The emergency hierarchical medical system in China: Improving patient waiting times and operation management.

DISCRETE event simulation; COVID-19 pandemic; MEDICAL care wait times; MEDICAL emergencies; RESOURCE allocation

The emergency hierarchical medical system, a multi-hospital collaborative approach, is one of the innovative healthcare management modes in China during the COVID-19 epidemic. This study aims to prove the waiting cost-saving effectiveness of the emergency hierarchical medical system. Two discrete event simulation models based on this system and traditional admission system will be constructed, and the M/M/1 queue structure with outpatient phase and hospitalization phase will be used to calculate the waiting time of those two systems. Furthermore, we do sensitivity analyses of hospital level, in-hospital disease cross-infection, and resource allocation to get the least costly strategy and to provide operational guidance. In the result, based on the regional virtual hospital structure constructed, the emergency hierarchical medical system outperforms the traditional system when the number of infection patients exceeds a threshold. Besides, the rate of in-hospital cross-infection does not affect the cost-saving effectiveness of system, and the centralized hospital should be set considering the hospital service ability. Moreover, given limited medical resources during the epidemic, the resource allocation between hospitals and patients can be optimized to improve the system's cost-saving. [ABSTRACT FROM AUTHOR]

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