https://scholars.lib.ntu.edu.tw/handle/123456789/109686
Title: | MODELING AN EMERGENCY MEDICAL SERVICES SYSTEM USING COMPUTER SIMULATION | Authors: | SU, SYI SHIH, CHUNG-LIANG |
Keywords: | reallocation;computer simulation;emergency medical service;prehospital care;utilization | Issue Date: | 2003 | Journal Volume: | v.73 | Journal Issue: | n.1-3 | Start page/Pages: | 57-72 | Source: | INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS | 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. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/64659 |
Appears in Collections: | 健康政策與管理研究所 |
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