Project Details
Projekt
AdaptInfra Subproject 5: Adaptation processes of the medical care landscape in rural-peripheral areas using the example of the Western Pomerania region – an analysis based on multi-method modelling
Applicants
Professorin Dr. Neeltje van den Berg; Professor Dr. Steffen Fleßa; Professor Dr. Wolfgang Hoffmann
Subject Area
Public Health, Healthcare Research, Social and Occupational Medicine
Term
since 2026
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 547031340
The adaptation of the structure of medical service providers to changing structural and regional conditions is a complex process with different target dimensions and groups, for which no systematic findings on the necessary adaptation processes are yet available. The aim of this project is therefore to analyze the changes in the adaptive infrastructure of a regional medical care landscape in order to gain fundamental insights into the planning, decision-making and adaptation processes of critical infrastructure. For this purpose, a hybrid simulation model will be developed and parameterized in order to analyze and predict the adaptation of the infrastructure and to quantitatively evaluate the influence of relevant determinants. On this basis, the development of a regional medical care structure with a balance between security of care and economic efficiency is determined. Thus, it is analyzed how the change of certain parameters of the health care landscape and the population affect the adaptation of the health care infrastructure as well as relevant system variables for service providers and the population, e.g. the influences of current reforms of the health care system. Both the institutional side and individual demand are considered. The influence of the adapted care landscape on the population is then examined. A system dynamics (SD) and an agent-based model (ABM) are combined to create a dynamic simulation model (multi-method modeling). SD models allow for a flexible simulation with feedback processes, which, however, is always limited to larger compartments. ABMs enable the modeling of independently acting individuals who shape group behavior through interaction, but cannot model complete, interdependent systems consisting of numerous elements. By integrating the two modeling methods, the advantages of each approach are combined to overcome disadvantages. For multi-method modeling, the adaptation process is modeled in parallel at the individual level, at the group level and at the control system level using a combined SD and ABM. The multimethod approach considers material, institutional and personal dimensions of the adaptation process of infrastructure and maps the co-evolutionary development process of these dimensions. With the help of the model, scenarios are calculated that allow an understanding of the adaptation processes that have already taken place as well as a forecast for the future, so that general insights can be gained about the dynamics of adaptation processes in the field of tension between operational logic and political process, which can form a basis for future regional and integrated planning processes.
DFG Programme
Research Units
