The problem of emergency department overcrowding: Agent-based simulation and test by questionnaire

Abstract

Overcrowding of hospital emergency departments is a recognized public health problem in the United States. This paper develops and simulates a noncooperative game model of emergency department overcrowding. This hypothesis naturally takes the form of an agent-based computer simulation. The predictions of the model are validated by a questionnaire administered to patients with experience in an urban hospital emergency department. These results favor the Nash equilibrium hypothesis, implying that emergency department crowding is the equilibrium of the current state of the U.S. health care system. It is hoped that this paper contributes by 1) improving our understanding of the problem of emergency department overcrowding, and 2) providing an example of the potentiality for questionnaire studies as evidence for agent-based simulation studies. © Springer-Verlag Berlin Heidelberg 2011.