System Dynamics Modeling And Simulation Study On The Contributing Factors And Prediction Of Total Health Expenditure

Objectives1.To analyze the changing trend and influencing factors of total health expenditure in China,and provides foundations for the establishment of total health expenditure forecasting model in China.2.The present study discussed the application of Rate Variable Fundamental Intree System Dynamics method in the construction of forecasting model of total health expenditure,provided basis for reasonable forecast of total health expenditure,and provided new ideas for controlling unreasonable growth of total health expenditure.3.The present study is aim to construct a predictive model suitable for the development trend of total health expenditure in China,to provide the basis for controlling the excessive growth of total health expenditure.MethodsOn the basis of the literature review,the present study clarified the main factors affecting the total health expenditure via brainstorming,the Delphi expert consultation method and focus group discussion method.The researcher established the system dynamic model though Rate Variable Fundamental In-tree Modelling method,including the main contributing factors.The present study explored the structure model of the dynamic flow diagram of the total health expenditure system and simulated the development trend of the total health expenditure and its main contributing factors.This study mainly used the Vensim software to conduct the system dynamic feedback complex analyses,model construction and the simulation.Results1.We identified the influencing factors of total health expenditure via the Delphi expert consultation method.The main influencing factors included the number of population,the number of elderly population,GDP,governmental health expenditure,the number of health technicians per thousand,and the cost of medicine.2.The System Dynamics model is established via Rate Variable Fundamental Intree Modeling method.The year 2001,2001-2016,and 2017-2025 was taken as the initiate year,historical period and predicted period in the System Dynamic model respectively.Time step was 1 year.Based on the data in 2001,the researcher predicted the development trend of all variables in 2002-2025.3.The analyses of the simulation in historical period was conducted by comparing the simulation results with the historical data collected from China Health Expenditure Report between 2002 and 2014.The average goodness-of-fit of total health expenditure,the population,the elderly population,the GDP,the GHE,the number of health professional personal per thousand population and the drug cost were 96.98%,100%,98.89%,94.67%,99%,99.99% and 96.97%,respectively.4.The forecast results show that during 2017-2025,China’s total health costs will continue to grow steadily,reaching 89 24.562 billion Yuan in 2025,while GDP will reach 1 400 29.087 billion Yuan,and the total health expenditure as a proportion of GDP is 6.37%.Conclusions1.The number of population,the number of elderly population,GDP,governmental health expenditure,the number of health technicians per thousand,and the cost of medicine are main influencing factors affecting the growth of China’s total health expenditure.2.The total health expenditure of China has been increasing every year,which is consistent with the developing social economic,increasing number of people,aging population,increasing government healthcare investment,and the rising drug costs.3.The System Dynamic flow diagram structure model of the total health expenditure can reveal the operating mechanism of total health expenditure as well as main influencing factors.The complexity,feedback and dynamics of the model can be clearly depicted.The simulation results of historical year are highly similar to the objective data,and the simulation results are also similar to those of the official forecast in the future years.The reliability of the model and the accuracy of the results are stable.