Survey-based hospital closure estimation using agent-based simulation

In this paper, we employ an agent-based simulation as a tool to estimate the influence of hospital closure to other hospitals in the neighborhood. In Japan, some hospitals managed by local governments face financial difficulties because of the change of medical fees and the increase in the number of aged patients. Although municipal hospitals greatly contributed to maintain Japanese health care, the role of them in the society is now changing since many private hospitals are installed for the society. Some of municipal hospitals have already been closed due to the financial crisis of the local governments that manage them. The closure or degradation of municipal hospitals can be considered in order to balance the budget of the government, however, the influence of the hospital closure to other hospitals in their neighborhood should be carefully concerned in advance. We have developed decision-making rules of citizens to consult their health condition based on the collected survey data. However, we did not consider the selection of the type of hospitals in our previous simulations. In this paper, we employ the probability of the priority of closeness in the decision-making rule. Simulation results show that encouraging citizens to consult nearest practitioners may reduce the total number of patients after a hospital closure.