On the modelling of large-scale health care systems†

Our health care systems are becoming increasingly complex, integrated and therefore unmanageable by traditional methods. Also new methods of health care delivery are subjects of experimentation, especially those methods giving increased emphasis to preventive medicine and primary health care. The need for a systematic approach to planning such systems is augmented by their rapidly escalating operational costs. Mathematical modelling of the system elements' functional properties allows the generation of a macromodel involving the flows of demands and resources, which can be useful for planning purposes over a time span of five to ten years. Computer simulation runs can quickly compare many different strategies for their effect on system performance provided that adequate data are available on the unit cost distributions and effectiveness. The choice of flow parameters is discussed and also the difficult problems of resource allocation and appropriate measures of system performance.