{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:43:00Z","timestamp":1777902180447,"version":"3.51.4"},"reference-count":96,"publisher":"SAGE Publications","issue":"8-9","license":[{"start":{"date-parts":[[2010,3,8]],"date-time":"2010-03-08T00:00:00Z","timestamp":1268006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SIMULATION"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:p>The problem of emergency department (ED) overcrowding has reached crisis proportions in the last decade. In 2005, the National Academy of Engineering and the Institute of Medicine reported on the important role of simulation as a systems analysis tool that can have an impact on care processes at the care-team, organizational, and environmental levels. Simulation has been widely used to understand causes of ED overcrowding and to test interventions to alleviate its effects. In this paper, we present a systematic review of ED simulation literature from 1970 to 2006 from healthcare, systems engineering, operations research and computer science publication venues. The goals of this review are to highlight the contributions of these simulation studies to our understanding of ED overcrowding and to discuss how simulation can be better used as a tool to address this problem. We found that simulation studies provide important insights into ED overcrowding but they also had major limitations that must be addressed.<\/jats:p>","DOI":"10.1177\/0037549709360912","type":"journal-article","created":{"date-parts":[[2010,3,9]],"date-time":"2010-03-09T00:10:07Z","timestamp":1268093407000},"page":"559-571","source":"Crossref","is-referenced-by-count":127,"title":["A Systematic Review of Simulation Studies Investigating Emergency Department                 Overcrowding"],"prefix":"10.1177","volume":"86","author":[{"given":"Sharoda A.","family":"Paul","sequence":"first","affiliation":[{"name":"College of Information Sciences and Technology, The Pennsylvania State\r                        University, University Park, PA 16802-6823, USA,\r                            spaul@ist.psu.edu"}]},{"given":"Madhu C.","family":"Reddy","sequence":"additional","affiliation":[{"name":"College of Information Sciences and Technology, The Pennsylvania State\r                        University, University Park, PA 16802-6823, USA,\r                            mreddy@ist.psu.edu"}]},{"given":"Christopher J.","family":"DeFlitch","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Penn State Hershey Medical Center, 500\r                        University Drive, Hershey, PA 17033-0850, USA,\r                            cdeflitch@hmc.psu.edu"}]}],"member":"179","published-online":{"date-parts":[[2010,3,8]]},"reference":[{"key":"atypb1","first-page":"145","volume":"13","year":"2004","journal-title":"Annals of Health Law"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1136\/emj.20.5.402"},{"key":"atypb3","volume-title":"Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers","year":"2000"},{"key":"atypb4","volume-title":"Institute of Medicine Committee on the Changing Market and the Future Viability of Safety Net Providers. 2000. America\u2019s Health Care Safety Net: Intact but Endangered"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01115.x"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1287"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.122707"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01280.x"},{"key":"atypb9","volume-title":"Hospital-based Emergency Care: At the Breaking Point","year":"2006"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1136\/emj.20.5.406"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-200295080-00013"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00203.x"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(00)70105-3"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2004.tb00686.x"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2003.302"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2003.07.017"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01117.x"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2003.tb00647.x"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2003.tb00575.x"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2006.tb01001.x"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.9.5.366-a"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2004.02.378"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2006.tb00320.x"},{"key":"atypb24","volume-title":"Proceedings of the Fall Symposium of the American Medical Informatics Association (AMIA 2006)"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.01.017"},{"key":"atypb26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01113.x"},{"key":"atypb27","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.121215"},{"key":"atypb28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2006.00872.x"},{"issue":"1","key":"atypb29","first-page":"40","volume":"19","year":"2004","journal-title":"Healthcare Executive"},{"key":"atypb30","volume-title":"To Err is Human: Building a Safer Health System","year":"2000"},{"key":"atypb31","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","year":"2001"},{"key":"atypb32","volume-title":"Building a Better Delivery System: A New Engineering\/Health Care Partnership","year":"2005"},{"key":"atypb33","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb34","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb35","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb36","unstructured":"Valinsky, D.1975. Simulation. In Shuman, L.J., R.D. Spears Jr., and J.P.\n                    Young, Eds. Operations Research in Health Care: A Critical                     Analysis. Baltimore, MD: John                         Hopkins University Press, pp.                     114-176."},{"key":"atypb37","volume-title":"Introduction to Simulation and SLAM II","year":"1986"},{"key":"atypb38","volume-title":"Simulation Modeling and Analysis","year":"1982"},{"key":"atypb39","volume-title":"Proceedings of the 13th Conference on Winter Simulation"},{"key":"atypb40","volume-title":"Proceedings of the 23rd International Conference of the Systems Dynamics Society"},{"key":"atypb41","volume-title":"Proceedings of the 10th Conference on Winter Simulation"},{"key":"atypb42","volume-title":"Proceedings of the 23rd International Conference of the Systems Dynamics Society"},{"key":"atypb43","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1634953"},{"key":"atypb44","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.15.12.B608"},{"key":"atypb45","first-page":"26","volume":"4","year":"1972","journal-title":"Industrial Engineering"},{"issue":"6","key":"atypb46","first-page":"66","volume":"78","year":"2004","journal-title":"Hospital and Health Networks"},{"key":"atypb47","doi-asserted-by":"publisher","DOI":"10.1080\/07408170590899625"},{"key":"atypb48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2004.tb00702.x"},{"key":"atypb49","volume-title":"Proceedings of the 36th Conference on Winter Simulation"},{"key":"atypb50","volume-title":"Proceedings of FREC SP00-02"},{"key":"atypb51","volume-title":"Proceedings of the 37th Conference on Winter Simulation"},{"key":"atypb52","volume-title":"Proceedings of the 27th Conference on Winter Simulation"},{"key":"atypb53","doi-asserted-by":"publisher","DOI":"10.1108\/01443579310025989"},{"key":"atypb54","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb55","volume-title":"Proceedings of the 34th Conference on Winter Simulation"},{"key":"atypb56","volume-title":"Proceedings of the 28th Conference on Winter Simulation"},{"key":"atypb57","volume-title":"Proceedings of the 19th Conference on Winter Simulation"},{"key":"atypb58","doi-asserted-by":"publisher","DOI":"10.1136\/emj.18.3.190"},{"key":"atypb59","volume-title":"Proceedings of the 31st Conference on Winter Simulation"},{"key":"atypb60","volume-title":"Proceedings of the 21st Conference on Winter Simulation"},{"key":"atypb61","volume-title":"Proceedings of the 25th Conference on Winter Simulation"},{"key":"atypb62","volume-title":"Proceedings of the 24th Conference on Winter Simulation"},{"issue":"9","key":"atypb63","first-page":"518","volume":"51","year":"2000","journal-title":"Journal of the Operations Research Society"},{"key":"atypb64","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb65","volume-title":"Proceedings of the 31st Conference on Winter Simulation"},{"key":"atypb66","volume-title":"Proceedings of the 26th Conference on Winter Simulation"},{"key":"atypb67","volume-title":"Proceedings of the 36th Conference on Winter Simulation"},{"key":"atypb68","volume-title":"Proceedings of the 35th Conference on Winter Simulation"},{"key":"atypb69","volume-title":"Proceedings of the 27th Conference on Winter Simulation"},{"issue":"1","key":"atypb70","first-page":"87","volume":"23","year":"1997","journal-title":"Computer and Industrial Engineering"},{"issue":"2","key":"atypb71","first-page":"35","volume":"24","year":"1992","journal-title":"Industrial Engineering"},{"key":"atypb72","volume-title":"Proceedings of the 7th Conference on Winter Simulation"},{"key":"atypb73","first-page":"263","volume":"34","year":"1996","journal-title":"INFOR"},{"key":"atypb74","volume-title":"IEEE International Conference on Systems, Man, and Cybernetics"},{"key":"atypb75","volume-title":"Proceedings of the 24th Conference on Winter Simulation"},{"key":"atypb76","volume-title":"Operations Research in Health Care: A Critical Analysis","year":"1975"},{"key":"atypb77","doi-asserted-by":"publisher","DOI":"10.1057\/palgrave.jors.2600669"},{"key":"atypb78","volume-title":"Industrial Dynamics","year":"1961"},{"key":"atypb79","volume-title":"Business Dynamics: Systems Thinking and Modeling for a Complex World","year":"2000"},{"key":"atypb80","doi-asserted-by":"publisher","DOI":"10.1108\/01443579310025989"},{"key":"atypb81","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2003.tb01353.x"},{"key":"atypb82","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2007.tb02018.x"},{"key":"atypb83","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2006.tb00985.x"},{"key":"atypb84","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2005.08.019"},{"key":"atypb85","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.08.041"},{"key":"atypb86","doi-asserted-by":"publisher","DOI":"10.5858\/2003-127-0456-IOAPSL"},{"key":"atypb87","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2003.tb00029.x"},{"key":"atypb88","first-page":"8","volume":"31","year":"2000","journal-title":"Decision Line"},{"key":"atypb89","volume-title":"Proceedings of ACM Conference on Computer Supported Cooperative Work (CSCW 2010)"},{"key":"atypb90","volume-title":"Proceedings of the Fall Symposium of the American Medical Informatics Association (AMIA \u201908)"},{"key":"atypb91","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2008.08.003"},{"key":"atypb92","volume-title":"Proceedings of the International ACM SIGGROUP Conference on Supporting Group Work (GROUP 2005)"},{"key":"atypb93","volume-title":"Social Organization of Medical Work","year":"1985"},{"key":"atypb94","volume-title":"Proceedings of the ACM Conference on Computer Supported Cooperative Work (CSCW 2008)"},{"key":"atypb95","volume-title":"Treating Ailing Emergency Departments with Simulation: An Integrated Perspective","year":"2005"},{"key":"atypb96","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.11.027"}],"container-title":["SIMULATION"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0037549709360912","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0037549709360912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:22:15Z","timestamp":1777634535000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0037549709360912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3,8]]},"references-count":96,"journal-issue":{"issue":"8-9","published-print":{"date-parts":[[2010,8]]}},"alternative-id":["10.1177\/0037549709360912"],"URL":"https:\/\/doi.org\/10.1177\/0037549709360912","relation":{},"ISSN":["0037-5497","1741-3133"],"issn-type":[{"value":"0037-5497","type":"print"},{"value":"1741-3133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3,8]]}}}