Simulating the financial health system of Health insurance with System dynamics approach

Yousefi Nezhad V (MA), Izadbakhsh H* (PhD), Ghanbar Tehrani N (PhD), Ataeipoor S (MA)

Industrial Engineering Department, Engineering College, Kharazmi University, Tehran, Iran

Original Article

Received: 27 Aug 2015, Accepted: 14 Dec 2015

Abstract

Introduction: The health is one of the main priorities of life which its maintenance and improvement in the social welfare and sustainable development is necessary. Health insurance is one of the ways which people has developed to deal with health care costs. The effective and the efficient use of financial resource is one of the major challenges to achieve the goals of health insurance. The aim of this paper is simulation of the financial system of health insurance according to its resources and uses to predict the health insurance condition in forthcoming years.

Methods: A systematic approach is a formulated method for the analysis of system components with causal relationships and logical infrastructure. Causal loops enable users to easily interact with the system feedback and its main assumptions. In this paper the simulation model of health care financing system and influencing factors using system dynamics approach was designed. In addition to the literature review, the semi-structured interviews were conducted with experts of health insurance, and the factors influencing the financial system were identified, and the causal and stock flow model simulation was implemented using Vensim software.

Results: The results of simulations model revealed that insurance organizations will face with shortage of funding resources in future, and reimbursement of medical expenses indicating a deep financial gap in insurance organization in forthcoming years.

Conclusion: The simulated model resulted from this study could help to the researchers, the managers, the policy-makers and the decision-makers to predict the health insurance funds condition in the future, and make a better decision, assuming consistent current trends.

Key words: System dynamics, Financial systems, Health insurance, Casual loop diagram, Stock flow diagram.

Please cite this article as follows:

Yousefi Nezhad V, Izadbakhsh H, Ghanbar Tehrani N, Ataeipoor S. Simulating the financial health system of Health insurance with System dynamics approach. Hakim Health Sys Res 2016; 18(4): 306- 315.