A review on simulation models applied to emergency medical service operations

• An exhaustive review of simulation models applied to EMS systems is conducted.
• A detailed presentation of the main processes involved in EMS systems is provided.
• Relevant key performance measures used for EMS systems are discussed.
• Existing papers are presented according to the scenarios used to improve EMS.

Emergency medical services (EMS) are public safety systems responsible for the pre-hospital stabilization and transport of seriously injured patients. The goal of such systems is to respond adequately to population calls by providing first aid services and transferring patients, when needed, to the emergency department of the appropriate hospital. In order to achieve this goal, a variety of tools (e.g. simulation, mathematical programming and queuing theory models) have been used to improve the performance of EMS. This paper focuses specifically on computer simulation models used for the analysis and improvement of EMS. In particular, we give a critical overview of the existing international literature on simulation models for EMS by pinpointing the issues considered, the associated modeling assumptions as well as the results obtained. Such a contribution is lacking in the current literature.