Improving health services through computer simulation

One of the major challenges of our health system is the gap between the health care that is possible and the care that is delivered.

The SIMCARE project was set by Dr. Boris Sobolev, a health services researcher at the Centre for Clinical Epidemiology and Evaluation (C2E2) and VCH Research Institute (VCHRI), to evaluate ways to improve the delivery of health services. Funded through a strategic initiative from the Canadian Institutes for Health Research, the ultimate goal of SIMCARE is to inform policy making about the most effective options in health care management.

Using computer simulation, Dr. Sobolev’s team evaluated the effects of proposed changes in managing access to cardiac care before they were put into practice. Simulations assessed alternative policies for patient admittance in hospitals, booking of appointments, capacity planning and waiting list management.

The SIMCARE evaluations confirmed that using a single queue system reduces the number of weeks to clear the list of patients waiting to see a doctor, allowing more patients to get an appointment.  These results have been taken into account for planning a new cardiac service in Kelowna where a central referral system has been set up by a former VCHRI research clinician, Dr. Guy Fradet, also a long-time collaborator in SIMCARE.

Because of constraints on conducting experiments in a patient care setting, empirical research offers limited evidence on how changes in healthcare delivery might affect outcomes of care. Computer simulation of systems’ operations provides a way to understand the effects of proposed policy changes based on current understanding of the system.

The results from SIMCARE have been summarized in two books, Analysis of Waiting-Time Data in Health Services Research and Health Care Evaluation Using Computer Simulation published by Springer. With over 2,200 electronic copies downloaded since 2009, the first title has been met with a warm reception from scholars and professionals around the world. The latter title can serve as a textbook in conducting simulations for policy evaluation.

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