Modeling and Simulation

Assessment Task 1

Exploring Different Types of Simulation Models

BSCS 3A
Banut, Alliah T.
Belleza, Nicole Alixia J.
Cion, Christine Mae T.
Navarro, Crizien Marnic H.
Abstract

This paper focuses on exploring the different types of simulation models and
identifying the fields that use each model. By exploring the different types, researchers may
be able to choose one simulation model. This paper provides illustrations of potential
situations where Discrete Event Simulation can be applied effectively. This paper provides a
technical discussion of each related study, related studies/literature, and diagrams of Discrete
Event Simulation that can be a guide to writing a write-up of the study.

Introduction

Simulation modeling is a method of resolving real-world problems safely and

effectively. It gives ways of analysis that are simple to verify, discuss, and comprehend.
Simulation modeling delivers valuable solutions across sectors and disciplines by providing
clear insights into complicated systems. Simulation models are classified into four types,
namely, Agent-Based Modeling & Simulation, Discrete-Event Simulation, Monte Carlo/ Risk
Analysis Simulation, and System Dynamics Simulation Solutions. In simple terms, Agent-
based Simulation is any model that examines the impact of an “agent” on the ‘system’ or
‘environment’. The ‘agent’ could be people, equipment, and practically anything else. The
simulation includes the agent’s ‘behavior’, which serves as rules of how those agents must
act in the system. Discrete-Event Simulation is a model that enables you to observe the
specific events that result in your system process. Discrete event models can be used to
examine the technical support process. It can be used to study many types of systems such as
healthcare, manufacturing, etc, and for a diverse range of outcomes. Monte Carlo simulation
is a method of risk analysis. Industry uses it prior to implementing a major project or change
in a process. It is a built-in mathematical model, it uses the empirical data of the real system’s
input and output. Then, it identifies uncertainties and potential risks through probability
distributions. Lastly, System Dynamics Simulation is a very abstract form of simulation
modeling. Unlike other simulation models, system dynamics does not include specific details
about the system. In other words, the priority is to get aggregate-level insights about the
entire system in response to an action.
Each simulation model has its advantages and specific purpose. By exploring all the
simulation models, researchers selected the Discrete-Event Simulation model.
Background

Discrete Event Simulations are often applied to assist with health decision-making, as
well as to categorize the wide spectrum of health-related topics where DES was applied. It is
a computer-based modeling methodology that provides an intuitive and flexible method by
simulating dynamic behaviors of complex systems and interactions between individuals,
populations, and their environments. DES also enables decision-makers to do "what if"
studies by altering operational scenarios and regulations, allowing them to foresee the likely
consequences of several policy options before putting them into practice without affecting
current systems. However, just as the portraits of other modeling techniques show, DES
models are simplified representations of reality.
The goal of this review is to provide an up-to-date overview of a large body of
academic journal literature relevant to the use of DES in healthcare, to have a deeper insight
into the point to which DES has been used to aid in health decision-making and to categorize
the wide range of health-related topics where DES has been used.

Related Literature and Studies

Application of discrete event simulation in health care: a systematic review

According to Huynh N. et., High-level decision support can be provided via DES
models for hospital managers in terms of the diagnosis of system inefficiencies and
evaluation of alternative system configurations. [1] There are also other reasons for DES
being chosen in preference to other alternatives, such as fewer limitations on the number of
events and health states to be represented, higher flexibility, less computing intensity, and
event-based conceptualization attributes. Taken together, DES models have increasingly
considered a more practical and flexible modeling technique in case of complex and dynamic
contexts in health care. [2]

The growing trend of DES applications in healthcare

The last two decades witnessed a noticeable scale of expansion of publications in this
arena as illustrated in Fig. 1, especially after 2010. The number of publications increased
from less than 10 papers annually published before 2010 (except for 2008) to almost 35 in
2016, with 73% of the included papers published after 2010. This indirectly reflects a
constantly rising popularity of DES modeling in health care management.

Figure 1

This systematic review demonstrated the adaptability and new trends of DES models
used to address a wide range of issues confronting health care administrators and
stakeholders. A survey of 211 studies was conducted, and the rapidly growing popularity of
DES in the health care sector may be reflected in the significantly and steadily increasing
number of publications, particularly after 2010. It could be interpreted as evidence that DES
models are becoming more widely used in healthcare management. Yet, this point
necessitates additional information on the value and scope of DES implementations in
realistic healthcare decision-making, which will be one of the focuses of the following
publication.
The Diffusion of Discrete Event Simulation Approaches in Health Care Management in
the Past Four Decades: A Comprehensive Review

According to Karnon J. et., DES has been used in a variety of health care applications.
Most early applications involved analyses of systems with constrained resources, where the
general objective was to improve the delivery service in hospitals, clinics, and pharmacies.
[1] Like other simulation tools, DES has advantages over other techniques due to its
flexibility, ability to handle variability and uncertainty, and dialog interfaces that facilitate
communication among researchers, health professionals, and policymakers.[2] DES has the
capability of modeling complex patient flow through health care clinics. Most importantly, it
facilitates scenario planning by answering “what-if” questions through changing patient flow
patterns and service policies. [3]

Analysis of the Diffusion of DES in Health Research

The Diffusion of DES Publications

As shown in Figure 2, from 1981 through 2014, 483 journal papers have been
published with an average of 14.2 papers per year. In addition to using the yearly number, use
a 3-year period to smooth out the curve. Among all of the retrieved papers, 40 of them are
review papers accounting for 8.3% of the total, in which two types of reviews are presented.
One of them is a review of the DES’s application in different perspectives of health research.
The other is a comparison between DES and other simulation methodologies such as MM,
SD, regression, and DM when evaluating the cost-effectiveness and clinical outcomes of
health care interventions.
 Figure 2

This systematic and comprehensive analysis looked into how adopters, channels,
expanding research topics, and a combination of these factors could help in the spread of
DES in health research. The following are the major results. In the early 1980s, publications
addressing the use of DES in health-related studies began to emerge. Prior to 1994, the field
grew at a slow pace, with a slight increase from 1994 to 2007. The dissemination of DES in
health research was very slow before the early 1990s. We believe there are four possible
reasons for this occurrence. To begin with, like any diffusion process, the early potential
adopters were unfamiliar with the application of this OR simulation method in health
research. Second, potential adopters had trouble programming for the health care issues they
were interested in due to a lack of personal computers (PCs), notably commercial-off-the-
shelf simulation software/platforms, and processing limits. Additionally, the multidisciplinary
requirements of using DES in health research necessitate academics' knowledge and abilities
not only in OR methods and software programming but also in health care systems and
related critical concerns, as well as health service operation management. The third reason
might be a lack of suitable resources. Many established mainstream publications will only
accept a new research paradigm if it is still in its early stages. This prevented the rapid
distribution of DES in health-related studies because of the lack of publicly acknowledged
venues. Lastly, due to the aforementioned difficulties and the limited research experience
using DES in health studies, only a restricted number of study areas in health domains could
be examined. This also halted the spread of DES in health-related studies.
The adopter identifies the author who contributed to creating the retrieved journal
paper. The number of writers who began publishing DES-based articles in health research in
a given year is referred to as annual new adopters. The publication that published DES-based
research in health studies is the channel. The number of journals that began publishing DES-
based papers in health research in a given year is referred to as annual new channels. The
research areas are organized using PubMed's MeSH headings. Some locations are labeled as
various areas because they have distinct features. From 2007 onwards, the number of
publications has exploded. In a typical S-shaped diffusion process, DES diffusion is now at
the stage of rapid development, indicating that this area is likely to remain active in the
future.
In conclusion, the rapid growth in the number of adopters, channels, and research
areas are all working together to propel the industry forward. DES has spread quickly in
health-related studies. Some obstacles remain in the use of DES, however interdisciplinary
and transdisciplinary research is undoubtedly providing solutions to these issues. The
diffusion of DES into the field of health-related studies will continue for many years to come.
 Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review

According to Marshall, D.A. et., As healthcare systems continually evolve, achieving

a better quality of care while reducing costs is a global concern [1]. Thus, strategic, tactical,
and operational decisions are made daily to evaluate and improve the efficiency and
effectiveness of different healthcare processes and services [2]. Simulations can estimate the
consequences of different interventions in healthcare, allowing for the incorporation of
behavioral aspects and personalized decisions [3].

Results

This section is presented through the three taxonomies mentioned before: (1) Review
papers; (2) Theoretical/conceptual papers; and (3) DES application papers. Figure 3 presents
the distribution of publications over the years.

Figure 3

This is reflected in the increasing number of research articles on DES in healthcare.

This study used a descriptive analysis of DES publications in healthcare to identify current
research trends as well as future research directions. The findings indicate that this approach
is commonly used in emergency departments, patient clinical conditions, and medical centers
seeking to allocate resources and improve turnaround times and efficiency.
Conclusion

Articles written in the last two decades that discussed discrete event simulation and
health-related topics in the title, abstract, or keywords were searched for. In addition, the
references of previously published appropriate reviews and most recent studies also were
scanned, and a hand-search of relevant open-access journals was performed to retrieve
additional potential peer-reviewed publications.

In the field of operations research, DES is a powerful tool, but it isn't as widely used
as lean/six sigma and other optimization techniques. Hybrid approaches combine several
techniques to produce a solid analytical approach that corrects DES's flaws. Strategic
alignment and stakeholder behavior, as well as integrated levels, are among them.

Future DES models must take into account two factors: proper and accurate
formulation, as well as the inclusion of healthcare staff behavior. The evaluation of long-term
effects and the publication of successful implementations following DES modeling are key
opportunities that must be addressed in future DES-related healthcare research.
References

4 Types of Simulation Models to Leverage in Your Business, The Leading Types of

Simulation Models
https://mosimtec.com/types-of-simulation-models/

Zhang, X. Application of discrete event simulation in health care: a systematic review.

BMC Health Serv Res 18, 687 (2018).
https://doi.org/10.1186/s12913-018-3456-4

Liu S, Li Y, Triantis KP, Xue H, Wang Y. The Diffusion of Discrete Event Simulation
Approaches in Health Care Management in the Past Four Decades: A Comprehensive
Review.
MDM Policy & Practice. January 2020.
https://doi.org/10.1177/2381468320915242

Vázquez-Serrano JI, Peimbert-García RE, Cárdenas-Barrón LE. Discrete-Event Simulation

Modeling in Healthcare: A Comprehensive Review.
International Journal of Environmental Research and Public Health. 2021; 18(22):12262.
https://doi.org/10.3390/ijerph182212262