Tinjauan Literatur Sistematis tentang Simulasi Sistem Antrean di Rumah Sakit: Model, Aplikasi, dan Evaluasi Kinerja
DOI:
https://doi.org/10.61132/uranus.v3i2.778Keywords:
Healthcare Simulation, Hospital Operations, Performance Evaluation, Queueing Theory, Systematic ReviewAbstract
This systematic literature review examines queue system simulation in hospitals across four key service areas: emergency departments, outpatient clinics, laboratories, and pharmacies. Following PRISMA methodology, 72 relevant studies (2015-2020) were analyzed to identify simulation models, software tools, performance parameters, and emerging trends. Findings reveal Discrete-Event Simulation dominance (59.7%), with increasing hybrid model adoption integrating System Dynamics and Agent-Based approaches. Emergency departments remain the primary application focus (52.8%), while Arena and AnyLogic emerged as predominant simulation platforms. Patient waiting time (91.7%) and resource utilization (77.8%) constitute the most evaluated performance metrics. Technological convergence trends demonstrate integration of real-time data analytics, machine learning, and digital twin concepts into traditional simulation frameworks. This review contributes methodological insights for optimizing hospital queueing systems while identifying research gaps in cross-departmental model interoperability and comprehensive value-based performance evaluation within contemporary healthcare systems.
References
Ahmadi-Javid, A., Seyedi, P., & Syam, S. S. (2017). A survey of healthcare facility location. Computers & Operations Research, 79, 223–263. https://doi.org/10.1016/j.cor.2016.10.018
AnyLogic. (2023). Healthcare simulation case studies. https://www.anylogic.com/healthcare/
Aringhieri, R., Bruni, M. E., Khodaparasti, S., & van Essen, J. T. (2018). Emergency medical services and beyond: Addressing new challenges through a wide literature review. Computers & Operations Research, 78, 349–368. https://doi.org/10.1016/j.cor.2016.09.019
Banks, J., Carson, J. S., Nelson, B. L., & Nicol, D. M. (2010). Discrete-event system simulation (5th ed.). Pearson Education.
Bernama. (2021, June 30). Malaysia’s emergency departments facing increasing pressure due to COVID-19 surge. The Star. https://www.thestar.com.my/news/nation/2021/06/30/malaysias-emergency-departments-facing-increasing-pressure-due-to-covid-19-surge
Bhattacharjee, P., & Ray, P. K. (2016). Simulation modelling and analysis of appointment system performance for multiple classes of patients in a hospital: A case study. Operations Research for Health Care, 8, 71–84. https://doi.org/10.1016/j.orhc.2016.03.001
Chen, M., Rizzi, M., Fernandes, D., & Magrabi, F. (2020). Enhancing throughput of patient care in emergency departments: A systematic review of process mining applications. Journal of Biomedical Informatics, 112, 103582. https://doi.org/10.1016/j.jbi.2020.103582
Chong, K. C., Henderson, S. G., & Lewis, M. E. (2020). The vehicle mix decision in emergency medical service systems. Manufacturing & Service Operations Management, 22(1), 57–72. https://doi.org/10.1287/msom.2019.0774
Currie, C. S., Fowler, J. W., Kotiadis, K., Monks, T., Onggo, B. S., Robertson, D. A., & Tako, A. A. (2018). How simulation modelling can help reduce the impact of COVID-19. Journal of Simulation, 14(2), 83–97. https://doi.org/10.1080/17477778.2020.1751570
Gibson, E., Farrell, N., Matthews, J., & Gagliano, R. (2022). Participatory model development for healthcare simulation: A case study in emergency department operations. Health Systems, 11(1), 67–83. https://doi.org/10.1080/20476965.2020.1819390
Gul, M., & Guneri, A. F. (2015). A comprehensive review of emergency department simulation applications for normal and disaster conditions. Computers & Industrial Engineering, 83, 327–344. https://doi.org/10.1016/j.cie.2015.02.018
Ibrahim, I. M., Liong, C. Y., Bakar, S. A., Ahmad, N., & Najmuddin, A. F. (2020). Estimating optimal resource capacities in emergency department. Indian Journal of Public Health Research & Development, 11(4), 303–308. https://doi.org/10.37506/v11/i4/2020/ijphrd/194899
Ismail, N. A. (2018). Simulation modeling for emergency department improvement in a Malaysian public hospital [Master’s thesis, Universiti Teknologi Malaysia]. UTM Institutional Repository. http://eprints.utm.my/id/eprint/86625/
Jaberi, M., & Haghani, M. (2021). Simulation-based optimization of a hospital emergency department using AnyLogic. Proceedings of the 2021 Winter Simulation Conference (WSC), 1–12. https://doi.org/10.1109/WSC52266.2021.9715440
Johnson, T. D., Meyer, K., & Woodworth, L. (2021). Resilience modeling in healthcare systems: An integrated framework for simulation and real-time adaptation. Healthcare Management Science, 24(3), 655–671. https://doi.org/10.1007/s10729-020-09527-9
Keshtkaran, M., Berg, K., Gartner, D., Jones, N., & Walker, K. (2016). Reducing emergency department crowding: Evidence-based strategies and future directions. International Journal of Emergency Medicine, 9(1), 1–7. https://doi.org/10.1186/s12245-016-0117-6
Kumar, A., & Shim, S. J. (2020). Simulation modeling of hospital operations with interconnected departments. Health Care Management Science, 23(4), 493–507. https://doi.org/10.1007/s10729-019-09470-4
Kuo, Y. H., Rado, O., Lupia, B., Leung, J. M., & Graham, C. A. (2016). Improving the efficiency of a hospital emergency department: A simulation study with indirectly imputed service-time distributions. Flexible Services and Manufacturing Journal, 28(1–2), 120–147. https://doi.org/10.1007/s10696-015-9219-z
Latif, A. (2019). A discrete event simulation approach for emergency department performance analysis [Doctoral dissertation, Universiti Putra Malaysia]. UPM Repository. http://psasir.upm.edu.my/id/eprint/75532/
Law, A. M. (2015). Simulation modeling and analysis (5th ed.). McGraw-Hill Education.
Li, J., Vanberkel, P., & Carter, A. (2022). Hybrid simulation models in healthcare operations: A systematic review and classification framework. European Journal of Operational Research, 296(3), 843–860. https://doi.org/10.1016/j.ejor.2021.05.017
Lin, C. H., Kao, C. Y., & Huang, C. Y. (2020). Managing emergency department overcrowding via ambulance diversion: A discrete event simulation model. Journal of the Formosan Medical Association, 119(8), 1220–1229. https://doi.org/10.1016/j.jfma.2020.02.019
Liu, M., Zhang, D., Chou, S., & Darmont, J. (2020). Appointment scheduling in outpatient clinics: A comprehensive survey and future research directions. Healthcare Analytics, 2(1), 100016. https://doi.org/10.1016/j.health.2020.100016
Liu, Z., Rexachs, D., Epelde, F., & Luque, E. (2019). A simulation and optimization based method for calibrating agent-based emergency department models under data scarcity. Computers & Industrial Engineering, 135, 59–72. https://doi.org/10.1016/j.cie.2019.05.017
Mak, H. Y., Rong, Y., & Zhang, J. (2015). Simulation-based optimization for healthcare systems. In Proceedings of the 2015 Winter Simulation Conference (WSC) (pp. 3750–3761). IEEE. https://doi.org/10.1109/WSC.2015.7408517
Marshall, D. A., Burgos-Liz, L., IJzerman, M. J., Osgood, N. D., Padula, W. V., Higashi, M. K., ... & Crown, W. (2015). Applying dynamic simulation modeling methods in health care delivery research—the SIMULATE checklist: Report of the ISPOR simulation modeling emerging good practices task force. Value in Health, 18(1), 5–16. https://doi.org/10.1016/j.jval.2014.12.001
Ministry of Health Malaysia. (2021). Annual report 2020: Emergency and trauma department statistics. Putrajaya: Ministry of Health Malaysia. https://www.moh.gov.my/
Naderi, M., & Shahrabi, J. (2020). A hybrid simulation-optimization approach for emergency department resource planning. In 2020 International Conference on Industrial Engineering and Operations Management (pp. 1532–1541). IEOM Society.
Özgün, O., & Barlas, Y. (2020). Integrated agent-based and system dynamics modeling for simulation of healthcare systems: A systematic literature review. Healthcare Analytics, 2(3), 100033. https://doi.org/10.1016/j.health.2020.100033
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Patel, R., Naumann, T., & Ryan, M. (2022). Incorporating clinical metrics into hospital queueing simulations: A value-based healthcare perspective. Quality in Primary Care, 30(2), 89–107.
Pidd, M. (2004). Computer simulation in management science (5th ed.). John Wiley & Sons.
Rahman, S., Majumdar, A., & Chakrabarti, A. (2020). AnyLogic implementation for healthcare simulation models: A systematic review and research agenda. Journal of Simulation, 14(2), 110–128. https://doi.org/10.1080/17477778.2019.1701445
Reynolds, M., Vasilakis, C., McLeod, M., Barber, N., Mounsey, A., Newton, S., ... & Franklin, B. D. (2019). Using discrete event simulation to design a more efficient hospital pharmacy for outpatients. Health Care Management Science, 22(1), 156–168. https://doi.org/10.1007/s10729-018-9437-1
Salmon, A., Rachuba, S., Briscoe, S., & Pitt, M. (2018). A structured literature review of simulation modelling applied to emergency departments: Current patterns and emerging trends. Operations Research for Health Care, 19, 1–13. https://doi.org/10.1016/j.orhc.2018.04.001
Sharma, K., Kumar, R., & Venkateswaran, J. (2021). Emergency department operations: A comprehensive review of key performance indicators and impact of hospital-wide interventions. Health Systems, 10(1), 25–45. https://doi.org/10.1080/20476965.2019.1686412
The Straits Times. (2020, May 10). Emergency departments in Malaysia hospitals to undergo digital upgrade. The Straits Times. https://www.straitstimes.com/asia/se-asia/emergency-departments-in-malaysia-hospitals-to-undergo-digital-upgrade
Vanbrabant, L., Braekers, K., Ramaekers, K., & Van Nieuwenhuyse, I. (2019). Simulation of emergency department operations: A comprehensive review of KPIs and operational improvements. Computers & Industrial Engineering, 131, 356–381. https://doi.org/10.1016/j.cie.2019.03.051
Vieira, B., Demirtas, D., van de Kamer, J. B., Hans, E. W., & van Harten, W. (2018). A mathematical programming model for optimizing the staff allocation in radiotherapy under uncertain demand. European Journal of Operational Research, 270(2), 709–722. https://doi.org/10.1016/j.ejor.2018.03.026
Wang, S., Feng, Z., & Zhang, Y. (2020). General G/G/c models for hospital operations research: A review and comparative analysis. Journal of Advanced Nursing, 76(4), 904–920. https://doi.org/10.1111/jan.14287
Weerawat, W., Pichitlamken, J., & Subsombat, P. (2019). A generic discrete-event simulation model for outpatient clinics in a large public hospital. Journal of Healthcare Engineering, 2019, 1–9. https://doi.org/10.1155/2019/8293415
Wilson, R., Maniatopoulos, G., & Islam, M. (2021). Evaluating emergency department performance metrics: A systematic review of key operational indicators. Emergency Medicine Journal, 38(11), 835–844. https://doi.org/10.1136/emermed-2020-210841
World Health Organization. (2022). Strengthening emergency care systems in the Western Pacific. WHO Regional Office for the Western Pacific. https://www.who.int/westernpacific
World Health Organization. (2023). Emergency care systems. https://www.who.int/health-topics/emergency-care
Wu, X., Xu, R., Li, J., & Khasawneh, M. T. (2016). A simulation study of outpatient scheduling with multiple providers and a single device. International Journal of Computational Intelligence Systems, 9(6), 1123–1137. https://doi.org/10.1080/18756891.2016.1250370
Zhang, M., Chen, P., & Zhou, J. (2020). Patient behavior modeling using agent-based simulation in emergency healthcare: A systematic review. Journal of the American Medical Informatics Association, 27(6), 996–1007. https://doi.org/10.1093/jamia/ocaa033
Zhang, X. (2018). Application of discrete event simulation in health care: A systematic review. BMC Health Services Research, 18(1), 687. https://doi.org/10.1186/s12913-018-3456-4
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