Analyzing national health reform strategies with a dynamic simulation model

Am J Public Health. 2010 May;100(5):811-9. doi: 10.2105/AJPH.2009.174490. Epub 2010 Mar 18.


Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and improving health care quality would likely improve health status but would also raise costs and worsen health inequity, whereas a strategy that also strengthens primary care capacity and emphasizes health protection would improve health status, reduce inequities, and lower costs. A software interface allows diverse stakeholders to interact with the model through a policy simulation game called HealthBound.

MeSH terms

  • Computer Simulation*
  • Health Care Costs
  • Health Care Reform / methods*
  • Health Policy*
  • Health Status Disparities
  • Humans
  • Insurance Coverage
  • Insurance, Health
  • Models, Theoretical*
  • Preventive Medicine
  • Quality of Health Care
  • Reimbursement Mechanisms
  • United States