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Most of the studies dealing with the increasing and well-known problem ofEmergency Department (ED) overcrowding usually mainly focus on modeling thepatient flow within a single ED, without considering the possibilities offeredby the cooperation among EDs. Instead, it is important to analyze theovercrowding phenomenon considering an ED network rather than a single ED. Inthis paper, the Simulation-Based Optimization approach is adopted for studyingan ED network under different conditions, by means of Discrete Event Simulationmodels. In particular we consider the so called Ambulance Diversion problem,analyzing different diversion policies. Such models are carried out from realdata collected from six big EDs in the Lazio region of Italy. The aim is tooptimize the performances of the entire network, in order to provide the bestservice to the patients without sustaining too high costs. The obtainedexperimental results show which are the best diversion policies both in termsof patient waiting time and costs for the service providers.

A Simulation-Based Optimization approach for analyzing the ambulance diversion phenomenon in an Emergency Department network