SHAPE - SHAPE: System Dynamics for Health-System Acceleration and Production in End-of-Life Care

As populations age, more people live with serious illness and need care at the end of life. Health systems are not keeping pace. Services are often fragmented, and much of the care is given by families, friends and communities. Planning rarely accounts for this contribution, which SHAPE calls social production.

SHAPE will build a system dynamics model that shows how need, services, costs and caregiving interact in end-of-life care. The model will let decision-makers test policy scenarios before putting them into practice. The project brings together six linked studies. They estimate the burden of serious health-related suffering, gather expert views on service needs, harmonise routine patient-reported outcomes, map patient pathways, cost care across settings, and measure the contribution of caregivers. Patients, caregivers, clinicians and policymakers co-design the model in participatory workshops.

Geneva and Zurich are the core study sites. Chile and Thailand provide comparative data. SHAPE is led by Swiss TPH with Geneva University Hospitals, University Hospital Zurich, Careum School of Health and the University of Zurich, together with international partners. It runs from October 2026 to July 2030.

This work was supported by the Swiss National Science Foundation (grant no. 10.010.802).