Syndemics Prevention Network, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Am J Public Health. 2010 May;100(5):811-9. doi: 10.2105/AJPH.2009.174490. Epub 2010 Mar 18.
Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and improving health care quality would likely improve health status but would also raise costs and worsen health inequity, whereas a strategy that also strengthens primary care capacity and emphasizes health protection would improve health status, reduce inequities, and lower costs. A software interface allows diverse stakeholders to interact with the model through a policy simulation game called HealthBound.
改善美国医疗体系的建议通常基于仅包含少数变量的模型，而这些模型忽略了可能会延迟、削弱或阻碍干预效果的某些过程。我们使用具有广泛国家范围的循证动态模拟模型来分析 5 项政策建议。研究结果表明，扩大保险覆盖范围和提高医疗质量可能会改善健康状况，但也会增加成本并加剧健康不平等，而强化初级保健能力和强调健康保护的策略则会改善健康状况，减少不平等，并降低成本。一个软件接口允许不同的利益相关者通过名为 HealthBound 的政策模拟游戏与模型进行交互。
