Discrete-event simulation modeling in healthcare: a comprehensive review

Jesús Isaac Vázquez-Serrano, Rodrigo E. Peimbert-García*, Leopoldo Eduardo Cárdenas-Barrón

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)
86 Downloads (Pure)


Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, approach, healthcare setting, outcome, provenance, and software use. Among the surveys, conceptual/theoretical studies, reviews, and case studies, it was found that almost two-thirds of the theoretical articles discuss models that include DES along with other analytical techniques, such as optimization and lean/six sigma, and one-third of the applications were carried out in more than one healthcare setting, with emergency departments being the most popular. Moreover, half of the applications seek to improve time-and efficiency-related metrics, and one-third of all papers use hybrid models. Finally, the most popular DES software is Arena and Simul8. Overall, there is an increasing trend towards using DES in healthcare to address issues at an operational level, yet less than 10% of DES applications present actual implementations following the modeling stage. Thus, future research should focus on the implementation of the models to assess their impact on healthcare pro-cesses, patients, and, possibly, their clinical value. Other areas are DES studies that emphasize their methodological formulation, as well as the development of frameworks for hybrid models.

Original languageEnglish
Article number12262
Pages (from-to)1-20
Number of pages20
JournalInternational Journal of Environmental Research and Public Health
Issue number22
Publication statusPublished - 2 Nov 2021

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Discrete-event
  • Healthcare
  • Hospital
  • Literature
  • Modeling
  • Review
  • Simulation


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