Synergia - Design Realise Sustain

Issue

Cardiovascular Disease (CVD) is the leading cause of death in New Zealand, accounting for over 40% of all deaths; the biggest burden falling on Maori and Pacific peoples. It is also one of the biggest areas of cost for the health services. It has a number of causes and has to be tackled on many fronts. This requires a common understanding of the factors that drive CVD events and a realistic appreciation of the realistic goals that could be achieved with any given set of strategies. What gain can be expected from any set of investments and programmes designed to reduce CVD and which set provides the optimum set of outcomes?

Solution

To help develop this common understanding Synergia, in partnership with Dr. Jack Homer, a world leader in the application of system dynamic modelling of health care issues, developed a national CVD model. Working with policy and clinical experts from the Ministry of Health and from throughout New Zealand Synergia incorporated the best available data into a model that captured the interrelationships between the prevention factors, such as obesity and smoking, and CVD events and deaths. The model built upon work that Dr. Homer has being doing with CDC in the United States and captures the key factors that drive mortality and morbidity data related to CVD. The model has been designed so that current interventions, such as improved diet and nutrition, can be modelled in more detail enabling exploration of more targeted strategies such as, for example, salt reduction in bread. The aim was to develop a ‘version 1’ model that captured the best evidence available but structured in such a way that it i) allowed improvements to be made as more data became available and ii) enabled more detailed model components to be built so that more specific interventions could be explored.

Outcome

The national model is currently being calibrated to a large urban population and being used to explore strategies for CVD in one of New Zealand’s largest District Health Board districts. This process has involved refining and recalibrating the data to reflect the local rather than national population and evaluating the model with local clinicians. The next stage in development will see the model being used to design and evaluate regional strategies to reduce the associated mortality and morbidity costs of CVD.