Simulation in Regional Hospital Planning

Abstract

In the past decades the trend towards urbanization and specialization in physician practices has resulted in serious maldistribution of health care facilities and manpower in favor of the urban areas. Normally, rural areas experience a chronic shortage of health services, largely because of their inability to attract new physicians. Even those who devote themselves to rural practices face great difficulty in delivering quality health services to rural populations because of low population density, poor accessibility to specialists for referral and consultation, lack of linkage to secondary and tertiary hospitals, and absence of paramedical and social services. The health problems of rural areas are further compounded due to dominance of poverty, lack of education, presence of large proportion of elderly population, and vulnerability to natural hazards. Thus, the so called health care crisis prevailing in rural areas today, although complicated by social and economic issues, is an acute reflection of the national problem in health care delivery resulting from fast urbanization of the population, accelerated development in engineering, medicine, and biology, and increased specialization of medical manpower (Stumbo, 1975). By building health care facilities on a satellite basis, installing tele-medical networks, improving utilization of scarce resources of health manpower, campaigning for preventive health care, spreading health care education, providing low cost health insurance coverage, developing HMOs, and/or using other strategies, this problem may be approached (Bandyopadhyay, 1975). However, rural communities should plan together in developing integrated and coordinated health care delivery systems over county or multi-county regions in order to have a population base large enough to support the system (Martin, Rockoff, and Polansky, 1975).