Analyzing Korean inpatient care supply structure reform strategies with a dynamic simulation model

Abstract

Improving the healthcare delivery system is essential to enhance the sustainability of the national health insurance and ensure the robustness of the system. The purpose of this study is to develop a healthcare delivery system simulation model and utilize it to perform experimental analyses of the policy interventions for improving the system. Through analyzing the key concepts in the literature and consulting with domain experts, the evidence-based inpatient care simulation model was developed for inpatient care system in this study. Further, we figure out how each health reform strategy, which have recently been discussed, improves the quality, inequality, and cost of inpatient care. Our results suggest that strengthening the proportions of severe patients in the tertiary hospital would likely improve the inpatient care quality and the cost, but would also worsen the inequality. On the other hand, the strategy of designating the new tertiary hospital in Gangwon Province would improve the quality and the inequality but would not worsen the cost. This is the first Korean inpatient care simulation study that reflects the disease severity and regional characteristics of the healthcare. Our simulation model can be used to estimate the indirect impact of interventions as well as the direct impact of those on the system, thereby reducing the risk factors of a policy by identifying unintended effects in the course of the experiment result analysis.