The purpose of this book is to place computer simulation studies
within the paradigm of intervention research that is concerned with
comparing the outcomes of health care delivered under different
policies. This book presents computer simulation as a tool for
testing various policy alternatives that have been developed by
decision-makers within health care systems. This approach differs
from the use of computer simulation in operations research, where
simulation helps determine the configurations of a system that will
allow it to function optimally. Although simulation of health care
processes is not new, few health care systems have used simulations
as a basis for re-engineering the delivery of health services.
There is growing appreciation that the complexity of health care
processes exceeds the capacity of individual disciplines-health
services research, health economics, or operations research-to
guide health care reform. In this book, the authors focus on
bringing the methodological rigor of evaluative research to the
design and analysis of such simulation studies.The book is intended
as a reference for health services researchers. It offers a
comprehensive description of the methodology of conducting
simulation studies in evaluation of service alternatives in
surgical care using discrete-event models, including the steps for
identifying the clinical and managerial activities of the
perioperative process, determining the model requirements,
implementing simulation models, designing simulation experiments
and analyzing the experimental data, and interpreting and reporting
results.The book also offers examples of specific aspects of
conducting simulation experiments: how to determine the number of
runs needed to estimate the effect of implementing a health care
policy; how to allocate the number of runs to study groups in
simulation experiments aiming to evaluate policy or management
alternatives; and how to use statistical analysis to estimate,
interpret, and report effect sizes."
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