Modelling and Simulating Complicated Service Networks in Health Care

  • Peter Ylén
  • Ossi Koivula
  • Joona Tuovinen
  • Jukka Ranta


The health-care system is a complicated network consisting of fragmented interest groups working towards their own internal goals causing suboptimal system performance and change resistance. In this chapter a system dynamic simulation model is constructed for the value creation in a health-care network containing different modules for doctors, rehabilitation personnel, patients and their relatives. The models are based on service-dominant logic. The dynamic hypothesis is created in collaboration with experts and different interest groups by using facilitated interviews and workshops. Strategies for transition towards customer-oriented health-care services are tested in simulations. The effect of political pressure and different value creation structures are analysed.


Change management Health care Service-dominant logic System dynamics Value network 


  1. 1.
    Vargo S, Lusch R (2004) Evolving to a new dominant logic for marketing. J Mark 68(1):1–17CrossRefGoogle Scholar
  2. 2.
    Vargo S, Lusch R (2008) Service-dominant logic: continuing the evolution. J Acad Mark Sci 36(1):1–10CrossRefGoogle Scholar
  3. 3.
    Sterman JD (2000) Business dynamics: systems thinking and modeling for a complex world. Irwin/McGraw-Hill, BostonGoogle Scholar
  4. 4.
    George A, Taylor R (2006) A systems theory of small-cell lung cancer. In: Proceedings of the 24th international conference of the system dynamics society, Nijmegen, The NetherlandsGoogle Scholar
  5. 5.
    Milstein B, Jones A, Homer J, Murphy D, Essien J, Seville D (2007) Charting plausible futures for diabetes prevalence in the United States: a role for system dynamics simulation modeling. Prev Chronic Dis 4(3):A52Google Scholar
  6. 6.
    Homer J, Jones A, Seville D, Essien J, Milstein B, Murphy D (2004) The CDC’s diabetes systems modeling project: developing a new tool for chronic disease prevention and control. In: Proceedings of the 22nd international conference of the system dynamics society, OxfordGoogle Scholar
  7. 7.
    Ritchie-Dunham JL, Méndez Galván JF (1999) Evaluating epidemic intervention policies with systems thinking: a case study of dengue fever in Mexico. Syst Dyn Rev 15(2):119–138CrossRefGoogle Scholar
  8. 8.
    Garnett G, Anderson R (1996) Sexually transmitted diseases and sexual behavior: insights from mathematical models. J Infect Dis 174(Suppl 2):S150–S161CrossRefGoogle Scholar
  9. 9.
    Homer JB, Hirsch GB (2006) System dynamics modeling for public health: background and opportunities. Am J Pub Health 96(3):452–458CrossRefGoogle Scholar
  10. 10.
    Homer J, Milstein B (2004) Optimal decision making in a dynamic model of community health. In: Proceedings of the 37th annual Hawaii international conference on system sciences, Big Island, Hawaii, USAGoogle Scholar
  11. 11.
    Homer J, Milstein B, Labarthe D, Orenstein D, Wile K, Trogdon J, Huang P (2010) Peer reviewed: simulating and evaluating local interventions to improve cardiovascular health. Prev Chronic Dis 7(1):1–11Google Scholar
  12. 12.
    Orenstein D, Homer J, Milstein B, Wile K, Pratibhu P, Farris R (2008) Modeling the local dynamics of cardiovascular health: risk factors, context, and capacity. Prev Chronic Dis 5(2):A63Google Scholar
  13. 13.
    Royston G, Dost A, Townshend J, Turner H (1999) Using system dynamics to help develop and implement policies and programmes in health care in England. Syst Dyn Rev 15(3):293–313CrossRefGoogle Scholar
  14. 14.
    Taylor K, Dangerfield B (2005) Modelling the feedback effects of reconfiguring health services. J Oper Res Soc 56(6):659–675CrossRefMATHGoogle Scholar
  15. 15.
    Koelling P, Schwandt M (2005) Health systems: a dynamic system: benefits from system dynamics. In: Proceedings of the 37th winter simulation conference, Orlando, FL, USAGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Peter Ylén
    • 1
  • Ossi Koivula
    • 1
  • Joona Tuovinen
    • 1
  • Jukka Ranta
    • 1
  1. 1.VTT Technical Research Centre of FinlandVTT EspooFinland

Personalised recommendations