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With the current economic situation the problem is even more exacerbated. For way too long, this has been largely ignored by many key people and organizations in USA. Obviously, there are many reasons for the escalating costs. Some notable ones are a insured patients utilizing the resources more often than needed; b insured patients not utilizing the resources at the right time or in a preventive way leading to more care down the road; c uninsured patients utilizing the resources; and d making everyone insured.

Hence, insured people as well as the governmental both local and federal agencies have been putting up the bill on the uninsured. While some uninsured are due to their own choice, majority of them cannot afford to pay for their insurance.

Simulation Modelling Practice and Theory

On the other hand, HCS in USA has so much waste [12,13] that a small percentage of the savings will pay for the costs associated with the uninsured patients. The functioning of the systems such as circulatory, endocrine, skeletal system, muscular, respiratory, digestive, nervous, and immune is very critical to the welfare of a human being. Each of these systems consists of major parts whose functioning is critical to keep the human body working like a machine.

A degradation leads to poor quality of life and eventually to the failure i. Thus, to some extent one can view a human as a machine with many complex systems and components. While some components self correct, some need constant maintenance. Malfunctioning or failed components require the attention of resources such as doctors, hospitals, labs, etc.

The amount of resources and their optimal allocation are very crucial for any HCS to sustain its operation and existence. Some of these are similar to production and manufacturing systems which rely mainly on concepts and tools from queueing theory.

Hence the complexities in a HCS provide challenging and interesting opportunities for operations researchers from both theoretical and practical points of view.

We refer the reader to the paper by Rais and Viana [11] for a survey of operations research in healthcare. We refer the reader to the handbook by Brandeau et al. This paper is an attempt to look at this from the point of view of an individual system rather than from queuing theory point of view i.

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The paper is organized as follows. In Section 2 we describe the model under study.


In Section 3 we simulate the model under study, and some concluding remarks including future work are given in Section 4. Model description We look at a human as a reliability system or a machine with, say K subsystems that are subject to extraneous shocks. Henceforth, we will refer to this as a system with K subsystems.

A pictorial representation of the model under study is displayed in Fig. The human picture was taken from Ref. We also assume that these K MAPs are independent of each other.

Note that the Markov chain can go from state j to state k only through Fig. Pictorial description of the model under study. Hence, we see that D0 is a stable matrix. Thus, D0 governs the transitions corresponding to no arrival and D1 governs those corresponding to an arrival.

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That is, p is the unique positive probability vector satisfying. For further details on MAP and their usefulness in stochastic modelling, we refer to [6,8—10] and for a review and recent work on MAP we refer the reader to [3,4].

Note that if the subsystem i is under maintenance, then the shocks will have no impact at all. When the shock has an impact we need to know the intensity level of the shock.

Further, we need to keep track of the cumulative impact of the shocks on the subsystem i since the subsystem may request for preventive maintenance or fail depending on whether the total accumulated damage exceeds certain lower and upper thresholds. We assume that the shock intensity level, X ij , of the jth shock of Type i is a random variable, and that the sequence fX ij g is an i.

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Call for Papers. Special Issues. Special issues published in Simulation Modelling Practice and Theory.Moreover, an accurate and relatively fast method to evaluate such large scale computing systems is needed. The Journal of Simulation presents theoretical papers that range across the entire simulation process, including modeling and analysis methodologies. For way too long, this has been largely ignored by many key people and organizations in USA.

This includes Jr. Policies and Guidelines. Healthcare system is currently getting a lot of attention due to escalating costs and the constant increase in the number of people requiring healthcare. A translator, editor, producer, and inventor are a few examples.