Authors: Justus Gallati, Eva Blozik, Corinne Chmiel, Oliver Kessler, Matthias Müller und Matthias Wächter
The Swiss health system is sound, but expensive and the discussion on how to curb rising costs without compromising quality of health care is controversial. This controversy pertains to the definition of an appropriate supply and to the design of adequate policy interventions. To address these issues, needs-based approaches are favored, but to date only few attempts have been made to adopt this approach. We propose and assess a simulation model as an instrument for a needs-based health care planning for an exemplary case. Our study is focused on coronary heart disease in Switzerland, following the patient pathway from the onset of symptoms to diagnostic and therapeutic interventions. We suggest that the proposed model is a valuable framework to explain empirical data and to test hypotheses with regard to potential overuse of diagnostic interventions. Moreover, it provides a generic cohort model structure to analyze a chronic disease in a population, where prognosis depends on age and time since first event (or the onset of the chronic disease). We identify relevant knowledge gaps and present suggestions for further model development.