On Calibrating a Microsimulation of Patient Movement Through a Healthcare Network

Hospital admission and discharge dynamics facilitate pathogen transmission among individuals in communities, hospitals, nursing homes, and other healthcare facilities. We developed a microsimulation to simulate this movement, as patients are at increased risk for healthcare-associated infections, antibiotic exposure, and other health complications while admitted to healthcare facilities. Patients can also serve as a source of infection throughout the healthcare network as they move locations. This microsimulation is a base model that can be enhanced with various disease-specific agent-based health modules. We calibrated the model to simulate patient movement in North Carolina, where over 1 million hospital admissions occur annually. Each patient originated from a unique starting location and eventually transferred to another healthcare facility or returned home. Here, we describe our calibration efforts to ensure an accurate patient flow and discuss the necessary steps to replicate this model for other healthcare networks.