MODELING AN EMERGENCY MEDICAL SERVICES SYSTEM USING COMPUTER SIMULATION
Resource
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS v.73 n.1-3 pp.57~72
Journal
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
Journal Volume
v.73
Journal Issue
n.1-3
Pages
57-72
Date Issued
2003
Date
2003
Author(s)
SU, SYI
SHIH, CHUNG-LIANG
Abstract
Study objectives: In the emergency medical services (EMS) system, appropriate prehospital care can substantially decrease casualty mortality and morbidity. This study designed a simulation model, evaluated the existing EMS system, and suggested improvements. Methods: The study focused on 23 networked EMS hospitals affiliated with 36 emergency response units (subgroups) to perform two-tier rescues (advanced life support [ALS] in addition to basic life support [BLS] services) in Taipei, Taiwan. Using the existing EMS model as a base, this research constructed a computer simulation model and explored several model alternatives to achieve the study's objectives. The virtual models varied with staffing Level, number of assigned emergency network hospitals, and various two-tier rescue probabilities. Results: Increasing the staffing to two teams for Hospital 22 lessened the call waiting probability ( delay between rescue call and ambulance dispatch) by 50%, even if the dispatch rate of the two-tier rescue increased from the empirical 2% to a simulated 10 and 20%. Changing the two-tier rescue pattern so each EMS subgroup cooperated with two specific, preassigned network hospitals towered the probability of patients having to wait for rescue dispatch to under 1%. Conclusion: The following alternatives provided the greatest combination of effectiveness, quality patient care, and cost-efficiency: (1) because of its unique location, increase Hospital 22's staffing level to two ALS teams. (2) Establish a specific rescue protocol for the two- tier system that preassigns two network hospitals to each of the 36 EMS subgroups along with a prearranged calling sequence. If implemented, this will improve EMS performance, streamline the system, reduce randomness, and enhance efficiency. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
Subjects
reallocation
computer simulation
emergency medical service
prehospital care
utilization
Type
journal article
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