Utilizing computer simulation to support public health experts'elicitation : studies on elderly depression and case management
(2014)
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- Public health is confronted with major challenges. Among others, the demographic transition and the rise of chronic diseases drive critical shifts in population epidemiology and healthcare organization. These health-related issues also carry serious economic and social implications, which generate significant political pressure. However, adequate decision-making is hard to inform, as these health matters may prove inherently complex. This complexity arises from the multiple interactions between actors of the health system, leading to unexpected emergent behaviors and system features, which are not always predictable. Appropriate data may also be lacking, as critical factors may remain unobservable or immeasurable. New methodologies are required in public health to account for complexity and cope with data scarcity. To compensate for this lack of data and interpret complex aspects, knowledge elicited from experts may prove to be a valuable source of information. Yet, this material often lacks formalism and generality. The design of simulation models could support expert elicitation, providing a formal language and generalizing insights through the study of multiple scenarios. We illustrate the use of this association by way of two applications, regarding the complex healthcare evaluation and organization of older persons. The first application investigates the influence of late-life events and social supports on elderly depression. Several experts were consulted to describe the role of social support. Multiple scenarios assessed the effects of bereavement, treatment, and socio-economic status on elderly depression. In the second application, a simulation model structures a discussion with experts in the case management of older persons. Resulting insights hint at possible recommendations regarding the organization of elderly case management. The design of computer simulations can help public health experts to articulate complex health state evolution and healthcare organization. The process of building the model can fuel a formal discussion between stakeholders, allowing for participatory research. Resulting simulations can generate diverse scenarios to inform better decision-making, anchored in field reality.
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Chiêm, J.-C. (2014). Utilizing computer simulation to support public health experts’elicitation : studies on elderly depression and case management. https://hdl.handle.net/2078.5/200988