Tutorial on the simulation of healthcare systems

For a variety of reasons, simulation has enjoyed widespread application in health care and health care delivery systems. Although the dominant modeling methodology is discrete event simulation, numerous studies employ system dynamics, agent-based simulation, and hybrid/combined methods. Software has been increasingly adapted to health care through enhanced visualizations and modeling. Virtually every health care environment has been studied using simulation including hospitals, extended care, rehabilitation, specialty care, long-term care, public health, among others. Frequent problems are patient flow, staffing, works schedules, facilities capacity and design, admissions/scheduling, appointments, logistics, and planning. Health care problems are especially complicated by the fact that “people serve people,” meaning people are both the customer and the supply. The customers arrive through a complex decision process that produces uncertain demand. The response is an even more complex organization of health care resources, each of which play a distinctive and overlapping role, providing a unique simulation challenge.