Markov Modelling of Coronary Artery Revascularization Procedures : Development and use of a Markov simulation model in CHD incidence/mortality and CARPs

This study provides a new Markov simulation model for requirements of coronary artery revascularization procedures (CARPs) in Western Australia which is one of the few locations in the world with a unique population based longitudinal data for coronary heart disease (CHD) and CARPs based on record linkage. The model also provides estimates of incident CHD cases in WA, and is useful for forecasting the future numbers of incident CHD cases in WA and other similar populations. The models are useful to understand the management and treatment of CHD in WA and to build what-if scenarios based on changes in the model parameters. In particular, these models can provide a range of estimates for requirements of CARPs allowing for changes in incidence/prevalence of CHD and CARPs, increasing levels of effective medical treatment, technological advances in surgical techniques, and population growth. These are demonstrated through two compelling examples. Similar simulation models can be used for modelling the need for other health service usage and incidence/mortality of other chronic diseases.