Understanding health system reform - a complex adaptive systems perspective.

Abstract:

BACKGROUND:Everyone wants a sustainable well-functioning health system. However, this notion has different meaning to policy makers and funders compared to clinicians and patients. The former perceive public policy and economic constraints, the latter clinical or patient-centred strategies as the means to achieving a desired outcome. DESIGN:Theoretical development and critical analysis of a complex health system model. RESULTS AND CONCLUSIONS:We introduce the concept of the health care vortex as a metaphor by which to understand the complex adaptive nature of health systems, and the degree to which their behaviour is predetermined by their 'shared values' or attractors. We contrast the likely functions and outcomes of a health system with a people-centred attractor and one with a financial attractor. This analysis suggests a shift in the system's attractor is fundamental to progress health reform thinking.

journal_name

J Eval Clin Pract

authors

Sturmberg JP,O'Halloran DM,Martin CM

doi

10.1111/j.1365-2753.2011.01792.x

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

202-8

issue

1

eissn

1356-1294

issn

1365-2753

journal_volume

18

pub_type

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