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

TL;DR

This paper introduces SiM-Care, a hybrid agent-based simulation model for primary health care systems, enabling detailed analysis of interactions, resource utilization, and policy impacts amid demographic and workforce challenges.

Contribution

The paper presents a novel hybrid agent-based simulation model, SiM-Care, for detailed primary care system analysis and policy evaluation, addressing complexity and data limitations.

Findings

Model effectively assesses patient waiting times and physician utilization.

Simulation reveals impacts of aging population and physician shortages.

Model supports comparison of different health care infrastructure scenarios.

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 investigate the effects of an aging population, a decrease in the number of physicians, as well as the combined effects.