Ambulatory Healthcare Utilization in the United States : A System Dynamics Approach

Ambulatory health care needs within the United States are served by a wide range of hosp~als, clinics, and private practices. The Emergency Depa rtment (ED) functions as an important point of supply for ambulatory healthcare services. Growth in our aging populations as well as changes stemming from broader healthcare reform are expected to continue trend in congestion and increasing demand for ED services. VVhUe congestion is, in part, a manirestation of unmatched demand , the state of the alignment between the demand for, and supply of, emergency department services affects quatity of care and profitabUrty. The central focus of this research is to provide an eKplication of the salient factors at play within the dynamic demand-supply tensions wrthin which ambulatory care is provided within an Emergency Department. A System Dynamics (SO) simulation model is used to capture the compleKities among the intricate balance and conditional effects at play within the demand-supply emergency department environment. Conceptual clarification of the forces driving the elements within the system , quantifying these elements, and empirically capturing the interaction among these elements provides actionable knowledge for operational and strategic