Hybrid health systems simulation modelling: controlling Covid-19 infections in care homes

Student thesis: Doctoral Thesis


Although healthcare-associated infections have caused significant burdens in care homes, the evidence for controlling infection spread in this setting is extremely limited, and the Coronavirus disease 2019 (COVID-19) pandemic highlights this limitation. Plenty of evidence exists for controlling infection in hospitals and especially in ICU settings, but care homes are unique in that they are a home rather than purely a health facility. The understanding of how a care home interacts with other care homes and the resulting transmission dynamics within and between homes is also incomplete. This research addresses these issues by combining system dynamics (SD) and agent-based modelling (ABM) to capture the complexity of the transmission dynamics of COVID-19 within a care home and across a heterogeneous network of care homes. Various approaches adapted from both SD and ABM practices are used to build confidence in the models. This research makes several theoretical, methodological, empirical, and practical contributions. The theoretical contributions to the infectious disease dynamics and modelling fields include the conceptualization of the care home environment with characteristics important for infection control that provides a basis for future research and the development of a multi-layer simulation that can be tailored and applied in different contexts. From a methodological perspective, this research contributes to the modelling and simulation field by proposing a detailed and practical framework for developing a conceptual hybrid simulation model, describing new practices for modelling interfaces between SD and ABM modules, and demonstrating the confidence-building approaches for a hybrid model. Lastly, this research makes two empirical contributions. This research helps understand the transmission dynamics of COVID-19 and the relative impact of interventions that mitigate the spread of COVID-19 within and across care homes. It has been instrumental for policymakers in making evidence-informed decisions and policies during the COVID-19 pandemic. Opportunities for future research are proposed.
Date of Award9 Jun 2022
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SponsorsUniversity of Strathclyde
SupervisorItamar Megiddo (Supervisor) & Susan Howick (Supervisor)

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