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Optimizing an HIV testing program using a system dynamics model of the continuum of care

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  • Sarah Kok
  • Alexander Rutherford
  • Reka Gustafson
  • Rolando Barrios
  • Julio Montaner
  • Krisztina Vasarhelyi

Abstract

Realizing the full individual and population-wide benefits of antiretroviral therapy for human immunodeficiency virus (HIV) infection requires an efficient mechanism of HIV-related health service delivery. We developed a system dynamics model of the continuum of HIV care in Vancouver, Canada, which reflects key activities and decisions in the delivery of antiretroviral therapy, including HIV testing, linkage to care, and long-term retention in care and treatment. To measure the influence of operational interventions on population health outcomes, we incorporated an HIV transmission component into the model. We determined optimal resource allocations among targeted and routine testing programs to minimize new HIV infections over five years in Vancouver. Simulation scenarios assumed various constraints informed by the local health policy. The project was conducted in close collaboration with the local health care providers, Vancouver Coastal Health Authority and Providence Health Care. Copyright The Author(s) 2015

Suggested Citation

  • Sarah Kok & Alexander Rutherford & Reka Gustafson & Rolando Barrios & Julio Montaner & Krisztina Vasarhelyi, 2015. "Optimizing an HIV testing program using a system dynamics model of the continuum of care," Health Care Management Science, Springer, vol. 18(3), pages 334-362, September.
    • Handle: RePEc:kap:hcarem:v:18:y:2015:i:3:p:334-362
    DOI: 10.1007/s10729-014-9312-0
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    References listed on IDEAS

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    Cited by:

    1. Margaret R Weeks & David W Lounsbury & Jianghong Li & Gary Hirsch & Marcie Berman & Helena D Green & Lucy Rohena & Rosely Gonzalez & Jairo M Montezuma-Rusca & Seja Jackson, 2020. "Simulating system dynamics of the HIV care continuum to achieve treatment as prevention," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-22, March.
    2. Chih‐Tung Hsiao & Chun‐Cheng Chen & Lee‐Kai Lin & Chung‐Shu Liu, 2023. "A systems view of responding to the COVID‐19 pandemic: A causal loop model for Taiwan's approach," Systems Research and Behavioral Science, Wiley Blackwell, vol. 40(1), pages 194-206, January.
    3. 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.
    4. 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.
    5. Mohammad Reza Davahli & Waldemar Karwowski & Redha Taiar, 2020. "A System Dynamics Simulation Applied to Healthcare: A Systematic Review," IJERPH, MDPI, vol. 17(16), pages 1-27, August.

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