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Computer simulation of dementia care demand heterogeneity using hybrid simulation methods: improving population-level modelling with individual-level decline trajectories

Computer simulation of dementia care demand heterogeneity using hybrid simulation methods: improving population-level modelling with individual-level decline trajectories
Computer simulation of dementia care demand heterogeneity using hybrid simulation methods: improving population-level modelling with individual-level decline trajectories
Objectives
The aim of the study was to model dementia prevalence and outcomes within an ageing population using a novel hybrid simulation model that simultaneously takes population-level and patient-level perspectives to better inform dementia care service planning, taking into account severity progression variability.

Study design
This is a simulation study.

Methods
We developed a hybrid computer simulation combining different methods to best represent population and individual dementia dynamics. Individual patient outcomes are aggregated into three progression rate types to report the effects of severity progression variability and intervention benefits.

Results
Fast progression of dementia severity is associated with higher annual care cost and short overall survival duration. Those patients are more likely to develop moderate to severe symptoms more quickly, highlighting a need for more urgent provision of appropriate care services. Slower severity progression is associated with lower annual care costs, but longer survival requires higher overall financial provision. Although lifestyle interventions reduce overall care costs, treatment and lifestyle intervention benefits are modest at the population level.

Conclusions
Individual variation of dementia decline is an important factor to include in planning adequate levels of care services and to ensure timely and appropriate service availability. Hybrid simulation models provide useful insights at the population and individual level, supporting effective decision-making.
Dementia, Care services, Simulation
197-203
Evenden, D.
5cd6f0ab-5269-447c-af32-01edac9c905d
Brailsford, S.
634585ff-c828-46ca-b33d-7ac017dda04f
Kipps, C.
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Walsh, B.
5818243e-048d-4b4b-88c5-231b0e419427
Evenden, D.
5cd6f0ab-5269-447c-af32-01edac9c905d
Brailsford, S.
634585ff-c828-46ca-b33d-7ac017dda04f
Kipps, C.
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Walsh, B.
5818243e-048d-4b4b-88c5-231b0e419427

Evenden, D., Brailsford, S., Kipps, C., Roderick, P. and Walsh, B. (2020) Computer simulation of dementia care demand heterogeneity using hybrid simulation methods: improving population-level modelling with individual-level decline trajectories. Public Health, 186, 197-203. (doi:10.1016/j.puhe.2020.07.018).

Record type: Article

Abstract

Objectives
The aim of the study was to model dementia prevalence and outcomes within an ageing population using a novel hybrid simulation model that simultaneously takes population-level and patient-level perspectives to better inform dementia care service planning, taking into account severity progression variability.

Study design
This is a simulation study.

Methods
We developed a hybrid computer simulation combining different methods to best represent population and individual dementia dynamics. Individual patient outcomes are aggregated into three progression rate types to report the effects of severity progression variability and intervention benefits.

Results
Fast progression of dementia severity is associated with higher annual care cost and short overall survival duration. Those patients are more likely to develop moderate to severe symptoms more quickly, highlighting a need for more urgent provision of appropriate care services. Slower severity progression is associated with lower annual care costs, but longer survival requires higher overall financial provision. Although lifestyle interventions reduce overall care costs, treatment and lifestyle intervention benefits are modest at the population level.

Conclusions
Individual variation of dementia decline is an important factor to include in planning adequate levels of care services and to ensure timely and appropriate service availability. Hybrid simulation models provide useful insights at the population and individual level, supporting effective decision-making.

Text
PUHE-D-20-00180R1(no reviewer comments - Accepted Manuscript
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Text
Computer simulation of dementia care demand heterogeneity using hybrid simulation methods improving population-level modelling with individual patient decline trajectories - Accepted Manuscript
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More information

Accepted/In Press date: 14 July 2020
e-pub ahead of print date: 27 August 2020
Published date: September 2020
Keywords: Dementia, Care services, Simulation

Identifiers

Local EPrints ID: 442922
URI: http://eprints.soton.ac.uk/id/eprint/442922
PURE UUID: 6e1e347c-73a6-4059-8b57-6274ec20167f
ORCID for D. Evenden: ORCID iD orcid.org/0000-0002-6798-648X
ORCID for S. Brailsford: ORCID iD orcid.org/0000-0002-6665-8230
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for B. Walsh: ORCID iD orcid.org/0000-0003-1008-0545

Catalogue record

Date deposited: 31 Jul 2020 16:30
Last modified: 26 Nov 2021 05:57

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Contributors

Author: D. Evenden ORCID iD
Author: S. Brailsford ORCID iD
Author: C. Kipps
Author: P. Roderick ORCID iD
Author: B. Walsh ORCID iD

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