Metaheuristics in the decentralization of SAMU bases using simulation in northeastern Brazil

Area of Science:

• Operations Research
• Public Health Management
• Emergency Medical Services

Background:

• Urban population growth increases demand for pre-hospital emergency medical care.
• Traffic accidents, medical emergencies, and disasters necessitate rapid EMS response.
• Optimizing the location of emergency medical service bases is crucial for efficient operations.

Purpose of the Study:

• To determine optimal locations for decentralized Emergency Medical Service (SAMU) dispatch bases in Natal/RN using a dual-standard model (DSM).
• To evaluate ambulance displacement and response times through a simulation study.
• To enhance pre-hospital medical care delivery in response to growing urban demands.

Main Methods:

• A 12-step methodological approach was followed.
• The Dual-Standard Model (DSM) was employed to establish optimal locations for decentralized ambulance dispatch bases.
• A simulation model using FlexSim© software (version 2018) evaluated base coverage against call demand points across various scenarios.

Main Results:

• Redefining decentralized SAMU/Natal ambulance bases is a feasible strategy to decrease emergency response times.
• The study demonstrated a significant reduction in ambulance response times, with some cases showing up to a 60% improvement.
• The optimized locations help ensure compliance with international performance standards, such as the WHO's 8-minute response time guideline.

Conclusions:

• Proposing new locations for SAMU/Natal's decentralized dispatch bases can substantially reduce overall ambulance response times.
• Expedited ambulance response facilitates earlier patient treatment initiation.
• Strategic base placement improves the efficiency and effectiveness of pre-hospital emergency medical care.