Projection of health service consumption and patient payment revenues in Central and Eastern European countries using system dynamics modeling

Questions concerning the use of evidence in policy making increasingly attract the interest of both policymakers and researchers. It is broadly recognized that the development of integrated policy frameworks can be facilitated by the use of quantitative analytical methods, such as system modeling, computer simulation, trend analysis, and scenario analysis. Although policy projections based on these methods cannot provide direct solutions to policy problems, they can help to minimize the undesirable effects of a policy choice. This paper presents the concept design of a policy projection tool that estimates the macro-level effects of patient charges. In particular, the paper explores the usefulness of system dynamics modeling for the development of the projection tool. The overall objective of the policy projection tool is to generate evidence relevant for the analysis of patient payment policies. Based on the concept projection tool, a simplified consumption-revenue module is developed for the estimation of the annual health care consumption and the revenue from patient payments during one year. The module is applied to data from six Central and Eastern European countries to test its accuracy. The results from the module testing provide directions for further modeling steps.