A system dynamics model to understand the effects of returning patients toward emergency department density

Abstract

As an integrated unit in the hospital, emergency department (ED) also depends on other unit like labs and wards. Due to this relationship, sometimes problems in ED not only originated from the department itself, but may also come from other units. The complex interactions of patients and resources in the ED are no longer just about clinical and medical issues, but the efficient health delivery and resource management is actually an engineering problem. One possible engineering tool to understand the complex behaviour of the health care system is using computer simulation modelling. This paper presents the development of a system dynamics (SD) simulation model to understand the effect of retreated patients to the ED. SD is used to model the complexity of many relationships in ED admission. The base case result shows that ED admission is also influenced by readmission resulted from non-recovery level after discharged from hospital.