区域内医养结合服务需求与资源匹配系统动力学模型初步构建与仿真

Modeling and simulation of the system dynamics of demand and resource matching for integrated elderly care and medical service in the region

目的探索区域范围内老年人群不同类型医养结合服务供需匹配关系,实现医养结合供需协调配置和平衡发展。方法结合文献、访谈、专家咨询对区域内医养结合服务供需主要因素和系统要素关系进行梳理,利用Vensim软件厘清医养结合供需服务各子系统间的关系和运行机制。并结合2010年1月1日—2022年12月31日江苏省苏州市医养结合项目建设基地的数据进行仿真模拟。结果结合数据的可获取性和完整性,筛选得到5大子系统的主要变量和指标,绘制系统动力因果关系图和流图明确各子系统主要变量及流向,构建的模型仿真运行较为稳定。仿真模型结果显示,2012年前的居家养老、社区养老供需比相对下降,2013年—2018年机构养老模式逐渐兴起发展,2019年—2022年医中有养、养中有医的供需比有所下降。结论以系统动力学为理论基础,将区域内医养结合供需服务看作一个复杂系统,通过子系统间系统要素的分析和机制梳理,可为构建和完善区域内医养结合服务需求与资源匹配的系统动力学模型提供一定理论支撑。

Objective To explore the matching relationship between the supply and demand of different types of integrated elderly care and medical service for the elderly population in the region,and achieve the simulation purpose of coordinated allocation and balanced development of supply and demand of integrated elderly care and medical service.Methods Combining literature,interviews,and expert consultation to sort out the main factors and system element relationships between the supply and demand of integrated elderly care and medical service in the region,the Vensim software was used to clarify the relationships and operation mechanisms between the subsystems of supply and demand of integrated elderly care and medical service.The data of the construction base for the integrated elderly care and medical service project in Suzhou city,Jiangsu province from January 1,2010 to December 31,2022 were selected.Results Combined with the accessibility and completeness of data,the main variables and indicators of the five subsystems were screened,and the causality diagram and flow diagram of the system dynamics were drawn to clarify the main variables and flow direction of the subsystems,and the constructed model was more stable in simulation operation.The simulation model results showed that the supply-demand ratio of home-based elderly care and community elderly care decreased relatively before 2012,and the institutional elderly care model gradually emerged and developed from 2013 to 2018.From 2019 to 2022,the supply-demand ratio of medical care with elderly care and elderly care with medical care decreased.Conclusions Based on the theoretical foundation of system dynamics,the supply and demand the integrated elderly care and medical service in the region are regarded as a complex system.Through the analysis of the system elements among the subsystems and the sorting out of the mechanisms,it can provide certain theoretical support for constructing and improving the system dynamics model for matching the supply and demand of integrated elderly care and medical service in the region.