Prospective healthcare decision-making by combined system dynamics, discrete-event and agent-based simulation

Prospective Health Technology Assessment allows early decision making for innovative health care technologies. The main idea is to combine available domain knowledge with advanced simulation techniques in order to predict the effects of medical products and to find bottlenecks and weaknesses within the health system. In our recent publications a hybrid simulation approach with System Dynamics and Agent-Based Modeling has been presented. Hospital workflows have been modeled by state charts within agent behavioral models and have to be instantiated each time an agent is entering a hospital. This paper presents a mechanism to generate agents dynamically from SD models and extends the previously presented hybrid approach by process-oriented Discrete Event Simulation for hospital modeling. It connects processes to health care institutions and not to persons traversing them. Two extended example case studies show potentials for medical decision making using the three simulation paradigms in a common environment.