Improving Overcrowding in Outpatient Departments of Old Hospitals: A Case Study in Beijing.

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Research ObjectiveThis study addresses the issue of excessive overcrowding in outpatient departments of old large tertiary hospitals in China and proposes a spatial optimization framework to improve patient experience and enhance hospital operational efficiency.Research BackgroundExisting research mainly focuses on emergency and inpatient departments, with limited attention to outpatient spaces. From the perspective of environmental behavior studies, this research proposes the "Traffic-Stay Dual Adaptation Model" to evaluate how spatial layout affects patient behavior and attempts to address overcrowding during the normal operation of outpatient departments.Research MethodsUsing Structural Equation Modeling (SEM) and Agent-Based Modeling (ABM), surveys were conducted in two hospitals in Beijing. Six behavioral dimensions were analyzed-comfort, service accessibility, safety, orientation, fluency, and accessibility. Outpatient spatial optimization strategies were proposed, and ABM simulations were conducted using AnyLogic to visualize and validate the effects of the strategies.Research ResultsThe SEM results show a significant positive correlation between traffic adaptability and stay adaptability (β = 0.91). Optimization strategies include adopting outer-corridor layouts, expanding public areas, improving patient flow, and adjusting spatial boundaries. Simulation results show that these measures effectively reduce spatial density and stress density. Hospitals with networked layouts have greater potential for optimization.Research ConclusionThe Dual Adaptation Model proposed in this study can effectively balance spatial fluidity and comfort, alleviating outpatient overcrowding. The findings offer practical guidance for outpatient space optimization, enhancing hospital efficiency and improving patient experiences.