Developing a Health Systems Design Lab in Singapore

Developing a Health Systems
Design Lab in Singapore
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Team Members
• John Ansah, Research Fellow
• Angelique Chan, Associate Professor
• Choy Lye Chei, Research Fellow
• Young Do, Assistant Professor
• Robert Eberlein, Consultant
• Amina Islam, Project Manager
• Carmen Lee, Research Assistant
• Sean Love, Research Assistant
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Team Members
• Rahul Malhotra, Assistant Professor
• David Matchar, Principal Investigator
• Truls Ostybe, Professor
• Nicholas Perkins, Research Associate
• Crystal Riley, Research Assistant
• Yasuhiko Saito, Consultant
• Monika Setia, Research Fellow
• Yuan Tian, Research Associate
• James Thompson, Senior Associate in Research
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Goals
• Establish a capability in a systems modeling
(particularly System Dynamics (SD) modeling)
• Apply SD to key problems in health care to a
population with a rapidly changing
demographic (focusing initially on dementia)
• Develop capacity in Singapore to create and
make effective use of modeling
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Apply SD to key problems in an aging
population
• Develop a deep understanding
– Focused interviews of stakeholders in dementia
care
• Insights
– The general problems are not entirely unique to Singapore
– A fundamental concern is how to meet the needs of
individuals with dependency and chronic conditions
– Data remains sparse
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Foundational efforts
• Model the dynamics of the Singapore
population
– Aging
– Family size
– Dependency (including dementia)
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The Singapore Population Model
BIRTH RATE
BIRTH RATE
MULTIPLIER
measured birth
rate
FRACTION
FEMALE
fecund female
cohort
population shift
AGE SPECIFIC
DEATH RATE
IMMIGRATION OF AGE
GROUP WEIGHT
total immigration of
age group weight
births
Resident
Population
deaths
fraction immigration
of age group
TRANSPOSED
AGE GROUP
fraction immigrating
by age
total immigrating
immigration by
age
emigrating
AGE COHORT
EMIGRATION RATE
deaths grouped
SWITCH OFF
EMIGRATION
resident
population 60 and
over
resident population
grouped
AGE GROUP
family size by age
average family size for
elderly 60 years and
older
AGE OF ELDERLY
birth year
average children
by age
AVERAGE
TOTAL FERTILITY
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Identify an urgent problem related to
service needs, and a policy partner
• The significant problem: long-term care
options for dependent elders
• The policy partner: The Agency for Integrated
Care
– Coordinates the transition from hospital to
community
– Engages in planning and advocacy for service
development
– Collects data on needs, utilization, outcomes
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The Long-term Care Model
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An iterative process
Simulation
Conceptual
model
Consultation
Insights
New data
collection
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Building capacity
• Workshops
– Initially 1-3 day sessions to develop interest and
understanding in systems modeling and its
potential
– This year: team project-based
• Problem formulation
• Tutorials in modeling basics
• Hands-on sessions to translate to application
• 3 month follow on to achieve “closure”
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Ongoing work
• Examination of the dynamic relationship
between capacity in different sectors of the
system (acute hospital, community hospital,
clinics, and private services)
• Focus on using models as a framework for
identifying and evaluating promising strategies
for meeting needs in a way that is sustainable
• Working with colleagues to develop a
community of researchers and stakeholders
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