Assessing the value of modelling and simulation in health care: An example based on increasing access to stroke treatment

Abstract

The use of modelling and simulation (M&S) to design, operate, and troubleshoot care delivery processes has not been the subject of economic evaluation, so we undertake such an analysis of a modelling exercise to design better delivery: in this case, stroke care. First, the financial impact is assessed, followed by a cost-effectiveness analysis in which the clinical impact is also assessed. Because it is not usually possible to obtain all the costs of modelling, probabilistic sensitivity and threshold analyses are used to explore the uncertainties in the absence of complete information. Threshold analysis is then applied to calculate the upper bound cost and the level of service improvement that would be needed for M&S to represent good value for money.

Keywords:

• Simulation
• modelling
• economic evaluation
• health technology assessment
• value assessment
• impact analysis

Acknowledgements

We wish to thank Dr Thomas Monk for informal discussions around this work, and Dr Steffen Bayer for pointing us towards a source of stroke data in Scotland. Both are from the University of Southampton. We are also grateful to the editor, for discussions around positioning this paper, to Prof Alec Morton for helpful suggestions, and to the anonymous referees who have helped to sharpen the focus of this paper.