Modelling and simulation of patients' access to healthcare system in South Africa clinic

Purpose Patient access to healthcare is a critical determinant of population health in South Africa, yet inefficiencies such as long waiting times and poor resource allocation often limit timely care. This study aims to model and simulate patient access to a South African clinic in order to better understand system behaviour and identify strategies to improve access and efficiency. Design/methodology/approach The study employs discrete event simulation (DES) to model patient flow through key stages of care, from arrival to consultation and treatment. The simulation was developed using data assumptions, personal experience and direct inspection of clinic activities. Key factors examined include the number of consultation rooms, staffing levels and working hours. Model verification and validation were achieved by comparing the conceptual model with the computerized simulation model. Input–output analysis and experimental scenarios were conducted to assess system performance. Findings The results indicate that patient arrival times are almost evenly distributed, while output measures exhibit negative skewness, suggesting that patients often receive limited or insufficient care. The simulation shows minimal patient refusal, largely because only stochastic arrivals were modelled. The analysis highlights bottlenecks related to resource constraints and demonstrates how changes in staffing and operational hours can influence waiting times and resource utilization. Originality/value This study demonstrates the value of DES as a decision-support tool for analysing patient access in resource-constrained healthcare settings. It provides actionable insights for policymakers and healthcare managers seeking to optimize clinic operations and improve patient access in South Africa.