Benefit System Dynamic

Proceedings of the 2005 Winter Simulation Conference M. E. Kuhl, N. M. Steiger, F. B. Armstrong, and J. A. Joines, eds.

HEALTH SYSTEMS: A DYNAMIC SYSTEM—BENEFITS FROM SYSTEM DYNAMICS Patrick Koelling Michael J. Schwandt Grado Department of Industrial and Systems Engineering 250 Durham Hall Virginia Tech Blacksburg, VA, 24061, U.S.A.

ABSTRACT Operations researchers, industrial engineers, and simulation analysts have applied their knowledge and skills to the health care system for a long time. This complex system needs their help today more than ever. The ever-growing need to understand and improve system performance challenges researchers to apply all the tools at their disposal. One of these tools that is getting increased attention is system thinking, with its application partner system dynamics. This paper presents a glimpse into the system thinking world as it is currently applied in the health care arena, and provides some thoughts on new directions for application. While there are other very useful tools, such as optimization and discrete-event simulation, that are effectively used for health care application, they should not always be the tools of choice, and suggestions are made for when system dynamics may be more appropriate for a particular application. 1 INTRODUCTION

reform and the need for an eclectic approach should be considered. 2 HEALTH SYSTEM MODELING

Health care is a subject that seems to continuously bombard our senses and pervade our culture. The popular media regularly print, say, and show current issues in health care, reiterate the current “crisis” we’re in, argue for or against major change, and fill us with a barrage of data to support or refute one cause or another. It seems the more we “tinker” with the system, the worse the situation gets. The health care system is large and complex, one that does not naturally lend itself to easy analysis, design, or even understanding. The complexity and critical nature of the system beg...