An interactive simulation of a renal unit

Abstract

This dissertation describes and discusses an interactive microcomputer model of the treatment of chronic renal failure by dialysis and transplantation. There is an unmet demand for the treatment of this condition, particularly in the older age-groups. A model of the treatment system is needed by planners in order to explore the implications of meeting the demand, giving different priorities to available treatments and changing the balance between home and hospital treatment. Previous models have been constructed, but they omit important elements from the system, have poor credibility, lack robustness and are not easy to use. This discrete event simulation, developed at Portsmouth, describes the system more realistically, including resource use and constraints, the arrival of kidneys and the matching of donors with recipients. The concept of 'shadow entities' is developed and used. The model was verified and validated using techniques which included using a tabular display while the simulation was running. The model is easy to use, and robust both to different data requirements and extreme policy changes. Interactive simulation runs, based on different admission policies and priorities for dialysis, are described, together with their use in the costing and budgeting of renal failure treatment services.

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