Abstract
A simulation model is developed for evaluating recommended changes in the operational configuration of a rural medical care delivery system. The model imitates the processing of patients at a rural clinic staffed by midlevel health personnel and linked by a communications system to supervisory physicians at an urban medical center. An explicit description of the patient-nurse practitioner-physician interactions which are relevant to system performance have been modeled. Simulated results of four experiments reflecting the influence of alternative operational policies are presented in a comparative framework.
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