Abstract：
CONTEXT:Systems science provides organizational principles supported by biologic findings that can be applied to any organization; any incongruence indicates an incomplete or an already failing system. U.S. health care is commonly referred to as a system that consumes an ever- increasing percentage of the gross domestic product and delivers seemingly diminishing value. OBJECTIVE:To perform a comparative study of U.S. health care with the principles of systems science and, if feasible, propose solutions. DESIGN:General systems theory provides the theoretical foundation for this observational research. MAIN OUTCOME MEASURES:A degree of compliance of U.S. health care with systems principles and its space-time functional location within the dynamic systems model. RESULTS OF COMPARATIVE ANALYSIS: U.S. health care is an incomplete system further threatened by the fact that it functions in the zone of chaos within the dynamic systems model. CONCLUSION:Complying with systems science principles and the congruence of pertinent cycles, U.S. health care would likely dramatically improve its value creation for all of society as well as its resiliency and long-term sustainability.Immediate corrective steps could be taken: Prioritize and incentivize health over care; restore fiscal soundness by combining health and life insurance for the benefit of the insured and the payer; rebalance horizontal/providers and vertical/government hierarchies.
journal_name
Health Res Policy Systjournal_title
Health research policy and systemsauthors
Janecka IPdoi
10.1186/1478-4505-7-1subject
Has Abstractpub_date
2009-01-02 00:00:00pages
1issn
1478-4505pii
1478-4505-7-1journal_volume
7pub_type
杂志文章abstract：BACKGROUND:Participatory research approaches improve the use of evidence in policy, programmes and practice. Few studies have addressed ways to scale up participatory research for wider system improvement or the intensity of effort required. We used the integrated Promoting Action on Research Implementation in Health S...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-018-0392-z
更新日期：2018-11-29 00:00:00
abstract：BACKGROUND:How to assess the impact of research is of growing interest to funders, policy makers and researchers mainly to understand the value of investments and to increase accountability. Broadly speaking the term "research impact" refers to the contribution of research activities to achieve desired societal outcome...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-9-26
更新日期：2011-06-24 00:00:00
abstract：:In developing countries building national health research systems is a movement similar to a political leadership contest. Increasingly, political campaigns to select leaders depend less on ideologies and political messages and more on promising change that will promptly improve the quality of life of the voters. In t...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-7-13
更新日期：2009-05-29 00:00:00
abstract：BACKGROUND:Local and national governments have implemented sector-specific policies to support economic development through innovation, entrepreneurship and knowledge exchange. Supported by the Welsh Government through the European Regional Development Fund, The Life Science Exchange® project was created with the aim t...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-016-0105-4
更新日期：2016-04-27 00:00:00
abstract：:Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for e...
journal_title：Health research policy and systems
pub_type： 社论
doi：10.1186/1478-4505-4-10
更新日期：2006-11-06 00:00:00
abstract：BACKGROUND:Priority-setting is a complicated and time-consuming process; however, if appropriately conducted, it could efficiently divert resources to the most important studies. A considerable body of evidence indicates that priority-setting measures in health research taken so far in Iran have not satisfied decision-...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-018-0313-1
更新日期：2018-07-02 00:00:00
abstract：BACKGROUND:The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the last of a series of 16 reviews that have been prepared as ba...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-4-28
更新日期：2006-12-08 00:00:00
abstract：INTRODUCTION:The importance of accessible mental health treatment is a global concern, particularly when one in five people will experience a mental health problem in their lifespan. This is no less important in Ghana; however, no studies have yet attempted to appraise and synthesise the potential enablers and barriers...
journal_title：Health research policy and systems
pub_type： 杂志文章,评审
doi：10.1186/s12961-018-0382-1
更新日期：2018-11-16 00:00:00
abstract：BACKGROUND:In rural settings where patients face significant structural barriers to accessing healthcare services, the formal existence of government-provided health coverage does not necessarily translate to meaningful care delivery. This paper analyses the effectiveness of an innovative approach to overcome these bar...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-020-00563-3
更新日期：2020-05-22 00:00:00
abstract：BACKGROUND:Internationally, there has been renewed focus on primary healthcare (PHC). PHC revitalisation is one of the mechanisms to emphasise health promotion and prevention. However, it is not always clear who should lead health promotion activities. In some countries, health promotion practitioners provide health pr...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-020-00561-5
更新日期：2020-05-14 00:00:00
abstract：BACKGROUND:Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature abou...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-020-0530-2
更新日期：2020-02-18 00:00:00
abstract：BACKGROUND:There has been considerable examination and critique of traditional (academic) peer review processes in quality assessment of grant applications. At the same time, the use of traditional research processes in Indigenous research has been questioned. Many grant funding organisations have changed the compositi...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-7-2
更新日期：2009-02-13 00:00:00
abstract：:The Cabinet of Health Research and Development (CHRD) has recently been established as the first health research institute in one of the world's newest nations, Timor-Leste. We discuss the development of this initiative to build health research capacity within the context of Timor-Leste's health system, history and fu...
journal_title：Health research policy and systems
pub_type： 社论
doi：10.1186/1478-4505-10-13
更新日期：2012-04-10 00:00:00
abstract：BACKGROUND:In Burkina Faso, malaria remains the primary cause of healthcare use, morbidity and child mortality. Therefore, efforts are needed to support the knowledge transfer and application of the results of numerous studies to better formulate and implement programs in the fight against the malaria pandemic. To this...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-017-0205-9
更新日期：2017-06-02 00:00:00
abstract：BACKGROUND:The Health Product Profile Directory (HPPD) is an online database describing 8-10 key characteristics (such as target population, measures of efficacy and dosage) of product profiles for medicines, vaccines, diagnostics and other products that are intended to be accessed by populations in low- and middle-inc...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-019-0507-1
更新日期：2019-12-12 00:00:00
abstract：BACKGROUND:Burkina Faso has made a number of health system policy decisions to improve performance on health indicators and strengthen responsiveness to health-related challenges. These included the creation of a General Directorate of Health Information and Statistics (DGISS) and a technical unit to coordinate perform...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-017-0173-0
更新日期：2017-02-13 00:00:00
abstract：BACKGROUND:The cooperation of actors across policy fields and the need for cross-sector cooperation as well as recommendations on how to implement cross-sector cooperation have been addressed in many national and international policies that seek to solve complex issues within societies. For such a purpose, the relevant...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-016-0103-6
更新日期：2016-04-29 00:00:00
abstract：BACKGROUND:Big data (BD) informs nearly every aspect of our lives and, in health research, is the foundation for basic discovery and its tailored translation into healthcare. Yet, as new data resources and citizen/patient-led science movements offer sites of innovation, segments of the population with the lowest health...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-020-00589-7
更新日期：2020-07-08 00:00:00
abstract：:The Swedish Medical Products Agency (MPA) objects to the fact that we occasionally refer to one of its senior ex-employees by name. However, names of individual MPA assessors, Food and Drug Administration (FDA) reviewers, and European Medicines Agency rapporteurs and co-rapporteurs are cited in regulatory documents an...
journal_title：Health research policy and systems
pub_type： 评论,信件
doi：10.1186/s12961-018-0371-4
更新日期：2018-11-15 00:00:00
abstract：BACKGROUND:Gender is often neglected in health systems, yet health systems are not gender neutral. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making. ...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-018-0338-5
更新日期：2018-07-06 00:00:00
abstract：BACKGROUND:Setting priorities is important in health research given the limited resources available for research. Various guidelines exist to assist in the priority setting process; however, priority setting still faces significant challenges such as the clear ranking of identified priorities. The World Health Organiza...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-016-0081-8
更新日期：2016-02-09 00:00:00
abstract：BACKGROUND:Burden of disease (BoD) studies have been conducted in numerous international settings since the early 1990's. Two national BoD studies have been undertaken in Australia, in 1998 and 2003, although neither study estimated the BoD specifically for Indigenous Australians. In 2005 the Australian Government Depa...
journal_title：Health research policy and systems
pub_type： 杂志文章,评审
doi：10.1186/s12961-015-0004-0
更新日期：2015-03-15 00:00:00
abstract：:There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few deve...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-5-14
更新日期：2007-12-12 00:00:00
abstract：BACKGROUND:There is increased international focus on improving the rigour of clinical practice guideline (CPG) development practices. However, few empirical studies on CPG development have been conducted in low- and middle-income countries. This paper explores national stakeholders' perceptions of processes informing C...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-018-0348-3
更新日期：2018-07-31 00:00:00
abstract：:Healthcare redesign, based on building collaborative capacity between academic and clinical partners, should create a method to facilitate flow between the key elements of health service improvement. However, utilising the skills and resources of an organisation outside of the health facility may not always have the d...
journal_title：Health research policy and systems
pub_type： 信件
doi：10.1186/s12961-019-0486-2
更新日期：2019-11-20 00:00:00
abstract：BACKGROUND:Promising health interventions tested in pilot studies will only achieve population-wide impact if they are implemented at scale across communities and health systems. Scaling up effective health interventions is vital as not doing so denies the community the most effective services and programmes. However, ...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-019-0494-2
更新日期：2020-01-03 00:00:00
abstract：: Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of e...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/1478-4505-9-8
更新日期：2011-02-09 00:00:00
abstract：BACKGROUND:Universal health coverage (UHC) has provided the impetus for the introduction of publicly funded health insurance (PFHI) schemes in the mixed health systems of India and many other low- and middle-income countries. There is a need for a holistic understanding of the pathways of impact of PFHI schemes, includ...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-020-00555-3
更新日期：2020-05-25 00:00:00
abstract：BACKGROUND:In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local...
journal_title：Health research policy and systems
pub_type： 杂志文章
doi：10.1186/s12961-018-0292-2
更新日期：2018-02-23 00:00:00
abstract：:Even the highest quality evidence will have little impact unless it is incorporated into decision-making for health. It is therefore critical to overcome the many barriers to using evidence in decision-making, including (1) missing the window of opportunity, (2) knowledge gaps and uncertainty, (3) controversy, irrelev...
journal_title：Health research policy and systems
pub_type： 杂志文章,评审
doi：10.1186/s12961-016-0086-3
更新日期：2016-03-14 00:00:00
