Health systems simulation

Most problems arising from the operation of the health system are studied and addressed using conventional reductionist methods, which reduce, isolate, and freeze aspects of the system at a given time. This fails to deal with the dynamic complexity inherent in the health system and which is often the source of the problem. The result is that all too often, well intentioned interventions make the original problem worse by failing to fully understand the complexities involved in the origin of a problem (Sterman, 2000). In this article, we introduce system simulation as a means of exposing the underlying causes and systemic structures of problems within the health care system, as well as providing a tool for assessing the likely impact of new interventions. The following sections will examine the advantages of simulation, areas of application, how simulation experiments can overcome some of the limitations of randomised control trials (RCTs), and various simulation methodologies as well as the challenges of conducting simulation experiments.