KIT students playing Health Resource Allocation Game, photo by Susan Huider

Health Resource Allocation Game

KIT’s Health Resource Allocation Game requires players to plan a complete health system in a fictitious country, allocating a limited budget to competing health programs and resources – from hospitals to primary care units, prevention programs, transportation and communication infrastructure etc. The game, developed by KIT almost 30 years ago and continuously updated, has been used by public health training institutions around the world.

The Health Resource Allocation Game (HRAG) is a simulation board game that recreates a health planning exercise for a hypothetical province. The game allows players to plan, implement and evaluate a health system from village up to province level. During the game, players are challenged while deciding on how to use the available resources for the optimal benefit of the population.

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Introduction

Health resources are limited whereas the demands are insatiable. The effective and equitable utilization as well as distribution of these limited resources for the optimal benefit of the population is a challenge for any nation, whether rich or poor. This game helps the user to experience first hand these challenges with a view to understanding the consequences of each action or inaction.

The game was developed by KIT in 1975 and has since then undergone series of improvements. It has been used by public health institutes all over the world. So far the game has been translated into Portuguese and Bahassa.

In its present form, the game is played as a board game where a hypothetical province is provided on a large map showing the main geographic features and the population distribution. The burden of disease is given and additional information regarding the most important demographic and socioeconomic characteristics of the population is also provided. With this information plus a realistic budget for running the health care delivery system the player is expected to plan a health system for the entire province, from the village and district level up to the provincial level.

Target group

The Health Resource Allocation is a game suitable for students from Public Health programs as well as for health professionals and managers of the Health Sector.

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The game can be divided into three phases:

Planning phase
In the first phase or planning phase the participants work in separate groups with each group having its own map and building its own health system. All necessary information is distributed, including background information and information on available resources and running cost. The main considerations in this phase will be on the coverage of the health care system and the quality of care to be provided. Each group develops its own criteria and objectives for the optimal health care delivery to the entire province. At this stage the groups can consult anybody from outside for advice. At the end of this phase all the groups would have successfully completed the allocation of the various resources in the entire province and placed their corresponding symbols on the maps.

Implementation phase
In the second phase or implementation phase each group is provided with a stack of 150 patient cards in 3 colours – green, yellow and red. Each card represents individuals in a particular location in the province and seeking care for a particular health problem. Each green card represents 300 cases; yellow card represent 10 cases and each red card a single case. The health problem may vary from trivial to serious and is indicated by the different colours on the card. The minimal level at which care should be given is also indicated on the cards. The group will make the decision whether adequate coverage was provided by taking into account certain factors like road, distance, availability of transportation, and seriousness of the cases.

Evaluation phase
The last phase or evaluation phase, unlike the previous phases is a plenary session for all groups. Calculations are made regarding the efficiency, success and failure rates. The groups discuss their results and brainstorm on possible alternatives, thereby exchanging experiences.
The following parameters are calculated in the evaluation phase (their definitions and how they can be calculated are given in ‘definition and calculation of rates’):
•    The disease prevention rate
•    The payment failure rate
•    The care failure rate
•    The cure failure rate
•    The preventable death rate
•    The economic failure rate

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