부산대학교 도서관

In this paper, a new method is presented to study the impacts of telemedicine on the performance of an emergency department in Spain. Spain's Demographics indicate that this country is experiencing population aging, resulting in overcrowding of emergency departments and significant demand on the healthcare system. However, it has been reported that most patients visiting emergency departments are not in an urgent clinical condition, thus they causing hospital overcrowding, high medical expenses, delays in clinical service delivery and low service efficiency for urgent patients who truly need emergency care. Telemedicine and e-health are considered as solutions for remote delivery of health services to care seekers in order to decrease hospital visits for patients who are in less of an emergency condition. In this study, by using detailed computational modeling and clinical data, we have investigated the impacts of telemedicine on the performance of an emergency department through estimations of Length of Stay as a quantitative index for evaluation of quality of service in the emergency department. Specifically, an agent-based modeling and simulation system was developed and used to study the behavior of the emergency department by taking detailed modeling parameters, including varying the number of non-urgent arrivals as a result of telemedicine, into account as inputs of the model. The inputs were provided through collection and analysis of clinical data that enabled us to predict how telemedicine changes emergency department visits. Our results indicated that emergency departments would experience decreases equal to 41.14% in total Length of Stay if eliminating all non-urgent visits and decreases of up to 10.48% if restricting the non-urgent visits. The developed computational tool in this study and the corresponding results obtained can provide decision makers and health care providers with objective information on the impacts of e-health services on the efficiency of emergency department and they can have also implications for care delivery, optimizing resources, planning, and improving the quality of care.