The system dynamics approach as a modelling tool for health care

In this dissertation System Dynamics is used as a modelling approach to model health care systems to gain a better understanding of the system’s behaviour. This improved understanding can be used to better manage the system and in turn will translate to improved health outcomes. The characteristics of complex systems were reviewed to define a health system as a complex system. Four appropriate modelling approaches was studied that could be used to model complex systems. These modelling approaches included: Monte Carlo Simulation, Discrete Event Simulation, System Dynamics and Agent Based Modelling. System Dynamics was identified as being the most appropriate modelling methodology to be used for the framework. Before the framework was developed health system performance measurement was reviewed to further the understanding of health system measurement. The framework was developed according to the insights gained from the previous reviews. Specifically the elements identification was customised to the health care environment based on available health indicators. The framework was applied in a case study where a section of the South Africa health care system was modelled to focus interventions for human immunodeficiency virus (HIV). The outcomes of the case studies delivered an increased understanding of the system behaviour and also showed appropriates of the framework.Dissertation (MEng)--University of Pretoria, 2012.Industrial and Systems Engineeringunrestricte

Modelling Social Care Provision in An Agent-Based Framework with Kinship Networks

Current demographic trends in the UK include a fast-growing elderly population and dropping birth rates, and demand for social care amongst the aged is rising. The UK depends on informal social care -- family members or friends providing care -- for some 50\% of care provision. However, lower birth rates and a graying population mean that care availability is becoming a significant problem, causing concern amongst policy-makers that substantial public investment in formal care will be required in decades to come. In this paper we present an agent-based simulation of care provision in the UK, in which individual agents can decide to provide informal care, or pay for private care, for their loved ones. Agents base these decisions on factors including their own health, employment status, financial resources, relationship to the individual in need, and geographical location. Results demonstrate that the model can produce similar patterns of care need and availability as is observed in the real world, despite the model containing minimal empirical data. We propose that our model better captures the complexities of social care provision than other methods, due to the socioeconomic details present and the use of kinship networks to distribute care amongst family members.Comment: 15 pages, 12 figure

Decision makers\u27 experience of participatory dynamic simulation modelling: Methods for public health policy

Background: Systems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings. This paper reports the experience of end-user decision makers, including senior public health policy makers and health service providers, who participated in three participatory simulation modelling for health policy case studies (alcohol related harm, childhood obesity prevention, diabetes in pregnancy), and their perceptions of the value and efficacy of this method in an applied health sector context. Methods: Semi-structured interviews were conducted with end-user participants from three participatory simulation modelling case studies in Australian real-world policy settings. Interviewees were employees of government agencies with jurisdiction over policy and program decisions and were purposively selected to include perspectives at different stages of model development. Results: The ‘co-production’ aspect of the participatory approach was highly valued. It was reported as an essential component of building understanding of the modelling process, and thus trust in the model and its outputs as a decision-support tool. The unique benefits of simulation modelling included its capacity to explore interactions of risk factors and combined interventions, and the impact of scaling up interventions. Participants also valued simulating new interventions prior to implementation in the real world, and the comprehensive mapping of evidence and its gaps to prioritise future research. The participatory aspect of simulation modelling was time and resource intensive and therefore most suited to high priority complex topics with contested options for intervening. Conclusion: These findings highlight the value of a participatory approach to dynamic simulation modelling to support its utility in applied health policy settings

A survey of simulation techniques in commerce and defence

Despite the developments in Modelling and Simulation (M&S) tools and techniques over the past years, there has been a gap in the M&S research and practice in healthcare on developing a toolkit to assist the modellers and simulation practitioners with selecting an appropriate set of techniques. This study is a preliminary step towards this goal. This paper presents some results from a systematic literature survey on applications of M&S in the commerce and defence domains that could inspire some improvements in the healthcare. Interim results show that in the commercial sector Discrete-Event Simulation (DES) has been the most widely used technique with System Dynamics (SD) in second place. However in the defence sector, SD has gained relatively more attention. SD has been found quite useful for qualitative and soft factors analysis. From both the surveys it becomes clear that there is a growing trend towards using hybrid M&S approaches

Reclaiming human machine nature

Extending and modifying his domain of life by artifact production is one of the main characteristics of humankind. From the first hominid, who used a wood stick or a stone for extending his upper limbs and augmenting his gesture strength, to current systems engineers who used technologies for augmenting human cognition, perception and action, extending human body capabilities remains a big issue. From more than fifty years cybernetics, computer and cognitive sciences have imposed only one reductionist model of human machine systems: cognitive systems. Inspired by philosophy, behaviorist psychology and the information treatment metaphor, the cognitive system paradigm requires a function view and a functional analysis in human systems design process. According that design approach, human have been reduced to his metaphysical and functional properties in a new dualism. Human body requirements have been left to physical ergonomics or "physiology". With multidisciplinary convergence, the issues of "human-machine" systems and "human artifacts" evolve. The loss of biological and social boundaries between human organisms and interactive and informational physical artifact questions the current engineering methods and ergonomic design of cognitive systems. New developpment of human machine systems for intensive care, human space activities or bio-engineering sytems requires grounding human systems design on a renewed epistemological framework for future human systems model and evidence based "bio-engineering". In that context, reclaiming human factors, augmented human and human machine nature is a necessityComment: Published in HCI International 2014, Heraklion : Greece (2014