Risk Modeling and Simulation in Service Delivery from Health Systems

Developing effective strategies and policies for continuation of health insurance requires a proper and comprehensive understanding of health insurance system and related risks.The health system, including the most complex systems in terms of design and engineering. These complexity system, in diversity of services, customers and suppliers requires the application of system simulation and modeling in the macro scale. Obviously, this system if the data are sufficient and has a confidence level of simulation accuracy is largely increased.This paper developed main loop causal diagrams of risks affecting health system infrastructures in VENSIM software using systemic approach and semi-structured interview with experts to provide an appropriate background to achieve a better understanding of factors influencing health promotion in developing countries, such as Iran. Then role and function of health insurances and management strategies of potential risks have been provided. Using world health organization systemic framework consisting of six building blocks including service delivery, health workforces, health information, products, vaccines and medical technology, financing, leadership and governance, identified risk sources were classified in 16 groups and effective loops of service delivery block were described. Diagrams developed in this paper can be a great help for researchers, managers, policy-makers and decision-makers to achieve a proper understanding and pathology in order to organize effective policies. The developed conceptual model can be used to create systemic quantitative models in this field.