Abstract for: Simulating Patient Outmigration Based on Regional-level Healthcare Quality: An Agent-based Modeling Approach

Patient outmigration in South Korea poses serious problems to the health system. Defined as patients in provincial areas bypassing local hospitals in favor of hospitals located in the capital city Seoul, outmigration is a result of complex and heterogeneous patient behaviors. In this work, we adopted an agent-based modeling (ABM) approach to examine the mechanism of such phenomenon. Using NetLogo, we modeled the process of quality evaluation and dynamic interactions within the health system - particularly between patients and the regional health system - using mathematical equations. We performed hypothetical policy simulations according to changes in quality-related parameters. Outmigration was mitigated with increased level of regional quality, decreased quality gap between regions, and increased number of provincial hospitals. The model and simulation results reflect the heterogeneous, nonlinear, and emergent properties of complex adaptive systems. We further plan to develop the model based on real-world data and to perform more sophisticated simulations.