System Dynamics Model for Simulating Patient-Centered Healthcare Management of Chronic Obstructive Pulmonary Disease using implementation of Integrated Scenario based Strategies

In this research work, a Computer Simulation Framework based System Dynamics model of Chronic Obstructive Pulmonary Disease (CSF-SD-COPD model) for patient-centered health care management is designed and developed for strategic management of rate of COPD progression by the implementation of formulated and generated integrated scenario based strategies.  The CSF-SD-COPD model consists of four sub-models: COPD: Undiagnosed and Grade 1 Patient Population (COPD-UG1PP) sub-model, COPD: Grade 2 Patient Population (COPD-G2PP) sub-model, COPD: Grade 3 Patient Population (COPD-G3PP) sub-model, and COPD: Grade 4 Patient Population (COPD-G4PP) sub-model which are based on international guidelines of Global Initiative for Chronic Obstructive Lung Disease (GOLD) and play an important role in improving the strategic health care management and overall quality of life of COPD population in India. Total eight integrated Scenario based Strategies (SS) -- SS-I: Educating GOLD guidelines to Pulmonologist, SS-II: Educating GOLD guidelines to Health Care Physicians and Specialists (HCPS), SS-III: Developing enrichment in consciousness of Pulmonologist for the role of Health Care Physicians and Specialists (HCPS), SS-IV: Health care coordination between Health Care Physicians and Specialists (HCPS) and Pulmonologist, SS-V: Synergism between SS-I and SS-II,  SS-VI: Synergism between SS-I and SS-III,   SS-VII: Synergism between SS-I and SS-IV, and last SS-VIII: Synergism between SS-I, SS-II, SS-III, and SS-IV with ninth Baseline scenario based strategy (SS-Baseline) are formulated, generated and then implemented for strategic management of rate of COPD progression. The developed model is validated, and a sensitivity test is used for the optimum management of the system. The simulation results clearly indicate that the implementation of SS-VIII has all in all the maximum effect on the prevalence of COPD and it increases both “TG-COPD-G2PP” and “TG-COPD-G3PP”, whereas implementation of SS-VI and SS-VII have a maximum effect on reducing the rate of COPD progression from “TG-COPD-G2PP” to “TG-COPD-G3PP” and from “TG-COPD-G3PP” to “TG-COPD-G4PP” respectively when minimum implementation cost is criteria. If implementation cost is not an issue, then implementation of SS-VIII is best from “TG-COPD-G2PP” to “TG-COPD-G3PP” and from “TG-COPD-G3PP” to “TG-COPD-G4PP”.