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Analyzing national health reform strategies with a dynamic simulation model

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  • Milstein, B.
  • Homer, J.
  • Hirsch, G.

Abstract

Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and improving health care quality would likely improve health status but would also raise costs and worsen health inequity, whereas a strategy that also strengthens primary care capacity and emphasizes health protection would improve health status, reduce inequities, and lower costs. A software interface allows diverse stakeholders to interact with the model through a policy simulation game called HealthBound.

Suggested Citation

  • Milstein, B. & Homer, J. & Hirsch, G., 2010. "Analyzing national health reform strategies with a dynamic simulation model," American Journal of Public Health, American Public Health Association, vol. 100(5), pages 811-819.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.174490_8
    DOI: 10.2105/AJPH.2009.174490
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    Cited by:

    1. Mohammad S. Jalali & Hazhir Rahmandad & Sally Lawrence Bullock & Alice Ammerman, 2017. "Dynamics of Implementation and Maintenance of Organizational Health Interventions," IJERPH, MDPI, vol. 14(8), pages 1-24, August.
    2. Negar Darabi & Niyousha Hosseinichimeh, 2020. "System dynamics modeling in health and medicine: a systematic literature review," System Dynamics Review, System Dynamics Society, vol. 36(1), pages 29-73, January.
    3. Wayne Wakeland & Alexandra Nielsen & Teresa D. Schmidt, 2016. "Gaining Policy Insight with a System Dynamics Model of Pain Medicine Prescribing, Diversion and Abuse," Systems Research and Behavioral Science, Wiley Blackwell, vol. 33(3), pages 400-412, May.
    4. Mahamoud, Aziza & Roche, Brenda & Homer, Jack, 2013. "Modelling the social determinants of health and simulating short-term and long-term intervention impacts for the city of Toronto, Canada," Social Science & Medicine, Elsevier, vol. 93(C), pages 247-255.
    5. Chang, Angela Y. & Ogbuoji, Osondu & Atun, Rifat & Verguet, Stéphane, 2017. "Dynamic modeling approaches to characterize the functioning of health systems: A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 194(C), pages 160-167.

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