Simulation in the health services with an application in hospital waiting lists

A description of simulation methodology has been presented in this thesis with emphasis on the generation of random variables, pseudo-random number generators and variance reduction techniques. Also shown is different applications o-f simulation within the health care services. As an application of health care simulation, we simulated a hospital waiting list model, seen as a queueing process with the arrivals rate equal to the admission rate <p=1>, to show the statistical effect of using a scoring system in the policies of admission. To study the effects in the waiting time the queuening theory concepts could not be applied when p=1, therefore simulation was used as an alternative procedure. From our simulation results, we could find an expression to the expected waiting time for any number of medical priorities defined in the waiting list, and we could develope a procedure to control the standard deviation of the waiting time. In general, the scoring sytem used in our simulation model was very useful to balance the waiting time distribution of those patients selected from a hospital waiting list which shown different levels of urgency for being hospitalized.