An agent-based simulation model for assessment of prehospital triage policies concerning destination of stroke patients

Stroke is a life threatening medical condition that is caused either by a blood clot or a bleeding inside the brain. It is generally agreed that immediate treatment of stroke patients is crucial for their ability to recover; however, before treatment can be initiated, the stroke patient has to be diagnosed using, for example, a computed tomography scan of the brain. This, in turn, requires that the patient is transported to a hospital for diagnosis, which is a procedure that consumes valuable time and resources. In the current paper, we present an agent-based simulation model for assessment of logistical stroke patient triage policies. Using a population of stroke patients as input, the model enables to simulate the activities and the main decisions involved in the logistical operations of stroke patients. In an experimental study covering the southernmost part of Sweden, we used the simulation model in order to assess two different policies regarding where to send patients for diagnosis; the nearest hospital policy and the nearest hospital towards the stroke center policy. Our simulation results show that the patients in need of special treatment favor from being transported in direction towards the stroke center, whereas the patients who are not in need of specialist treatment favor from being sent to the closest hospital