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A system dynamics approach to planning and evaluating interventions for chronic disease management

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  • Hyojung Kang
  • Harriet Black Nembhard
  • Nasrollah Ghahramani
  • William Curry

Abstract

Studies have been reported on the applications of systems science to chronic disease management, but few, if any, have concentrated on chronic kidney disease (CKD). We examined the impact of a system dynamics approach to the evaluation of interventions in care of patients with CKD. We developed a stock flow simulation model and a multi-objective goal programming model. After calibrating the model, eight scenarios were analysed to measure intervention effects. Physician education (PE) had the most significant impact on reducing disease progression rate (DPR) from Stage 3 to Stage 4, while care coordination had a substantial impact on decreasing DPR Stage 4 to Stage 5. The addition of either CME or primary care team building to PE led to significant reductions in DPR for patients with Stage 3 CKD. The goal programming model indicated that a growing number of primary care physicians and care managers are needed to manage CKD patients overtime. This study showed that the stock flow model is a potentially powerful tool for supporting informed decision-making for planning and implementing interventions at various phases.

Suggested Citation

  • Hyojung Kang & Harriet Black Nembhard & Nasrollah Ghahramani & William Curry, 2018. "A system dynamics approach to planning and evaluating interventions for chronic disease management," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 69(7), pages 987-1005, July.
  • Handle: RePEc:taf:tjorxx:v:69:y:2018:i:7:p:987-1005
    DOI: 10.1057/s41274-017-0279-3
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    Cited by:

    1. Özge Karanfil & Niyousha Hosseinichimeh & Jim Duggan, 2020. "System dynamics and bio‐medical modeling," System Dynamics Review, System Dynamics Society, vol. 36(4), pages 389-396, October.
    2. Chih‐Tung Hsiao & Chun‐Cheng Chen & Lee‐Kai Lin & Chung‐Shu Liu, 2023. "A systems view of responding to the COVID‐19 pandemic: A causal loop model for Taiwan's approach," Systems Research and Behavioral Science, Wiley Blackwell, vol. 40(1), pages 194-206, January.
    3. Negar Darabi & Niyousha Hosseinichimeh, 2020. "System dynamics modeling in health and medicine: a systematic literature review," System Dynamics Review, System Dynamics Society, vol. 36(1), pages 29-73, January.
    4. Edward G. Anderson & David R. Keith & Jose Lopez, 2023. "Opportunities for system dynamics research in operations management for public policy," Production and Operations Management, Production and Operations Management Society, vol. 32(6), pages 1895-1920, June.
    5. Mohammad Reza Davahli & Waldemar Karwowski & Redha Taiar, 2020. "A System Dynamics Simulation Applied to Healthcare: A Systematic Review," IJERPH, MDPI, vol. 17(16), pages 1-27, August.

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