Abstract
Background: Emerging pandemics can rapidly overwhelm hospital capacity, leading to increased mortality and healthcare costs. Objective: We develop an optimization-based framework that dynamically schedules hospital beds across multiple facilities to minimize total healthcare costs, including patient rejections and logistical expenses, under resource constraints. Methods: The model integrates several real-world flexibilities: standard hospital beds, buffer capacity from non-pandemic wards, in situ field hospitals, and inter-hospital patient transfers. To capture demand uncertainty, we link the model with an SEIRD epidemic forecasting approach and further extend it with a robust optimization variant that safeguards against worst-case surges. Recognizing computational challenges, we reformulate the problem to significantly reduce solution times and derive structural properties that provide guidance on when to open field hospitals, allocate buffer beds, and prioritize patients across facilities. Results: A case study based on COVID-19 data from Northern Virginia shows that the proposed framework reduces healthcare costs by more than 50% compared with current practice, mainly by lowering patient rejection rates. Conclusions: These results highlight the value of combining epidemic forecasting with prescriptive optimization to improve resilience and inform healthcare policy during crises.