Modeling long-term population health and healthcare demand under baseline, prevention, and efficiency scenarios in BNSSG ICS

Decisions around medium and long-term allocation of healthcare resources are fraught with challenges and uncertainties.
Working for the UK’s National Health Service (NHS), our organisation (BNSSG ICS) part a regional NHS apparatus responsible for planning the current and future health needs of the one million resident population.

We have developed a Dynamic Population Model (DPM) that combines local primary care and NHS health activity data with Office for National Statistics local population projections, to give projections out to 2043.

The model has been developed and coded in R, both as a deterministic set of difference equations and as a microsimulation model at person-level. Both formulations are discrete-time with time-step 1 year.

The model allows for different scenarios to be tested, such as prevention efforts in certain cohorts or efficiency measures in different points of delivery like hospital wards. This makes for an effective comparison of cost projections under these scenarios, with not just financial cost but also Years of Life Lost as a human cost, and C02kg-equivalent as an environmental cost.

The model highlights through a combination of an ageing population and increasing multimorbidity that healthcare utilisation is projected to grow significantly if we deliver per-person care at the same level as now. Further, it shows this growth is not uniform across the health service, and it quantifies yearly cost-saving effects from different interventions.