title: Systems modelling and simulation in health service design, delivery and decision making.
abstract: The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future.
authors.affiliation: NIHR CLAHRC South-West Peninsula, Medical School, University of Exeter, Exeter UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Pitt
authors.affiliation: NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Monks
authors.affiliation: Clinical Operational Research Unit, University College London, London, UK.
authors.forename: Sonya
authors.initials: S
authors.lastname: Crowe
authors.affiliation: CHI, School of Management, University of Bath, Bath, UK.
authors.forename: Christos
authors.initials: C
authors.lastname: Vasilakis
mesh_terms: D057191:Capacity Building / Q000458:organization & administration; D003198:Computer Simulation; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D008962:Models, Theoretical; D009874:Operations Research; D020521:Stroke / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000379:methods
keywords: Healthcare quality improvement; Quality improvement; Quality improvement methodologies