School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey 64849, Northeast Nuevo Leon, Mexico.
School of Engineering, Macquarie University, Sydney, NSW 2109, Australia.
Int J Environ Res Public Health. 2021 Nov 22;18(22):12262. doi: 10.3390/ijerph182212262.
Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, approach, healthcare setting, outcome, provenance, and software use. Among the surveys, conceptual/theoretical studies, reviews, and case studies, it was found that almost two-thirds of the theoretical articles discuss models that include DES along with other analytical techniques, such as optimization and lean/six sigma, and one-third of the applications were carried out in more than one healthcare setting, with emergency departments being the most popular. Moreover, half of the applications seek to improve time- and efficiency-related metrics, and one-third of all papers use hybrid models. Finally, the most popular DES software is Arena and Simul8. Overall, there is an increasing trend towards using DES in healthcare to address issues at an operational level, yet less than 10% of DES applications present actual implementations following the modeling stage. Thus, future research should focus on the implementation of the models to assess their impact on healthcare processes, patients, and, possibly, their clinical value. Other areas are DES studies that emphasize their methodological formulation, as well as the development of frameworks for hybrid models.
离散事件模拟(DES)是一种广泛用于解决动态和复杂系统问题的随机建模方法,例如医疗保健。在本次综述中,我们系统性地检索了学术数据库,以确定 231 篇专注于医疗保健领域 DES 建模的论文。这些研究按年份、方法、医疗保健环境、结果、来源和软件使用进行了分类。在调查、概念/理论研究、综述和案例研究中,我们发现,近三分之二的理论文章讨论了包含 DES 以及其他分析技术(如优化和精益/六西格玛)的模型,三分之一的应用在多个医疗保健环境中进行,其中急诊科是最受欢迎的。此外,一半的应用旨在提高与时间和效率相关的指标,三分之一的论文使用混合模型。最后,最受欢迎的 DES 软件是 Arena 和 Simul8。总体而言,在医疗保健领域使用 DES 来解决运营层面的问题呈上升趋势,但不到 10%的 DES 应用在建模阶段之后真正实现了模型的实施。因此,未来的研究应重点关注模型的实施,以评估其对医疗保健流程、患者的影响,以及可能对其临床价值的影响。其他领域是强调 DES 研究方法制定以及混合模型框架开发的研究。