Modelling multi-player strategic decisions in animal healthcare: A scoping review.

Strategic decision making in animal healthcare involves an array of complex factors interacting for the allocation of scarce resources. Consequently, modelling techniques which consider the actions and interactions of multiple decision makers, such as game theory and agency theory, have potential to provide insight of past and future interventions and policy which seek to improve economic efficiency. This scoping review aimed to identify, describe, and synthesise literature relating to multi-actor strategic decision making in animal healthcare. Embase, Web of Science, PubMed, CAB direct, EconLit, and AnthroSource were searched for literature published until November 2020. Studies were included if they were written in English, modelled strategic decisions between multiple actors, and contained information that related to animal healthcare practices. Data were analysed within the context of a conceptual framework based on strategic decision-making literature and modelling techniques. The identified literature (n = 31) had a strong focus on livestock healthcare and particularly on cattle (n = 13). Most studies (27/31) examined decisions concerning infectious disease and seven studies used compartmental models to include disease prevalence data. Almost all the articles (n = 30) used the monetary outcome of strategic decisions as a basis for expected utility, either through direct profit maximisation or via the aversion of losses. Nine studies used discursive and conceptual models to describe the strategic decision-making process, providing a wide lens by which to view decisions and opportunity to discuss the role of behavioural contributors to utility. Twenty-two studies used formal mathematical models to describe strategic decisions and used model solutions to provide recommendations to a specific problem, ten of which were parameterised with empirical data. Consequently, 20 articles provided specific policy recommendations to improve the welfare output of a system, the majority of which suggested the need for an increased level of state intervention in the animal health sector. This review describes the range of studies which have approached strategic decision making in animal healthcare through multi-player modelling techniques. These modelling techniques provide opportunity to consider the perspectives of multiple stakeholders and to combine economic and epidemiological data which may be beneficial to the development of animal health interventions.