System dynamics applications in healthcare: a literature review

Healthcare simulation allows management to make decisions based on a solid framework. Continuous simulation is the foundation for systems dynamics, an approach to structure problems, understand those complex interactions within these problems and their changes over time. This paper reviews and resumes the state-of-the-art of system dynamics applications in healthcare. There are 74 publications related to system dynamics and healthcare that were identified in academic databases worldwide from 1999 to 2019. These articles were sorted by their characteristics, revealing that the applications of system dynamics have been broadly used in the healthcare to gain understanding about policy planning and public health decisions. The representation of patient behavior and technology advances, and the management of quality, staff and risk, are areas with potential application for systems dynamics in future research. The tendency to use continuous simulation in healthcare has been decreasing since 2014; however, the strength of hybrid simulation could exploit the innate power of the holistic view of system dynamics.