Itamar MegiddoUniversity of Strathclyde
Itamar Megiddo
PhD Management Science, Modeling for Healthcare Policy
About
48
Publications
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Introduction
Dr Itamar Megiddo is an Associate Professor (Senior Lecturer) at the Department of Management Science at the University of Strathclyde. His research focus is on improving evidence-based decision making and resource allocation in healthcare policy. His main body of work integrates disease, health system, and economic models to evaluate impact and design policy and strategy.
Skills and Expertise
Additional affiliations
March 2017 - present
March 2015 - present
March 2015 - March 2017
Education
March 2015 - November 2016
September 2008 - August 2009
September 2005 - May 2008
Publications
Publications (48)
System Dynamics (SD) and Agent-Based Modelling (ABM) are two commonly used simulation methods with different characteristics and benefits. When tackling a complex problem, the use of one of these methods may be insufficient and, instead, a combination of the two methods in a hybrid simulation may be required. To support modellers in the development...
The growing complexity of systems and problems that stakeholders from the private and public sectors have sought advice on has led systems modellers to increasingly use multimethodology and to combine multiple OR/MS methods. This includes hybrid simulation that combines two or more of the following methods: system dynamics (SD), discrete-event simu...
Classical mosquito control methods (e.g. chemical fogging) struggle to sustain long-term reductions in mosquito populations to combat vector-borne diseases like dengue. The Mosquito Home System (MHS) is an auto-dissemination mosquito trap, that kills mosquito larvae before they hatch into adult mosquitoes. A novel hybrid stochastic-deterministic mo...
Pests and diseases are an existential threat to trees in forests and woodlands. There is, therefore, a pressing need to use ecological and bioeconomic models to inform forest managers on control and mitigation strategies. For example, the incidence of Dothistroma needle blight in the UK has increased rapidly since the 1990s, and it is a significant...
Objectives
Allocation of development aid for health is controversial and challenging. In recent years, several planning-software tools have promised to help decision-makers align resource allocation with their objectives, more clearly connect prioritisation to evidence and local circumstances, and increase transparency and comparability. We aim to...
Modelers in various disciplines have applied system dynamics (SD) and agent-based models (ABM) to support decision-makers in managing complex adaptive systems. Combining these methods in a hybrid simulation offers an opportunity to overcome the challenges that modelers face using SD or ABM alone. It also provides a complementary view and rich insig...
Background:
Decision analytical models (DAMs) are used to develop an evidence base for impact and health economic evaluations, including evaluating interventions to improve diabetes care and health services-an increasingly important area in low- and middle-income countries (LMICs), where the disease burden is high, health systems are weak, and res...
UK urgent care health policies advocate senior clinical decision-making at the point of referral into the system. The costs of employing senior clinicians in this role are substantial with little evidence of the value they bring over other strategies, particularly for patient outcomes. We sought to explore current remote and ambulatory emergency ca...
Objective
The barriers to delivering clinical non-communicable disease services in low- and middle-income countries have risen with the onset of COVID-19. Using Ghana as a case study, this article examines the changes COVID-19 has brought to diabetes service delivery and considers policy responses to deal with future such outbreaks.
Methods
We con...
The recent report of the Intergovernmental Panel on Climate Change is stark in its warnings about the changing climate, including future increases in the frequency and intensity of extremely hot weather. The well-established impacts of extreme heat on human health have led to widespread implementation of national and city-wide heat plans for mitiga...
Objective
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations provide information on how these types of investment might best be balanced but can be challenging. We conducted a systematic review to evaluate how researchers address these economic e...
Novel subscription payment schemes are one of the approaches being explored to tackle the threat of antimicrobial resistance. Under these schemes, some or all of the payment is made via a fixed “subscription” payment, which provides a funder unlimited access to the treatment for a specific duration, rather than relying purely on a price per pill. S...
Although system dynamics [SD] and agent-based modelling [ABM] have individually served as effective tools to understand the Covid-19 dynamics, combining these methods in a hybrid simulation model can help address Covid-19 questions and study systems and settings that are difficult to study with a single approach. To examine the spread and outbreak...
Background: Decision analytical models (DAMs) are used to develop an evidence base that is used in impact and health economic evaluations, including to evaluate interventions to improve diabetes care and health service—an increasingly important area in low- and middle-income countries (LMICs), where the disease burden is high, health systems are we...
Antimicrobial resistance is a serious challenge to the success and sustainability of our healthcare systems. There has been increasing policy attention given to antimicrobial resistance in the last few years, and increased amounts of funding have been channeled into funding for research and development of antimicrobial agents. Nevertheless, manufac...
Care homes in the UK were disproportionately affected by the first wave of the
COVID–19 pandemic, accounting for almost half of COVID–19 deaths over the course
of the period from 6th March – 15th June 2020. Understanding how infectious diseases
establish themselves throughout vulnerable communities is crucial for minimising
deaths and lowering the...
The development of COVID-19 vaccines does not imply the end of the global pandemic as now countries have to purchase enough COVID-19 vaccine doses and work towards their successful rollout. Vaccination across the world has progressed slowly in all, but a few high-income countries (HICs) as governments learn how to vaccinate their entire populations...
Ghana has signed on to the United Nations Sustainable Development Goal to achieve universal health coverage (UHC), ensuring that all individuals receive the health care they require without financial hardship. Achieving that goal is a difficult task in any setting. The challenges are further exacerbated by a changing disease landscape, as the burde...
Background: This study examines the impact of visitation and cohorting policies as well as the care home population size upon the spread of COVID-19 and the risk of outbreak occurrence in this setting.
Methods: Agent-based modelling
Results: The likelihood of the presence of an outbreak in a care home is associated with the care home population siz...
Background: Mathematical models have been used throughout the COVID-19 pandemic to inform policymaking decisions. The COVID-19 Multi-Model Comparison Collaboration (CMCC) was established to provide country governments, particularly low- and middle-income countries (LMICs), and other model users with an overview of the aims, capabilities and limits...
Background:
Care homes are vulnerable to widespread transmission of COVID-19 with poor outcomes for staff and residents. Infection control interventions in care homes need to not only be effective in containing the spread of COVID-19 but also feasible to implement in this special setting which is both a healthcare institution and a home.
Methods:...
Healthcare-Associated Infections (HAIs) are a major public health problem as they pose a serious risk for patients and providers, increasing morbidity, mortality, and length of stay as well as costs to patients and the health system. Prevention and control of HAIs has, therefore, become a priority for most healthcare systems. Systems simulation mod...
- The COVID-19 pandemic has disrupted routine and campaign-based vaccination, potentially increasing the future vaccine-preventable disease burden and threatening to overwhelm health systems.
- Vaccine-preventable diseases are transboundary problems that require global cooperation to achieve the best outcomes.
- Investments, predominantly by rich...
Residents living in long-term care facilities (LTCFs) are at high risk of contracting
healthcare-associated infections (HAIs). The unique operational and cultural
characteristics of LTCFs and the currently evolving models of healthcare delivery in
Scotland create great challenges for infection prevention and control (IPC). Existing
literature that...
Background:
Health care-associated infections (HAIs) are a global health burden because of their significant impact on patient health and health care systems. Mechanistic simulation modeling that captures the dynamics between patients, pathogens, and the environment is increasingly being used to improve understanding of epidemiological patterns of...
The increase of multidrug resistance and resistance to last-line antibiotics is a major global public health threat. Although surveillance programs provide useful current and historical information on the scale of the problem, the future emergence and spread of antibiotic resistance is uncertain, and quantifying this uncertainty is crucial for guid...
Over 95% of post‐mortem samples from the 1918 pandemic, which caused 50
to 100 million deaths, showed bacterial infection complications. The introduc-
tion of antibiotics in the 1940s has since reduced the risk of bacterial infections,
but growing resistance to antibiotics could increase the toll from future
influenza pandemics if secondary bacteri...
Introduction: Dengue is a serious global health problem endemic in Brazil. Consequently, our aim was to measure the costs and disease burden of symptomatic dengue infections in Brazil from the perspective of the Brazilian Public Health System (SUS) between 2000 and 2015, using Brazilian public health system databases. Specific age group incidence e...
Pneumococcal pneumonia causes an estimated 105 000 child deaths in India annually. The planned introduction of the serotype-based pneumococcal conjugate vaccine (PCV) is expected to avert child deaths, but the high cost of PCV relative to current vaccines provided under the Universal Immunization Programme has been a concern. Cost-effectiveness stu...
Each year, more than 300,000 children in India under the age of five years die from diarrheal diseases. Clean piped water and improved sanitation are known to be effective in reducing the mortality and morbidity burden of diarrhea but are not yet available to close to half of the Indian population. In this paper, we estimate the health benefits (re...
Considers equity and financial protection as important attributes of health systems, and uses case studies from India and Ethiopia to analyze epilepsy, schizophrenia, and depression. In India, there is a strong push toward universal public finance (UPF) to reverse decades of high, often impoverishing out-of-pocket (OOP) health care expenditures and...
Appendix S1. Modeling details.
Table S1. Disease input parameters.
Figure S1. Significance of state‐wise DALYs per 100,000 in the baseline scenario.
Figure S2. Significance of state‐wise DALYs averted per 100,000 in UPF scenario 1 (from the baseline scenario).
Figure S3. Significance of state‐wise DALYs averted per 100,000 in UPF scenario 2 (fr...
In a highly interconnected world, immunizing infections are a transboundary problem, and their control and elimination require international cooperation and coordination. In the absence of a global or regional body that can impose a universal vaccination strategy, each individual country sets its own strategy. Mobility of populations across borders...
Objective:
An estimated 6-10 million people in India live with active epilepsy, and less than half are treated. We analyze the health and economic benefits of three scenarios of publicly financed national epilepsy programs that provide: (1) first-line antiepilepsy drugs (AEDs), (2) first- and second-line AEDs, and (3) first- and second-line AEDs a...
Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling up the HBNC in rural India usi...
Abstract
Background
Cardiovascular diseases are the single largest cause of death in India, with acute myocardial infarction (AMI) accounting for one-third of all heart disease deaths. Although effective treatment is available for AMI, access to treatment is dictated by cost and ability to pay. With scarce treatment resources, healthcare decisions...
Background and objectives
India has the highest under-five death toll globally, approximately 20% of which is attributed to vaccine-preventable diseases. India's Universal Immunization Programme (UIP) is working both to increase immunization coverage and to introduce new vaccines. Here, we analyze the disease and financial burden alleviated across...
Cost-effectiveness analysis (CEA) is widely used as a tool for prioritising health interventions, particularly in low-income and middle-income settings. However, among the major limitations of CEA are the omission of health-care seeking behaviour, heterogeneous mechanisms across populations or regions that determine the delivery and quality of heal...