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A System Dynamics Approach to Healthcare Infrastructure Changes

Overview
Background
Methods
Results
Sources

Methods

The HealthBound Model

This project extends an analysis of the HealthBound policy simulation model, developed by the Center for Disease Control and Prevention (CDC) to model the United States health care system. The model was designed with input from stakeholders, subject-matter experts, and systems scientists.

This model approximates conditions observed in 2003, the last year for which key data were available. It is based on data from ten national databases and key reference studies. The model does not predict exact forecasts, but offers insight into how the US health care system tends to respond to significant intervention initiatives. The simulation results allow the comparison of broad categories of interventions based on their timing, costs, benefits, and impact on other key areas.

The model includes approximately 850 variables, 200 specified constants, and 9 X-Y lookup functions that capture dynamic relationships within the health care industry. It spans health status, equity, and costs, and it is detailed enough to allow insight into health delivery, financing, and decision making.

modeloverview

Major Causal Pathways in the Model

Main outcome variables are red. Possible areas for policy intervention are brown. Blue arrows indicate increasing effect and green arrows indicate decreasing effect.

Systems Dynamics Modeling

The HealthBound model is developed according to the principles of system dynamics modeling. It focuses on dynamics due to causal relationships between elements in the system and seeks to gain insight about reinforcing and balancing feedback loops. Systems dynamics modeling differentiates itself from other forms of mathematical modeling by including the impacts of accumulations, time delays, resource constraints, and behavioral feedback (Milstein 2010).