerations in the
measure of effectiveness and the cost of inventory was
not as important. However, if the cost data are available,
it is possible to optimize the inventory bank policy by
minimizing the total relevant cost consisting of carrying
inventory, replenishment, shortages and blood expira-
tions, on the basis of the information provided by the
simulation model described above.
As can be readily seen from Table 3, it is easy to find the
optimal policy for the Rh t ve blood groups, but the Rh
- ve blood groups pose some problems as the optimal
solution is not obvious from the results of the simulation.
As can be seen from the Fig. 4, the % expirations wilt
increase for these blood groups if a certain reasonable

K- 1.4
J(K)=J(K)+I(K)

Fig. 3. Flow diagram for computer simulation.

0 1 1
quite sensitive in the range 3-5 for N. As N = 4, there is a
44 48 52 56 60 64 68 72
low probability of shortage and expirations. The %
Percentage expirations of the blood
shortages and expirations are expressed as a % of total
blood handled, annually. Fig. 4. Operating characterstics of Rh - ve bloodgroups.
 Simulation of a blood-inventory-bank system in a hospital

Table 3. Sjmulation results for blood groups A and AB, Rh + ve

No. of days
in the Bank Average Average
(decision inventory age of
Blood variable) level in blood in Per cent Per cent
Group N. units days Shortages expirations

A, Rh+ 1 8.99 6.8 20,82 0.0

2 1404 7.3 2.65 0.0
3 21.49 12.2 0.48 a.0
4 26,53 11.2 0.0 0.0
(optimal
policy)
5 36.44 14.1 o-0 0.23
6 40.22 12-S 0.0 0.65
7 41.20 14‘3 0.0 2.34

AB Rh+ 1 5.83 4.9 18.3 0.17

2 5.57 5.3 13.9 0.0
3 9% 5.4 0.54 1.38
4 12.25 5.6 0,057 142
(near
optimal)
5 14.83 6.9 0.0 2.28
(near
optimal)
6 17.40 7.8 0.0 5.16
7 18.87 8.6 0.0 5.49

level of blood availability is to be ensured. For example;
the expiration for A, Rh - for 6.18% shortage level will be
as high as 69.10% and for B Rh - a 2.18% shortage level
will result in 61.37% blood expiration. The blood
expiration for 2.52% of shortage level was 58.44% in
blood group 0, Rh-ve. This means that the total
operating cost of the blood-inventory-bank system will be
substantially higher in case of negative Rh factors as
compared to positive Rh factors. Thus it is proposed, that
for negative blood groups, the management should keep a
list of potential donors for rare blood groups in order to
meet any emergency situation and aim at a relatively
higher % of shortages at inventory planning level in order
to reduce the blood expirations.
Interestingly, the average age of the blood in all
negative Rh blood groups was constant at 3 days and the
average inventory was not sensitive to the decision
variable h? For example, the average inventory varied
from 2.05 to 2.96 units for B Rh -ve as compared to
18~12-63.48units for B Rh t ve for N ranging from 1 to 7.
Thus, average inventory ~onsjderat~ons hardly should
influence the inventory decisions in these blood groups.
Blood group AB Rh- gave very inconsistent results and
nothing could be said with confidence regarding the
group; except that more data may be collected and a
similar analysis applied to see that a coherent picture of
the system behaviour emerges.
The limitations of the study reported here are that the
possibility of substituting a blood group by some other
permissible blood groups is not examined. For example,
as per Fig. 2 the shortages of blood group AR can be met
by inventories of blood group A, 0 or B. This will make
the model more complex though more realistic. The
proposed recommendations have been submitted to the
Hospital but as yet no feed back is available as to the effect
of changes incorporated. Such information, if available,
could have validated the simulation model substantially.
Thus at this stage the study presented gives only the
findings of a research model for better planning, but its
actual validation in practice and impact on improved
system p~rformation is yet to be seen.
Acknowledgements-Authors thank Prof. T. J. Ramiah of
National Institute of Health Administration and Education for his
valuable assistance in the study undertaken. Thanks are also due
to referees for their useful suggestions regarding the presentation
of this paper.
RF~ERENC~
1. T. H. Rockwell, R. A. Barum and W. C. Gin, Inventory
analysis as applied to hospital whole blood supply and demand,
J. Ind. Engng XIII, 109-W (1962).
2. R. C. Elston and J. C. Pickrel, Guide to inventory levels for a
hospital blood bank determined by electronic computer
simulation, ~ra~s~~~si~~5, 465-470 (1965).
3. J. B. Jennings, An analysis of hospital blo~bank whole blood
inventory control policies, ~~ans~~s~on8, 335-342(1968).
4. E. L. Hurlburt and A, R. Jones, Blood bank inventory control,
Trunsfttsirin 4, 126- 130 f 1964).
5. A. Silver and k\. M, Silver, An empirical system for hospital
blood banks, 1. Am. Hf?sp~~a~ A~soc~ufion38, 56-60 (19641.
6. M. J. Ashok Sath~anatham~ Management TechniqlIes in
hospital, ~~dKstriu1Etzgng Pngmt 7, 43-49 (1972).
7. E. Naddor, Markov chains and simulation in an inventory-bank
system, J. ind. Engag XIV,91-98 (I963).
8. E. Naddor, Inuenlory systems. Wiley, New York (1966).
9. A. B. Khan, Optimal inventory policies in central drugstore and
the blood-bank of a Hospital, unpublished &&Tech. thesis
I.I.T., Delhi (July 1974).

APPE~IX
LIST (LP)
SEND TO (SIMULATION SM22f
L,IBRARY(SUBGROUPSR~t)
12 PREM VRAT and A. B. KHAN

PROGRAM jl3ANK.l
IWUTI = CR0
OUTPUT2 = LPO
END
MASTER BLOODBANKINVENTORYSIMULATION
REAL II,12
REAL Jl,J2
INTEGER SBAR
DIMENSION NAGE (lOO),IS(11OO),IC(11OO)
DIMENSION IQ(llOO),IQi(l1OO)
DIMENSION DISTBO)
DIMENSION COL(&)
DIMENSION IP( I lOO),ISBARjl ~OO),IA~(ilOO),~BA~K(l lOO)IR(llOO)
CO~~~~ON!BLOODl~~A~~,~A,IS,IC.~4
CG~~O;\J(BLGGD2iiQ,IQ‘4,~1,12
CO~MGNiBLG~D3inrST,ND
CO~MG~~BLG~D4~&GL.~C
COMMG~~3LG~D~~A~C~
COMMvroNI3LDOD6iIP,rSBAR,IBI,IBANK,IR
READ (I, 103)STREAM
103 FORMAT(FO,O)
DO 58 JSIM = 1,8
READ (l,lOl)NC,ND
101 FORMAT(210)
READ(1,102)(COL(I),I = l,NC),(DIST(I),I = 1,ND)
102 FORMAT(lOF0,)
READ(l,IOO)SBAR,IA,M,IL,NMAX,IM
100 FORMAT(610)
DO SO I = IA-IL,IA - 1
IP(II = SBAR
50 IC(I)=ct
&AL TIME(S)
WRITE(2,I I il)S
DO 51 I=IA-M+ &IA-.1
51 IS(I) = SB AR
DO 999 J = 1,NMAX
IQA(IA - 1) = SBAR
IR(IA - I) = SBAR
Jl=O
52 = 0
53 = 0
J4 = 0
NA= SBAR
DO 52 II = I,NA
52 NAGE(I1) = 9
AVEA = 9.0
DO 53 I= IA,IA+fM- 1
IF(~A.~Q.~) GO TO 14
CALL ADDl(I)
GO TO 13
14 14=0
13 IF(IQA(I- l),GT.O) IQA(I - 1) = IQA(I- 1) - 14
IA(I) = IQA(I - 1)+ IR(I- 1)
IF(IQA(I- l),LT,O)GOTOIS
15 IF(IQ(I).LT.O)GOTOl6
NA = IQ(I)
AVEA = (AVEA + 3)/2.
GOT0 18
16 NA=O
AVE.4 = (AVEA i- 3)/Z
GO TO 18
17 CALL ADDCOL@f
$8 CALL DEMAND
IQA(I) = rQ@ - K(I)
IF(NA.EQ.0) GO TO 12
CALL ADJUST(I)
AVEA = (AVEA + AiCU)iZ
12 ISBAR(1) = 0
DO54JJ=I-M+l,I
54 ISBAR(1) = ISBAR(1) + IS(JJ)
ISBAR(1) = ISBAR(I)/FLOAT(M) + 0.5
IAI(1) = IQA(1)
DO%JJ=I-IL,I-I
5S IAI(1) = IAI(1) + IP(JJ) + IC(JJ)
 Simulationof a bled-inventory-bank system in a hospital 13

IBANK~) = J*ISBAR(I)
IF(I~(I).LT.lBANK(I))GO TO 10
IP(I) = 0
13=0
GO TO 19
10 IP(1) = IBANK(1) - IAI(1)
13= 1
19 TEST = FLOAT(I)/7.
NTEST = TEST
IF(NTEST.EQ.TEST) GO TO 20
CALL COLLECTION(I)
GO TO 21
20 IC(I)=O
21 IR(IR) = IP(I- 1) + IC(1 - 1)
CALL AVERSHOT(1)
Jl=Jl+Il
J2=J2+12
53 = .I3+ I3
J4=54+14
53 CONTINUE
AVEIl = Jl/IM
AVE12 = 52
AVE13 = FLOAT(J3)/IM
AVE14 = FLOAT(J4)/IM
CALL STAR
WRITE (2,202)M,J,AVEIi,AVEI2,AVEI3,AVEI4
202 FORMAT(SX,‘M = ‘,12,10X,‘N = ‘,12//SX,‘AVG,INVENTORY = ‘,Fl
10.2iiSX:AVG.SHORTAGE = ‘,FlO,2//5X:AVG.REPLENISHMENT = ‘,F
210.2/iSX.‘AVG. EXPIRATION = ‘,F10.2/)
CALL STAR
WRITE(2.203)Jl,J2,J3,J4
203 FORMAT(~~lOX;Jl =‘,El?.ll/lOX:J2= ‘,El7.ll~SOX;l3 =I,
lIlO/lOX;J4 = ‘,110/i)
CALL STAR
WRITE(2,204)AVEA
204 FORMAT(////ZOX,‘****‘,‘AVERAGE AGE = ‘,F10,2X,‘****‘)
CALL STAR
KTOCON = 0
IORD = 0
IDEM = 0
DO 56 I = 6,llOO
IDEM = IDEM + IS(I)
IORD = IORD t IP(1)
56 KTOCON = KTOCON t IR(I)
ADEM = FLOAT(IDEM)/IM
PSHORT = FLOAT(J3)/KTOCON
PEXP = FLOAT(J4)/KTOCON
CALL STAR
WR~E(2,2O~)KTOCON,PSHORT,PEXP
205 FORMAT(2OX~TOTAL UNITS = ‘,110/20X,‘PERCENTAGE SHORTAGE = l’,
E17.1i/ZOX,‘PERCENTAGE EXPIRATION =‘,El?.lll)
WRITE(2,206)IORD,ADEM
206 FORMAT(20X,‘TOTAL UNITS ORDERED = ‘,110//20X,‘AVERAGE DEMAND = l’,F6.2)
999 CONTINUE
CALL TIME(S)
WRITE(2,llll)S
111I FORMAT(ZlX,AS)
58 CONTINUE
STOP
END
SUBROUTINE ADDI
DIMENSION NAGE(l~),IS(ll~),IC(ll~)
COMMON~BLOODi~NAGE,NA,IS.IC,l4
NAE=NA
IF(NA.EQ.0) GO TO 64
DO 60 IAD = 1,NA
60 NAGE(IAD) = NAGE(IAD) + 1
14 = 0
DO 61 IAD = 1,NA
IF(NAGE(IAD) .GE .20) GO TO 62
GdTO61 ’
62 14=14+1
NAE=NAE-I
61 CONTINUE
 14 PREM VRAT and A. 8. KHAN

IF(NAE.EQ. NA)GO TO 64
IF(~AE.EQ. 0)GO TO 65
DO 63 IAD=i,NAE
63 NAGE(IAD)=NAGE(IAD+NA-NAE)
65 NA=NAE
64 RETURN
END
SUBROUTINE ADDCOL(1)
DIMENSION NAGE(lOO),lS(ilOO),IC(llOO)
DIMENSION IP(1100),ISBAR(1100),IAI(1100),IBANK(1100),IR(1100)
COMMON/BLOODl/NAGE,NA,IS,IC,14
COMMON/BLOOD6/IP,ISBAR,IAI,IBANK,IR
IF(IR(I-l).EQ.O) GO TO 81
NC1 = NA f IR(I- 1)
DO 80 JCO = NA t I,NCI
80 NAGE(J~O)=3
NA=NCI
81 RETURN
END
SUBROUTINE DEMAND(I)
DIMENSION NAGE(l00),IS(11OO)IC(1100)
DIMENSION DIST(S0)
COMMON/BLOODl/NAGE,NA,IS,IC,I4
COMMON/BLOOD3/DIST,ND
IZ=FPMCRV(STREAM)*lOOO
RAN=IZ/lOOO.
DO 90JJ= l,ND
IF(RAN,LT.DIST(JJ))GO TO 40
GOT090
40 IS(I)=JJ -1
\ TOT094
90 CON~NUE
94 RETURN
END
SUBROUTINE ADJUST(I)
DIMENSION NAGE(IOO),IS(I100),IC(11OO)
COMMON/BLOODl/NAGE,NA,IS,IC,I4
COMMON/BLOODS/AICU
AICU = 0.0
IF(IS(1) .GT.NA)GO TO 20
IF(IS(1) .EQ.O) GO TO 21
NN = IS(I)
DO 71JAD=l,NN
71 AICU=AICU+NAGE(JAD)
AICU=AICU/NN
NA = NA - IS(I)
DO 70 JAD = I,NA
NAGE~JAD) = NAGE(JAD+ NN)
70 CONTINUE
GO TO 21
20 NN=NA
DO 72 JAD = 1,NN
72 AICU = AICU + NAGE(JAD)
AICU = AICU/NN
NA=O
21 RETURN
END
SUBROUTINE COLLECTION(I)
DIMENSION NAGE(lOO),IS(l lOO),IC(l100)
DIMENSION COL (5)
COMMON/BLOODl/NAGE,NA,iS,IC,I4
COMMON~BLOO~/COL,NC
IZ = FPMCRV(STREM)~l~
RAN = JZ/lOOO.
DO 91 JJ = l,NC
IF(RAN.LT.COL(JJ)) GO TO 41
GO TO 91
41 IO(I) = JJ - 1
GO TO 93
91 CONTINUE
93 RETURN
END
SUBROUTINE AVERSHOT(1)
REAL Il,I2
 Simulationof a blood-inventory-banksystem in a hospital

DIMENSION NAGE (l~),IS(l l~),IC(ll~)

DIMENSION lQ(i i~),IQA(llOO)
COMMON~BLOODl~NAGE,NA,iS,IC,I4
COMMON/BLOOD2/IQ,IQA,II,I2
IF(IQA(1) GE. 0) GO TO 30
IF(IQ(1)GT.O) GO TO 31
11 =o
I2 = -(IQ(I) + IQA(I))/Z
GO TO 32
31 I1 = IQ(I)**2/(2*Is(I))
I2 = IQA(I)**2/(2*IS(I))
GO TO 32
30 I1 = (IQ(I) + IQA(I))/2
I2 = 0
32 RETURN
END
SUBROUTINE STAR
WRITE(2.5~)
500 FORMAT( 1X,119(‘*‘))
RETURN
END
FINISH