Abstract for: Achieving the Real-World Application of Long-Range Health System Simulation: Insight from Two Case Studies

Despite the growing use of simulation in health systems research, the path from model development to real-world decision making remains uneven. There is limited understanding of the practical conditions under which simulation models are taken up, trusted, and used in real-world planning processes. Rather than focusing primarily on model structure or technical performance, this paper examines the implementation process surrounding two modelling projects. Our aim is to draw lessons from these projects to better understand how simulation can support real-world policy analysis. The analysis focuses on how the models were scoped, how stakeholders were engaged, how data and assumptions were negotiated, and how modelling outputs informed policy discussions. Six implementation characteristics (ICs) relevant to model-informed evidence-based policymaking are distilled. These ICs are project champions, alignment with critical policy questions, cultural dynamics, appropriate data, managed expectations, and stakeholder participation. The ICs collectively highlight that the real-world impact of strategic simulation models depends as much on stakeholder engagement and organisational context as on technical design. Modelling projects that are tightly connected to policy questions, decision timelines, and organisational priorities have greater potential to shape real-world planning and remain useful over the longer term. AI was used to support literature search