Patients, Primary Care, and Policy: Simulation Modeling for Health Care Decision Support

Abstract

Demand for health care is constantly increasing due to the ongoing demographic change, while at the same time health service providers face difficulties in finding skilled personnel. This creates pressure on health care systems around the world, such that the efficient, nationwide provision of primary health care has become one of society's greatest challenges. Due to the complexity of health care systems, unforeseen future events, and a frequent lack of data, analyzing and optimizing the performance of health care systems means tackling a wicked problem. To support this task for primary care, this paper introduces the hybrid agent-based simulation model SiM-Care. SiM-Care models the interactions of patients and primary care physicians on an individual level. By tracking agent interactions, it enables modelers to assess multiple key indicators such as patient waiting times and physician utilization. Based on these indicators, primary care systems can be assessed and compared. Moreover, changes in the infrastructure, patient behavior, and service design can be directly evaluated. To showcase the opportunities offered by SiM-Care and aid model validation, we present a case study for a primary care system in Germany. Specifically, we in-

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“…Although each violation can potentially lead to an avoidable emergency room visit, this is an admittedly good performance of the deterministic solutions. A possible reason for this is the fact that SiM-Care does not feature an infectious model; compare [14]. Thus, the generated realizations do not show the local surges in demand resulting from the outbreak of an infectious disease.…”

“…As empirical data concerning the primary care demand at each demand origin is unavailable, we have to rely on simulation to obtain rough estimates. Specifically, we use the existing model of the considered primary care system in the hybrid agent-based simulation tool SiM-Care [14] to obtain the number of primary care visits q i v ∈ N per demand origin v ∈ V for every week i ∈ {1, . .…”